Healthy Relationships in Middle School Lead to Better Mental Health Years Later

When we think about supporting youth mental health, school-based relationship education may not be the first thing that comes to mind. But a groundbreaking study from UTHealth Houston suggests it should be.

A new study published in the Journal of Adolescent Health has confirmed something we at Lumina Alliance have long believed: when young people are taught how to build healthy relationships early on, the benefits ripple outward for years to come.

Researchers from UTHealth Houston followed students who participated in a program called Fourth R, which focuses on building respectful relationships and recognizing risky behaviors like bullying and substance misuse. The results? Students who completed the program were significantly less likely to experience depression five years later.

“That this program helps prevent adolescent relationship abuse wasn’t necessarily surprising,” said lead author Dr. Jeff Temple. “The secondary benefit that it helps these kids with depression is just incredible.”

The name Fourth R stands for “relationships”—a reminder that teaching students how to connect with one another in safe, respectful ways is just as essential as reading, writing, and arithmetic.

At Lumina Alliance, we implement the Fourth R curriculum through our Prevention Education Program, reaching hundreds of students across San Luis Obispo County each year. By partnering with local schools, we teach healthy relationship skills, challenge harmful norms, and help young people build the confidence to set boundaries, seek support, and care for themselves and others.

With nearly one in three teens experiencing some form of relationship abuse, and one in five facing major depression by graduation, prevention is no longer optional—it’s essential.

This study reinforces what we’ve seen in classrooms across the county: early education creates lasting change. Healthy relationships today can mean safer, stronger futures for our youth.

The bottom line: Investing in prevention works. And it starts in the classroom.