Maria Issue's elementary school-age daughter started having trouble with a bully on the playground. Her girls flocked to her, calling her “fat” and “ugly.” The boys stumbled and pushed her. A California mother watched as her normally cheerful second-grade son holed up in his bedroom and spent the afternoon curled up in bed.
For Valerie Aguirre's daughter in Hawaii, a series of “friend dramas” at her middle school escalated into violence and cyberbullying, leaving the 12-year-old feeling isolated and alone.
Both children received support through telehealth therapy. Telehealth therapy is a service that schools across the country are offering in response to this problem. Mental health issues on the rise among American youth.
At least 16 of the 20 largest public school districts in the United States are now offering online therapy sessions to millions of students, according to an Associated Press analysis. In these districts alone, schools have more than $70 million in provider contracts.
This growth reflects the rapid growth of new businesses born of America's youth mental health crisis, which have proven so lucrative that venture capitalists are funding new school teletherapy companies. There is. Some experts have expressed concerns about the quality of care provided by fast-growing technology companies.
But as schools grapple with a shortage of in-person therapists, educators say teletherapy is working for many kids and becoming increasingly effective. huge needs. Treatment has become more accessible, especially for students in rural schools and low-income families. At school, students can connect with their counselors online from home during school hours or after hours.
“This keeps people from falling through the cracks,” said Ishu, a mother of two who lives in Lancaster, California.
Issue recalls standing in front of the second-grader's bedroom door last year, wishing he could reach her. “What's wrong?” her mother would ask. Her answer made her heart heavy. “It's nothing, Mom.”
Last spring, her school district started a teletherapy program, and she enrolled her daughter, too. During her month-long weekly sessions, the girl logged in from her bedroom and opened up to her therapist, who taught her coping tools and breathing techniques to reduce her anxiety. The therapist told her daughter, “You manage your emotions.” Don't give control to others.
“She learned that it's okay to ask for help and that sometimes everyone needs a little extra help,” Issue said.
The 13,000-student school system, like many other schools, has counselors and psychologists, but there aren't enough to meet the needs, said Trish Wilson, counselor coordinator for the Lancaster district. .
Therapists in the area are at full capacity, making it impossible to refer students for urgent care, she said. However, students can schedule virtual sessions within the next few days.
“Our preference is to provide in-person therapy for our students. Obviously, that's not always possible,” Wilson said. In his district, he launched an online therapy program and since then he has referred more than 800 sessions to more than 325 students.
Students and their parents said in interviews that they turned to teletherapy after struggling with sadness, isolation, academic stress and anxiety. For many, returning from distance learning to in-person classes was traumatic. Friendships were broken, social skills deteriorated, and I became angry easily.
As experts warn of alarming infection rates, many schools are using federal pandemic relief funds to pay for them. Depression, anxiety, and suicide in young people. Many school districts contract with private companies. Some work with local health care providers, nonprofit organizations, or state programs.
Mental health experts welcome the additional support, but are wary of potential pitfalls. School counselors and psychologists, for one, are becoming increasingly difficult to hire, and competition from telehealth providers isn't helping either.
“We have 44 counselor vacancies and telehealth has definitely impacted our ability to fill those vacancies,” said Doreen Hogans, school counseling supervisor in Prince George's County, Maryland. Hogans estimates that 20% of retired school counselors have taken teletherapy jobs that offer more flexible work hours.
Kevin Dahil Hookel, executive director of Counseling in Schools, a nonprofit that helps schools strengthen traditional, in-person mental health services, said the rapid growth of companies has made it difficult for therapists to be certified and to work with children. He said questions have arisen about the experience and privacy protocols. .
“We are providing access to telehealth for these young people, but we want to hear how all the other bases are being covered,” he said.
San Francisco-based Hazel Health, one of the largest providers, launched telehealth health services in schools in 2016 and expanded to mental health in May 2021, CEO Josh Golomb said. he said. Currently, more than 300 clinicians are employed and provide teletherapy in more than 150 of her school districts in 15 states.
Rapid expansion means millions of dollars in revenue for Hazel. This year, the company signed a two-year, $24 million contract with Los Angeles County to provide teletherapy services to 1.3 million students.
Other clients include the state of Hawaii, which is paying Hazel nearly $4 million over three years in aid to public schools, and Clark, a Las Vegas-area district that has allocated $3.25 million for teletherapy provided by Hazel. Also includes county schools. School districts in Miami-Dade, Prince George's and Houston are also partnering with Hazel.
Despite the huge contract, Hazel is focused on ensuring child welfare outweighs the bottom line, Golomb said.
“We have a nonprofit company ethos, but we use private sector mechanisms to reach as many children as possible,” Golomb said. Hazel raised $51.5 million in venture capital funding in 2022, which fueled its expansion. “Are you concerned about a decline in quality? The resounding answer is no.”
Other providers are also entering the space. New York City launched a free telehealth therapy service for teens in November to break down barriers to access, said Ashwin Vasan, the city's health commissioner. New York City awarded startup TalkSpace three years for a service that allows teens ages 13 to 17 to download an app and connect with qualified therapists by phone, video, or text message. He paid $26 million.
Unlike other cities, New York offers this service to all teens, whether they are enrolled in private, public, or home school. not at school at all.
“I really hope this normalizes and democratizes access to mental health care for young people,” Vasan said.
Many of Hawaii's referrals come from schools in rural and remote areas. Since the number of student visitors has increased rapidly on Maui, deadly august wildfiressaid Fern Yoshida, who oversees teletherapy for the state Department of Education. So far this fall, students have logged his 2,047 teletherapy visits, which is an increase of three times his number from the same period last year.
One of the students was Valerie Aguirre, whose daughter was in sixth grade last year when a fight with two of her friends led to one of the girls slapping her in the face. Mr. Aguirre suggested her daughter try her teletherapy. After two months of online therapy, Aguirre said, she “felt better,” and she realized that everyone makes mistakes and that friendships can be repaired.
In California, Issue says her daughter, now in third grade, is passing on some wisdom to her younger sister, who started kindergarten this year.
“She walks her sister to class and tells her everything is okay. She's a different person. She's older and wiser. She makes her sister feel safe,” Issue said. She said, “I heard her say, “If the kids are being mean, she can just ignore them.''
___
Associated Press data writer Sharon Lurie contributed.
___
The Associated Press education team receives support from the Carnegie Corporation of New York. AP is solely responsible for all content.
