To learn how to most effectively reach young users, MindRight Health, a New Jersey-based mental health coaching provider, interviewed hundreds of teenagers. Interviewers asked the kids, “How does a person earn your trust?”
“We sat and listened to the answers for hours,” MindRight CEO Ashley Edwards said at an Aspen Ideas Health panel on Friday, “and a lot of young people said, ‘No one has ever asked me this question before.'”
Edwards said respondents then provided MindRight with information about how to provide young people’s mental health care in a way that would keep young people feeling safe and engaged.
“Instead of what we expect from our users, we expect from our users,” Edwards said.
One audience member who describes herself as a mental health care entrepreneur in Nigeria said Edwards’ approach resonated with her, even when he spoke about young people across the ocean.
“Young people need to get the solutions they want,” said one audience member. “Not solutions that make them look like little adults. Kids need to be kids.”
Edwards was one of several speakers at the Two Ideas: Health event on Friday, where he stressed the importance of incorporating teenagers’ voices and knowledge into efforts to address the alarming rise in mental health issues in their age group.
Friday’s speakers represented a wide range of stakeholders in combating the declining mental health trend among teenagers, which U.S. Surgeon General Vivek Murthy called an “emergency” in a June 17 New York Times essay. Panelists brought perspectives from nonprofits, the private sector and the federal government.
According to the U.S. Department of Health and Human Services, emergency room visits for diagnosed mental illnesses among U.S. children under the age of 17 increased by 11.5% between 2016 and 2020, and suicide deaths among youth ages 12-17 increased by 75.7% between 2008 and 2021. The Department of Health and Human Services says the COVID-19 pandemic has exacerbated these trends.
Locally, high school students across five Western Slope counties, including the Roaring Fork Valley, reported significant declines in suicidal thoughts and depression between 2021 and 2023 after the pandemic peak, according to the Healthy Kids Colorado survey.
To combat the crisis, speakers said there has been an explosion in the country of available tools and programs aimed at improving the inner lives of young people.
Speakers agreed that the big problem in mental health care today is not a lack of solutions or lack of access to solutions, but a lack of engagement.
Tom Insel, co-founder and chairman of Vanna Health, said many people who should or could receive treatment for mental illness choose not to get treatment when it could be available to them.
“In mental health, the bigger issue is not access but engagement,” Insel says. “Patients don’t seek treatment. They don’t want it. They don’t buy what we sell them. Unlike with infectious diseases or heart disease or cancer, the more severe the mental health issue, the less likely they are to engage.”
Edwards said communicating directly with young people helps address engagement issues. Edwards and other panelists alike praised the company’s stellar track record in keeping young users mindfully engaged.
“Our most active users have been using MindRight every day for five to six years,” Edwards said, adding that high user retention is why MindRight’s services are now covered by Medicaid in some states.
MindRight connects users, mostly young people of color, with mental health coaches who communicate via text and are supervised by licensed clinicians.
Edwards said the core of her approach is reaching young people in ways that work for them: In addition to using methods that are culturally appropriate for communities of color, MindRight employs an approach designed with input from young people at the core.
When Edwards first sought venture capital investment for MindRight, investors often encouraged him to use chatbots instead of relying on SMS text messages.
“At every investor meeting, I was turned down because they wanted to see a chatbot,” Edwards says, “but I was adamantly resistant because having worked with and spoken to hundreds, and now thousands, of young people, none of my young people want to talk to a chatbot. In fact, I can’t tell you how many of them have texted us to say, ‘Hey, you’re a real person, right?'”
Edwards said her hunch has now been proven correct.
“The lesson has been repeated many times that adults cannot decide what intervention or healing looks like for young people. Only young people can decide that,” Edwards said.
Panelist Margaret Rose, CEO of San Francisco-based mental health investment group Hopelab, said working directly with young people during product development is a key factor her firm focuses on when deciding whether to invest in a mental health startup. Hopelab invested in MindRight in 2021. Rose praised Edwards for the company’s high engagement rates from its users.
Outside the private sector, psychologist and author Lisa Damore has argued that direct communication with adolescents is especially important for school mental health programs: Students, she argues, know their peers better than school administrators do, so they can alert adults to their friends’ mental health concerns before they escalate into a crisis.
Damore encourages the schools he works with to gather their “six most outspoken juniors” in a room and ask them if they would feel comfortable speaking to an adult at school about a classmate who is having trouble that worries them. He says schools should try to address whatever answers students give.
“You can have the best health and wellness program in the world, but it’s meaningless if students don’t feel able to tell an adult about a classmate they’re worried about,” D’Amore said.
Damore said he was impressed by the teens’ ability to adapt and cope with challenges in their own ways, arguing that their compassion and knowledge for one another is an important resource for mental health professionals.
At the end of D’Amour’s panel, moderator Savannah Sellers, a journalist, asked the speakers how they saw the future of mental health care in the United States.
“I believe in young people,” said Rachel Levine, U.S. assistant secretary of health. “They are our future. They understand what the challenges are, and I think with our support and guidance, they can get through it.”
