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The division said it will start a statewide TBI ECHO in January (5–6 sessions) and a peer-support curriculum next summer; the ECHO will include de-identified case-based learning and invited national partners.

Background: Adolescent mental health needs remain largely unmet, particularly among youth in geographically underserved communities. Digital peer support is a promising approach to expanding access to mental health support, yet real-world evidence on engagement patterns and clinical outcomes remains limited. Objective: The purpose of this study was to characterize engagement patterns and real-world outcomes among adolescents and young adults enrolled in a commercially available, text-based peer support platform. Methods: This retrospective observational study analyzed secondary data from 5673 adolescents and young adults enrolled in a commercially available digital peer support platform from January 29, 2023, through June 3, 2026. Engagement was operationalized as communication days per month. Standardized clinical outcome measures (Patient Health Questionnaire-9 [PHQ-9], Generalized Anxiety Disorder-7 [GAD-7], and World Health Organization-Five Well-Being Index [WHO-5]) were administered as part of routine measurement-based care. Ordinary least squares regression was used to examine predictors of engagement, and complete-case pre-post change scores were evaluated across 4 assessment windows among participants with paired assessments. Results: The sample was predominantly female (4600/5673, 81.1%) with a mean age of 16.4 (SD 2.1) years and moderate-to-severe symptom burden at baseline (PHQ-9: mean 12.6, SD 6.1; GAD-7: mean 10.7, SD 5.0; WHO-5: mean 44.8, SD 21.0). Of enrolled adolescents and young adults, 98.1% (5565/5673) had at least one recorded engagement with the platform, with a mean of 4.56 (SD 6.12) communication days per month. Female sex was a significant positive predictor of engagement intensity (β=.64, SE 0.22; =.004). Hispanic and Latino adolescents and young adults engaged significantly more frequently than White or non-Hispanic adolescents and young adults (β=.61, SE 0.26; =.02). Health Professional Shortage Area (HPSA) shortage score was significantly and positively associated with engagement intensity (β=.08, SE 0.02;