Innovations in Youth Mental Health

By Nia West-Bey 

Despite the unprecedented attention, we have yet to make a dent in the youth mental health crisis, particularly among young people from marginalized communities. Overall levels of anxiety and depression remain high. Federal policy efforts have been insufficient at best and, in several cases, are making the problems worse. Although the scope of the challenge is great, local communities have launched innovative approaches to youth mental health that meet the moment and have the potential to transform access to care. 

As part of Mental Health Awareness Month, I highlight in this piece an example of a promising program aimed at young adults in Los Angeles County that will launch this summer. It brings together two sectors that are often siloed: workforce development and mental health services.  

Our nation has a well-documented shortage of clinical mental health providers. The truth is that we will never have enough mental health clinicians to meet young people’s mental health needs, nor are they the kinds of providers that young people prefer. CLASP’s mental health work has consistently shown that young people strongly prefer to receive support from peers and to receive support in trusted community-based settings, including youth workforce development programs. Research has also shown that youth workforce system leaders and providers feel their programs are unprepared to meet the mental health needs of their participants, whom have disproportionately experienced trauma because of community violence, financial strain, racism and discrimination, and/or histories of child welfare and criminal legal system involvement. CLASP’s mental health work has consistently shown that young people strongly prefer to receive support from peers and to receive support in trusted community-based settings, including youth workforce development programs.  

The City of Los Angeles operates 14 centers, which are referred to as YouthSource Centers, that serve as hubs for youth workforce development programs. As part of this new program to support mental health, each center will recruit 3 to 5 young people ages 18-24 to participate in a peer youth support certification program. Program participants will be paid $16.75 per hour to complete 300 hours of certification training. The participants will spend about one-third of these hours taking the county’s Department of Mental Health peer support certification curriculum. They will also be required to spend 200 practicum hours providing mental health support—including assistance navigating the mental health system, referral to services, and other supports as needed—to other young people who are accessing youth workforce services through the center.  

Upon completion of the program, certified youth peer specialists will be eligible for hire as Medicaid-reimbursable providers through the county’s Department of Mental Health. The partnership between the youth workforce system and the county-level mental health system in LA County demonstrates an expansion of mental health care for opportunity youth enrolled in workforce development programs while also building career opportunities for young people who want to provide much-needed support to their peers. 

This project also fits into broader efforts to reimagine mental health access for young people in California by democratizing mental health and shifting agency and power. This shift involves changing who can provide services, where they can provide them, and how much they get paid to provide them. In addition to the peer support project, California is building out several new Medicaid-reimbursable career pathways including community health workers, doulas, wellness coaches, and a $10 million pilot program to build momentum for high-school-age peer support providers. These strategies increase both the number of providers and the likelihood that young people can access care in their communities from true peers who share culture, context, and experience. 

CLASP’s technical assistance work has consistently found a major disconnect between youth workforce development systems and mental health systems. LA’s program demonstrates what is possible when initial philanthropic investment supports planning, launch, and effective cross-sector partnership between these two sectors. Two policy pre-conditions make this program sustainable with public dollars: 

1915b Specialty Mental Health Waiver: California’s 1915(b) waiver provides for non-specialty mental health services as part of its Medicaid managed care plans, while specialty mental health services are provided through a separate county mental health delivery system. Peer support is a reimbursable service through the specialty mental health system, and an established credentialing process and reimbursement rates for youth ages 18 and over already allow young people to provide peer support.  

The Workforce Innovation Opportunities Act (WIOA):  WIOA supports the nation’s workforce development system. The act’s youth title provides funding to local communities with a priority to serve young people ages 16-24 who are not engaged in school or work. LA’s program relies on WIOA funding to support curriculum development for the program and general funds to pay young people a living wage in an earn-and-learn model. This approach is mutually beneficial to peer support program participants and other young people taking part in more traditional youth workforce development and training programs. 

This Mental Health Awareness Month, we are highlighting transformative solutions aligned with our core principles to reframe mental health. LA’s new youth peer support program demonstrates that innovative solutions are possible at the intersection of youth workforce development and mental health that can address both the youth mental health crisis and the mental health workforce shortage, neither of which will be solved by clinicians alone. 

Note: This blog was updated on June 8 to correct the name and affiliation of YouthSource centers.