Faced with a shortage of counselors, US schools are turning to the booming business of online therapy

Maria Ishu's daughter started having trouble with bullies on the playground in elementary school. The girls united in calling her "fat" and "ugly." The boys staggered and pushed him away. California Mom saw her usually bubbly second grader go to her bedroom and spend the afternoon curled up in bed.

For Valerie Aguirre's daughter AirportA series of middle school "friend drama" turned into violence and online bullying, leaving a 12-year-old feeling isolated and alone.

Both children got help through telehealth therapy, a service that schools across the country are offering in response growing mental health struggles Among American youth.

At least 16 of America's 20 largest public school districts are now offering online therapy sessions, reaching millions of students, according to an analysis by the Associated Press. In those districts alone, schools have signed provider contracts worth more than $70 million.

This growth reflects a burgeoning new business born out of America's youth mental health crisis that has proven so lucrative that venture capitalists are funding a new generation of school teletherapy companies. Some experts raise concerns about the quality of care provided by fast-growing technology companies.

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Although schools are struggling with a shortage of in-person therapists, teachers say teletherapy works for many kids, and it's making up for it a great need, For rural schools, and especially low-income students, this has made therapy easier to access. Schools let students connect with counselors online after hours during the school day or from home.

"This way we can stop people from falling through the cracks," said Ishu, a mother of two in Lancaster, California.

Ishu remembers standing at her second-grader's bedroom door last year and wishing she could reach her. "What's wrong?" Mother will ask. The response made her heart heavy: "It's nothing, Mom."

Last spring, her school district started a teletherapy program and she enrolled her daughter in it. During a month's worth of weekly sessions, the girl logged in from her bedroom and talked to a therapist, who gave her coping tools and breathing techniques to reduce anxiety. The therapist told his daughter: You are in charge of your emotions. Don't give that control to someone else.

"She learned that it's OK to ask for help, and sometimes everyone needs a little extra help," Ishoo said.

The 13,000-student school system, like many others, has counselors and psychologists on staff, but not enough to meet the need, said Trish Wilson, coordinator of counselors for the Lancaster district.

He said physicians in the area are overwhelmed with cases, making it impossible to refer students for urgent care. But students can schedule virtual sessions within a few days.

“Our priority is to provide personalized therapy to our students. Obviously, that's not always possible,'' said Wilson, whose district has referred more than 800 students for more than 325 sessions since launching the online therapy program.

Students and their parents in interviews said they turned to teletherapy after struggling with feelings of sadness, loneliness, academic stress and anxiety. For many, going back to in-person school after remote learning was painful. Friendships were broken, social skills deteriorated and tempers flared up more easily.

Schools are footing the bill, many of them using federal pandemic relief money as experts warn of worrying rates Youth depression, anxiety and suicide, Many school districts are signing contracts with private companies. Others are working with local health care providers, nonprofits, or state programs.

Mental health experts welcome the additional support but caution about the potential harm. For one, it's becoming harder to hire school counselors and psychologists, and competition with telehealth providers isn't helping.

"We have 44 counselor vacancies, and telehealth definitely impacts our ability to fill them," said Doreen Hogans, supervisor of school counseling in Prince George's County. maryland, Hogans estimates that 20% of counselors leaving school have taken teletherapy jobs, which offer more flexible hours.

The companies' rapid growth raises questions about the qualifications of therapists, their experience with children and privacy protocols, said Kevin Dahill-Fuchel, executive director of Counseling in Schools, a nonprofit that helps schools transition away from traditional, individual mental health care. Helps in promoting services. ,

“As we provide these youth access to telehealth, I want to hear how all these other bases are covered,” he said.

One of the largest providers, San Francisco-based Hazel Health, started with telemedicine health services in schools in 2016 and expanded to mental health in May 2021, CEO Josh Golomb said. It now has more than 300 therapists providing teletherapy to more than 150 school districts in 15 states.

Rapid expansion means millions of dollars in revenue for Hazel. This year, the company signed a $24 million contract with Los Angeles County to provide teletherapy services to 1.3 million students for two years.

Other clients include Hawaii, which is paying Hazel nearly $4 million over three years to work with its public schools, and Clark County Schools in the Las Vegas area, which paid $3.25 for teletherapy provided by Hazel. Million has been allocated. Miami-Dade, Prince George's and Houston school districts have also partnered with Hazel.

Despite the huge contracts, Golomb said Hazel's focus is on making sure child welfare exceeds the threshold.

“We have the ethos of a nonprofit company, but we are using private sector mechanisms to reach as many children as possible,” Golomb said. Hazel raised $51.5 million in venture capital funding in 2022 to fuel its expansion. “Are we concerned about any compromise in quality? The resounding answer is no.”

Other providers are entering the field. in November, New York The city has launched a free telehealth therapy service for adolescents to eliminate barriers to access, said city health commissioner Ashwin Vasan. New York is paying startup Talkspace $26 million over three years for a service that allows teens ages 13 to 17 to download an app and connect with licensed therapists by phone, video or text.

Unlike other cities, New York is serving all adolescents, whether enrolled in private, public, or home schools. not in school at all,

“I really hope this will normalize and democratize access to mental health care for our youth,” Wasson said.

Many of Hawaii's referrals come from schools in rural or remote areas. Student clientele in Maui has since grown rapidly. Deadly August Wildfire, said Fern Yoshida, who oversees teletherapy for the state education department. So far this fall, students have logged 2,047 teletherapy visits, three times more than the same period last year.

One of them was the daughter of Valerie Aguirre, whose fight with two friends in sixth grade last year turned physical when one of the girls slapped her daughter in the face. Aguirre suggested her daughter try teletherapy. After two months of online therapy, "she felt better," Aguirre said, with the realization that everyone makes mistakes and friendships can be improved.

In California, Ishu says her daughter, now in third grade, is passing on knowledge to her sister, who started kindergarten this year.

“She takes her little sister to class and tells her everything will be OK. He is a different person. She is older and wiser. She reassures her sister,” Ishu said. "I heard him say, 'If kids are being mean to you, just ignore them.'"

Associated Press data reporter Sharon Lurie contributed.

The Associated Press education team receives support from the Carnegie Corporation of New York. AP is solely responsible for all content.

Copyright 2023 The associated Press, All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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