Benefits of Using Telehealth in Schools to Address the Adolescent Mental Health Crisis

In its early days, telehealth was under-researched, underfunded, and underutilized by a general public largely unaware of the vast potential benefits. Today, following a period of rapid evolution fueled by the COVID-19 pandemic, telehealth may offer a solution to one of the most pressing problems facing our nation’s youth: mental health crises.  

As of 2019, one in three high school students had experienced persistent feelings of sadness or hopelessness, a 40 percent increase since 2009. Despite these substantial increases, experts believe the trend is only getting worse. In December of 2021, U.S. Surgeon General Dr. Vivek Murthy issued an official advisory to highlight the urgency of addressing the nation’s youth mental health crisis, stating: 

“Mental health challenges in children, adolescents, and young adults are real and widespread. Even before the pandemic, an alarming number of young people struggled with feelings of helplessness, depression, and thoughts of suicide—and rates have increased over the past decade … the COVID-19 pandemic further altered their experiences at home, school, and in the community, and the effect on their mental health has been devastating. The future well-being of our country depends on how we support and invest in the next generation. Especially in this moment, as we work to protect the health of Americans in the face of a new variant, we also need to focus on how we can emerge stronger on the other side. This advisory shows us how we can all work together to step up for our children during this dual crisis.” 

The experts at the California Telehealth Research Center (CTRC) believe that school-based health centers (SBHCs) can play a significant role to address mental health crises in adolescent school-aged children.  

What is a School-Based Health Center? 

School-based health centers are clinics that exist to ensure our youth have equal and equitable access to care. SBHCs employ several different models ranging from clinics with full-time medical and mental health staff to part-time clinics that offer a limited set of health services. Some SBHCs serve only students while others serve the entire community. The highly customizable nature of these clinics allows health professionals to better fill the gaps in equitable access to care.  

California’s School-Based Health Centers 

Of California’s 293 school-based health centers, 39% are in high schools, 21% are in elementary schools, 10% are in middle schools, and 25% are school-linked through the use of mobile medical vans. Many of these SBHCs serve the state’s most vulnerable children. For example, on campuses with SBHCs, about 70% of students receive free or reduced-price meals. Most of California’s SBHCs are located in low-income schools with student populations that experience higher rates of violent injury, poor nutrition, physical inactivity, substance abuse, and sexually risky behaviors.     

SBHCs offer high-risk adolescents services that have the potential to save their lives, given the impacts of childhood risk factors on higher rates of diabetes, heart disease, cancer, and other chronic illnesses in adulthood. In addition, these services can help high-risk adolescents overcome obstacles to academic success.    

Mental Health of School-Aged Children: The Statistics       

As of 2019, approximately one in six youth reported making a suicide plan in the past year, a 44 percent increase since 2009. With suicide now among the top five causes of death among children ages 12-19, action to remedy this crisis is urgently needed. 

California’s Numbers 

According to data from Kidsdata.org, among California’s young people aged 5-19 there were over 37,000 hospital discharges for mental health issues; 12,719 for children ages 5-14; and 25,068 for teens ages 15-19 in 2020 alone. 

7 Reasons Why Supports for Adolescent Mental Health are Important 

• Most mental health disorders emerge before age 24, and the prevalence of such disorders is on the rise, affecting as many as one in five U.S. children and youth each year.  

• Suicide is the second leading cause of death among youth ages 10-24.  
• Treatment of mental illness is costly and accounts for the largest share of health care spending for children and youth in the U.S. 
• Most young people who need mental health treatment do not receive it, placing them at increased risk for negative outcomes throughout their lifetimes.  
• Anxiety disorders are the most commonly-diagnosed mental health conditions among youth, affecting an estimated 32% of U.S. adolescents.  
• Depression-related feelings also are common, with 37% of high school students nationwide in 2019 estimated to have had persistent feelings of sadness or hopelessness in the previous year, up from 26% in 2009.  
• Youth with anxiety, depression, or other mental health disorders are more likely to exhibit suicidal behavior, drop out of school, use alcohol or drugs, and engage in unsafe sexual activity, in addition to experiencing greater difficulties in school and with relationships