College can be a stressful time for many young people, and these days especially so as more than 40% of students have reported having symptoms of anxiety and depression.
Youth troubles are getting attention at the federal level, as the Substance Abuse and Mental Health Services Administration recently unveiled a mental health grant package that included over $2 million in funding for higher education suicide prevention and resources.
Additionally, President Biden has said the Department of Education will extend funding for recruiting and retaining mental health professionals at colleges and universities through the Higher Education Emergency Relief Fund – which is part of an investment package in excess of $160 billion.
The mindstate of young America overall has been enough of a concern to have warranted the attention late last year of U.S. Surgeon General Vivek Murthy, who issued a national advisory on youth mental health. And the mental health business space has taken note, as deals and funding for youth-focused providers last year reached record levels.
Much of the record-busting activity for youth services has been for children who are not yet in college. However, many of them are on the verge of entering the world of higher learning.
Those college-age youth are part of the so-called Generation Z that has tripled their use of telehealth during the pandemic, and who have proven quite savvy when it comes to adopting new technologies. For college students looking to receive mental health assistance by online means, a provider market has emerged to meet the demand.
How virtual providers are meeting the mental health needs of students
Telehealth – which in many ways had previously been looked upon as a novelty service – has jumped by an estimated 38X during the pandemic, according to McKinsey & Company. Like the general population, higher education institutions took their time embracing telehealth before Covid, as over half of college counseling director centers offered no virtual services as recently as 2019, according to a survey of college behavioral health directors.
Times are changing, as virtual provider TimelyMD reports that 75% of college students say they are open to receiving some sort of mental health assistance virtually.
Founded in 2017, Fort Worth, Texas-based TimelyMD specializes in mental health counseling, psychiatry and health coaching for the college age population. The company has raised over $65 million to date in funding, and provides both behavioral and medical services at no cost to students.
The company’s mental health services are paid and provided through partnerships with over 200 higher education institutions, with TimelyMD operating as an around-the-clock extension of campus counseling centers. Since last year, TimelyMD’s number of partnerships has more than doubled.
Licensed health care providers from all 50 states are available to the platform’s users, who currently number nearly 1 million. TimelyMD presently has over 500 professional providers, of which around 350 work in mental health.
“In the past two years, we’ve generated and created a lot of trust within the higher education industry,” Chris Clark, the chief strategy officer and co-founder of TimelyMD, told Behavioral Health Business.
Speaking to BHB last year, Clark said that over 60% of TimelyMD’s visits were mental health-related.
“The stressors that were there pre-pandemic still exist around academics [and] holding it all together,” Clark said at the time. “There was already such a need for behavioral health services, and then you add on the stress from a pandemic.”
At the moment, Clark puts the number of total mental health visits to the platform at 70%, whereas pre-Covid it was 10%. He asserted that the uptick in visits has chiefly been the result of students experiencing increased anxiety from factors like the pandemic, academic obligations and relational issues. The second biggest contributor for the rise has been from stress, followed by depression.
Clark notes the company is also seeing a trend of visitors coming to the platform with suicidal ideation.
“One of the things that’s also a little different today than last year is that daily, we are treating suicidal students,” he said. “They either have suicidal ideation, or unfortunately some of them even have a plan and are equipped to follow through. We’re intervening in crises every day now.”
In addition to having therapists, clinicians and coaches, TimelyMD has partnered with anti-suicide organization Active Minds, which works to promote peer services to young adults. TimelyMD also offers group sessions for users to engage in wellness practices such as yoga, with sessions led by a mental health professional.
According to the company, 60% of users have said that they would have not sought mental health assistance if TimelyMD was not available. Around 40% of visits to the platform are coming after hours when campus mental health centers are closed.
“We’re a business, but for every single person that works at TimelyMD, there’s an altruistic component to what we all do,” Clark said.
When it comes to help at the federal level for youth mental health, Clark said that he applauds Biden’s commitment to providing funding and resources to higher education students.
“Mental health doesn’t just impact Democrats or Republicans or someone in between,” he said. “We’re excited to learn more about what the administration means when they’re committing resources and dollars for a national strategy to improve overall mental health in [grades] K -12, and then also in higher education.”
Impacting clinical and academic outcomes through mental health assistance
Mantra Health is another virtual health care provider making a name for itself by focusing on the college age population.
Founded in 2018, New York-based Mantra Health operates a psychiatry and therapy provider network that is available through 57 campuses, with over a half million covered students. Video appointments and 24/7 messaging are available through Mantra’s platform, with services reimbursed by insurers such as Cigna, Aetna and UnitedHealthcare.
The company raised $22 million in a January Series A funding round, which it plans to use to grow its provider network that is currently around 100 clinicians.
Like TimelyMD, Mantra likes to think of themselves as an extension of a college campus mental health center as opposed to a replacement for it.
“The way we’ve built our model is in such a way where we actually partner directly with colleges and universities to expand the on-the-ground operations they already have, or simply act as the mental health benefit of record for all the college students,” Mantra Health Co-Founder and CEO Ed Gaussen told Behavioral Health Business.
The company claims that 91% of students who are referred by campus counselors to the platform make it to their first appointment. Mantra’s partnerships with campus counseling centers are meant to cut down on wait times a student might experience by being referred to a provider in the community, which is done when campus capacity for services has been exhausted.
Mantra also claims that 70% of users report that the company’s services have helped them to stay engaged and enrolled in school.
“This is really exciting in the sense that we are actually not only having an impact on clinical outcomes, but also academic outcomes, which is extremely important in the long-term success of our patients,” Gaussen said.
Mantra’s emphasis on demonstrating outcomes also dovetails with the trend throughout behavioral health in value-based care.
Gaussen is a proponent of value-based care, but acknowledges that it is difficult at the current time to integrate it into Mantra’s reimbursement arrangements.
“It’s been hard to implement because of the challenges we have at measuring outcomes,” he said. “The PHQ-9 and GAD-7 are prone to recency bias, and being able to assess medical costs offsets can take a long time.”
Nonetheless, Gaussen has not discounted the possibility of entering into future value-based care arrangements with payers.
“As a company, we’ve been narrowly focused on solving the needs of our college and university partners,” he said. “As of right now, we have had more traditional agreements with our health insurance payers. But over time, we’ll definitely be excited to explore some value-based care options with health insurance partners.”
Gaussen also welcomes Biden’s efforts to ramp up behavioral health funding for young people in general, and for college students in particular.
“From our perspective in mental health, we’ll always need to have some level of on-the-ground operation to help navigate students on campus, and who need to be steered towards the right resources,” Gaussen said. “We envision a future where virtual care providers like Mantra collaborate deeply with on-the-ground support.”
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