Trust in Action: Strengthening Parent–Teen–School Relationships to Increase Adolescent Mental-Health Access
In many urban districts, the infrastructure for adolescent mental-health care already exists. In New York City, for example, teens can access free, confidential tele-therapy through school-linked platforms. Yet utilization remains uneven. The limiting factor is often not cost or availability, but relational trust: whether teens feel psychologically safe disclosing distress, whether caregivers feel confident navigating consent, and whether schools are experienced as collaborative partners rather than evaluative authorities.
An MRI-funded project led by Dr. Crystal Martin, PhD (New York University Metropolitan Center for Research on Equity & School Transformation), takes this relational barrier seriously. Trust in Action: Strengthening Parent–Teen–School Relationships to Increase Adolescent Mental-Health Access tests a central systems-level hypothesis: that family–school trust is not merely contextual, but mechanistic—shaping whether adolescents engage with available mental-health services.
Conceptually, the project situates service uptake within an ecological framework. Adolescents’ help-seeking behaviors are embedded in relational systems characterized by power, history, stigma, and structural inequities. Particularly for Black, Brown, and immigrant families, historical and ongoing institutional mistrust can influence perceptions of confidentiality, labeling, and long-term consequences of disclosure. Strengthening trust at the family–teen–school interface may therefore function as a leverage point for increasing equitable access to care.
To operationalize this theory, the project implements Family–School Trust Circles at two to three New York City school or community sites. Each site hosts four 90-minute gatherings grounded in Healing-Centered Engagement and restorative circle methodologies. The intervention follows a structured arc: an opening ritual to establish psychological safety; relational check-ins; facilitated, story-based dialogue addressing trust, stigma, and consent barriers; and a collaborative “solution design” phase in which participants co-create concrete changes (e.g., clearer consent language, improved communication norms, or revised referral pathways).
Implementation is deliberately equity-centered. Recruitment prioritizes Black, Brown, and immigrant families, with participation supports including translated outreach materials, stipends, light meals, and on-site childcare to reduce structural barriers. Each circle is co-facilitated by a trained parent leader and youth leader who complete preparation in healing-centered practice, trauma-informed listening, circle facilitation, and cultural humility. Fidelity is documented through attendance tracking, facilitator logs, and structured debrief protocols to ensure consistency across sites.
Methodologically, Trust in Action is designed as a community-based participatory research (CBPR) pilot with a mixed-methods framework. Quantitative pre–post measures assess changes in parent–teen communication quality, family–school trust, school connectedness, stigma toward mental-health care, and adolescents’ help-seeking intentions. Qualitative focus groups and facilitator reflections provide contextualized insight into how trust shifts are experienced and enacted within relationships.
Importantly, the study moves beyond attitudinal outcomes to include behavioral indicators. Using de-identified referral and session-completion data from the Teenspace tele-therapy platform, the research team examines whether improvements in relational trust correspond to measurable increases in service uptake and sustained engagement. This linkage between relational constructs and real-world utilization strengthens the project’s contribution to implementation science.
Looking ahead, the pilot is structured with scalability in mind. Findings will inform policy briefs, practitioner toolkits, and community-facing dissemination materials that translate relational insights into adaptable practice models. Future iterations may test expanded site implementation, longitudinal follow-up of service engagement, and integration with broader school-based mental-health initiatives.
At its core, Trust in Action reframes adolescent mental-health access as a relational systems problem rather than a simple supply issue. By strengthening trust among teens, caregivers, and schools, the project aims to convert theoretical availability into meaningful accessibility—ensuring that when adolescents need care, relational pathways support rather than obstruct their ability to receive it.