The Making Connections Intervention: Engaging African American Youth in School Mental Health and Preventative Services

Introduction: Moving evidence-based practices (EBPs) into a “real-world” setting requires a keen focus on factors that attenuate patient participation and quality intervention implementation. In particular, how patients conceptualize mental illness and perceive their involvement in interventions influences both the clinical effectiveness and transportability of treatments into community settings. Completion of EBPs for depression has been shown to be particularly problematic for Black adolescents. It is imperative, therefore, to focus on patient-/provider-level factors (e.g., adolescent/family engagement; provider resistance to EBPs) that influence successful participation and completion of EBPs, including those that may be preventative in nature.

This paper presentation describes the Making Connections Intervention (MCI), a novel intervention aimed at engaging Black adolescents with mental disorders, particularly those with depression, in school mental health services. While traditionally used as a treatment engagement intervention, the MCI can be used in concert with prevention interventions, as well, to increase treatment engagement and completion.

Methods: MCI was developed to promote engagement among Black adolescents in school mental health services. A unique feature of MCI is its three-level focus on adolescents, the caregivers of the adolescent, and the therapists who treat adolescents, creating an approach that is far more comprehensive than previous engagement efforts. MCI is a 1-2 session intervention for adolescents and their caregivers in which the therapist, while utilizing screenings and assessments, seeks to clarify the need for mental health care, increase the adolescent’s investment in help-seeking, review the adolescent’s stage of change, address obstacles that might impede mental health services, and develop strategies to overcome the individual’s expressed barriers to treatment via a decisional balance and culturally-sensitive role plays.

Results: Data from a pilot study will be shared. Statistically significant improvement was observed on major MCI constructs, including resolution of adolescents’ perceived barriers to treatment, help-seeking efficacy, and treatment motivation over time, as well as their levels of depression severity. A small-scale pilot study showed MCI had greater effects on treatment motivation, help-seeking efficacy, and depression symptoms versus those in the control condition.

Conclusions: Overall, our findings suggest that offering underserved, Black adolescents MCI has a positive impact on several targets of change associated with engagement and depression outcomes. Implications for future work with MCI and best practices for the field of preventative mental health services will be considered.