About the author: Stephanie Nieman is a principal at SJF Ventures based in Durham, N.C. SJF Ventures is a venture capital fund investing in high-growth, positive-impact companies across the U.S. and an active healthcare investor.
The current COVID-19 pandemic and resulting need for schools and universities to close, and for families to socially distance and practice remote learning, have only exacerbated the mental health crisis the United States is facing among its youth and young adults. Even before the crisis, anxiety and depression were afflicting young people in steadily growing numbers, but the treatment options available remain limited, leaving many to wonder how to deal with this dawning emergency.
The problem is widespread. According to a Pew Research Study, 70% of teens consider depression and anxiety to be a “major problem” among their peers. The support network in place – young peers, parents and educators – has limited guidance, and these people often struggle to navigate the needs of those with mental health issues.
Parents face the daunting challenge of identifying, assessing and treating issues within their families. Even if a parent can identify an issue, which is a difficult task unto itself, families are then faced with another set of obstacles. They may not know where to go for treatment; there may not be an available provider; and they may not be able to pay for treatment. Getting a child the care they need is a trying, sometimes seemingly insurmountable process. In fact, the CDC reports that up to 80% of youth suffering from a mental health disorder like depression or anxiety are undertreated or not treated at all.
Trends in the young adult population are similarly negative. Between 2008 and 2017, young adults surveyed between the ages of 18 and 25 reported a 71% increase in having experienced serious psychological distress in the last month. In 2016, the CDC reported that the suicide rate among young adults ages 15 to 24 has tripled since the 1950s, and that suicide is currently the second-leading cause of death among college students.
In response, parents are seeking solutions for their children through both traditional and novel behavioral health channels. Given how serious the issue can be, they’re showing an increased willingness to pay out of pocket for tools that protect their children, provide greater transparency into child needs and show improved outcomes.
Educational institutions are becoming likewise proactive. While schools may not have seen themselves as custodians of their students’ mental health, the never-before-seen levels of today’s challenges directly impact schools’ ability to teach and drive student outcomes. K-12 schools and higher education institutions are taking a variety of steps to bolster student mental health, ranging from prevention, to treatment, to crisis support. They’re increasing resources across the board and leveraging new treatment options that promise better ways of addressing student mental health.
Parents, education and healthcare systems alike have shown a willingness to adopt digital tools at increasingly rapid rates. Many of them are just looking for the right tools to meet youth and young adult mental health needs in scalable, affordable ways. In many respects, technology has the potential to bring solutions to the space. It’s highly accessible to a variety of populations; it’s cost-efficient; and it’s easy to use. Amidst a wave of technological adoption in the U.S., we’re starting to see technology turn its lens to the issue of mental health.
Technology has the opportunity to intervene in youth and young adult mental health in several, significant ways:
- Prevention: Mental wellness tools offering resilience training, meditation exercises, social-emotional skills building and more. These tools help in building positive mental health habits. They can serve all youth and young adults, not only those with identified mental health concerns.
- Protection and detection: Digital safety tools that protect individuals from abuse, harassment and cyberbullying, or provide alerts for potential mental health issues including self-harm or harm to others. Tools in this category focus on mobile and online content monitoring. They alert parents, teachers and/or school administrators of questionable content or interaction. They can also passively detect and flag signals of depression or anxiety.
- Treatment: Digital and virtual therapy options, as well as technologies that scale access to in-person clinician reach, like teletherapy and crisis lines. Many technologies integrate ongoing clinical assessments, including new ways to deploy “Patient Health Questionnaires” (e.g. PHQ-9 for depression).
The suite of technological solutions available is only growing, and there are several ways to deploy these technologies to those in need. We’ve seen three primary channels to deliver solutions: K-12, higher education, and parent/D2C. Each channel is different, and each has unique needs.
On average, there is one school counselor for every 482 K-12 students, with a wide disparity by state. The American School Counselor Association's recommended student-to-school counselor ratio is 250:1, but only three states meet that standard. With increasing student demands and meager resources, schools need either more counselors and psychologists or new tools to help scale the work and reach of these professionals.
K-12 students and schools need the full suite of preventative, protective and treatment solutions due to the high sensitivity of their student population. Reaching this type of student body can address mental health issues early and create good habits for students to carry with them throughout their lives. As it stands, there are several technological options available.
Mental health among students in higher education has declined markedly even in recent years. In a 2016 survey by the American College Health Association, “52.7% of students surveyed reported feeling that things were hopeless and 39.1% reported feeling so depressed that it was difficult to function during the past 12 months.”
As institutions of higher education face these figures and create strategies around how to address them, there is new demand for solutions that can span the range of needs across their student bodies. Schools are considering a variety of options: tools to roll out to all incoming freshmen, virtual therapy, options for students with mild-to-moderate conditions, and 24/7 crisis lines for acute events.
One specific problem afflicting schools is the wait times for college students to access on-campus, in-person counseling. Between 2009 and 2015, the number of students who visited campus counseling centers increased by more than 30%, while college enrollment climbed just 5%, according to a 2015 report by the Center for Collegiate Mental Health. Solutions that can scale the reach of existing counseling centers are becoming paramount, even with improved alternative and after-hours care.
Importantly, colleges want to be integrated into the mental healthcare provided to their students. They aren’t looking to merely “outsource” it to third parties. For the most part, they want to remain involved and contribute to a comprehensive solution. As such, there is an increasing demand for these solutions to be compatible with on-campus resources and for them to partner with on-campus counselors to create a care system that can cater to individual student needs.
Parents care deeply about the happiness and health of their children, and as mental health issues have started to take center stage, many parents have shown interest in new technologies to help manage them. Some parents are also willing to pay for solutions not yet covered by their healthcare insurance or offered by family healthcare providers.
A challenge for direct-to-consumer behavioral-health models is navigating the privacy privileges of the children using their services and the parents who are paying for those services. These models have to balance respect of the child’s privacy on the one hand, and the critical information that parents want and need on the other. Many protection models must also respect youth digital-communication privacy while still alerting parents to the need for intervention.
Moreover, many parents simply don’t know what their children may need, or they may not have access to what their children need. Solutions combining both digital assessments and treatment recommendations will be crucial to bridging that knowledge gap for parents. Similarly, solutions that allow for convenient and appealing treatment options to meet youth demographic preferences, like text-based counseling or mobile-first digital tools, will be helpful in engaging children.
Today’s youth and young adult mental health challenges are driving increased responsiveness from K-12 schools, higher education institutions and parents, especially as the challenges only worsen due to new fears and increased isolation during the COVID-19 pandemic. Tackling the problem will be a group effort, and entrepreneurship and technology have critical roles to play. Innovative entrepreneurs are working hard to deliver effective products to those who can help guide our youth. We are excited to follow these innovations now and in the future, and we’re eager to see them reverse trends and push forward towards greater mental well-being.