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Public schools in the United States are increasingly employing online mental health services, or teletherapy, for students.
At least 16 of the 20 largest American public school systems are offering online therapy to reach millions of students, reports the Associated Press. In those systems alone, schools have signed provider contracts worth more than $70 million.
The business model is making so much money that venture capitalists are investing in new companies as the market grows. However, some experts have raised concerns about the quality of care offered by fast-growing tech companies.
But educators say teletherapy works for many kids and is meeting a large need. Schools are also experiencing shortages in on-site therapists. Online help has made therapy more easily available to children, especially poorer students and those in rural areas. Schools let students connect with online counselors during the school day or after hours from home.
Ishoo is a mother of two in Lancaster, California. She struggled to help her second-grade daughter deal with severe anxiety.
Last spring, her school district started a teletherapy program and Ishoo signed up her daughter. During a month of weekly video sessions at her home, the girl opened up to a therapist. The therapist gave the student tools and techniques to reduce anxiety.
“She learned that it’s OK to ask for help, and sometimes everyone needs some extra help,” Ishoo said.
The 13,000-student school system, like many others, has counselors and psychologists on staff. But it is not enough to meet the need, said Trish Wilson, the Lancaster supervisor of counseling.
Therapists in the area have full caseloads, making it impossible to offer students immediate care, she said. Students rarely have to wait long for an online session.
Students and their parents said in interviews they turned to teletherapy after struggling with feelings of sadness, loneliness, stress and anxiety. For many, returning to in-person school after distance learning was very difficult.
Schools are using federal pandemic relief money to pay for help as experts have warned of worrying rates of 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 extra support but warn about possible risks. For one, it is getting harder to employ on-site school counselors and psychologists. Competition with telehealth providers is not helping.
“We have 44 counselor vacancies, and telehealth definitely impacts our ability to fill them,” said Doreen Hogans. She is supervisor of school counseling in Prince George’s County, Maryland. Hogans estimates 20 percent of school counselors who left have taken teletherapy jobs. The jobs often provide more favorable working hours than the schools.
The quick growth of the companies raises questions about the quality of the therapists, and their experience with children and privacy, said Kevin Dahill-Fuchel. He is executive director of Counseling in Schools, a nonprofit that helps schools improve traditional, in-person mental health services.
One of the biggest providers is San Francisco-based Hazel Health. It started with telemedicine health services in schools in 2016 and expanded to mental health in May 2021, CEO Josh Golomb said. It now employs more than 300 therapists providing teletherapy in over 150 school districts in 15 states.
Other providers are getting into the space. In November, New York City started a free telehealth therapy service for teens to help end barriers to access, said Ashwin Vasan, the city's health commissioner. New York is paying the company TalkSpace $26 million over three years for a service permitting teenagers to download an app and connect with therapists.
Unlike other cities, New York is offering the service to all teens, whether attending private, public or home schools, or not in school at all.
“I truly hope this normalizes and democratizes access to mental health care for our young people,” Vasan said.
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Words in This Story
venture capital— n. money that is used to start a new business
counselor — n. a person who provides advice as a job : a person who counsels people
anxiety — n. fear or nervousness about what might happen
supervise — v. to be in charge of
vacancy — n. a job or position that is available to be taken
impact — n. the act or force of one thing hitting another
access — n. a way of getting near, at, or to something or someone
参考译文：
美国的公立学校越来越多地采用在线心理健康服务，即远程治疗，为学生提供帮助。
据美联社报道，美国最大的20个公立学区中至少有16个正在提供在线治疗，以接触数百万学生。仅在这些学区中，学校已经签署了总值超过7000万美元的服务合同。
这种商业模式赚了大钱，风险投资者正在投资于这个不断增长的市场中的新公司。然而，一些专家对快速增长的科技公司提供的护理质量提出了担忧。
但教育工作者表示，远程治疗对许多孩子是有效的，而且满足了很大的需求。学校还在现场心理治疗师方面存在短缺。在线帮助使治疗更容易获得，尤其是对于贫困学生和农村地区的学生。学校允许学生在上学期间或在家里课后与在线辅导员联系。
Ishoo是加利福尼亚州兰开斯特的一名两个孩子的母亲。她努力帮助她二年级的女儿应对严重的焦虑。
去年春天，她所在的学区启动了一项远程治疗项目，Ishoo为她的女儿报名参加。在一个月的每周视频会议中，女孩向治疗师敞开了心扉。治疗师为学生提供了减轻焦虑的工具和技巧。
"Ishoo说：“她学会了寻求帮助是可以的，有时每个人都需要一些额外的帮助。”
这所拥有13000名学生的学区和许多其他学区一样，有着自己的辅导员和心理学家。但是这远远不够满足需求，兰开斯特的辅导主管Trish Wilson表示。
她说，该地区的治疗师负载已经很大，几乎不可能为学生提供即时的关怀。学生很少需要等待很长时间才能进行在线会话。
在采访中，学生及其家长表示，他们在与悲伤、孤独、压力和焦虑感的斗争后转向了远程治疗。对于许多人来说，从远程学习后重返面对面学校是非常困难的。
学校正在利用联邦大流行病救助资金支付帮助费用，因为专家们警告青少年抑郁、焦虑和自杀的发病率令人担忧。许多学区正在与私人公司签署合同。还有一些与当地医疗保健提供者、非营利组织或州级计划合作。
心理健康专家对额外支持表示欢迎，但也对可能的风险提出了警告。首先，雇用学校心理辅导员和心理学家变得越来越困难。与远程医疗服务提供者的竞争也没有帮助。
玛丽兰州Prince George's County心理辅导主管Doreen Hogans表示：“我们有44个辅导员空缺，远程医疗服务肯定影响了我们填补这些空缺的能力。”她估计有20%的辅导员离职后选择了远程治疗工作。这些工作通常提供比学校更有利的工作时间。
其中一个最大的提供商是总部位于旧金山的Hazel Health。它于2016年开始在学校提供远程医疗服务，并于2021年5月扩展到心理健康领域，首席执行官Josh Golomb表示。它现在雇佣了300多名治疗师，在15个州的150多个学区提供远程治疗服务。
其他提供商也进入了这个领域。去年11月，
纽约市推出了为青少年提供的免费远程健康服务，以帮助消除获得服务的障碍，该市卫生专员Ashwin Vasan说。纽约市向TalkSpace公司支付了2600万美元，用于为青少年提供下载应用程序并与治疗师建立联系的服务，为期三年。
与其他城市不同，纽约向所有青少年提供该服务，无论是上私立学校、公立学校、在家上学，还是根本不上学。
Vasan表示：“我真的希望这能让我们的年轻人更容易获得心理保健服务，实现民主化访问。”
