Youth in the US are facing a mental health crisis. Adolescents and young adults ages 10–24 are at the highest risk for mental health problems, but they are the least likely to seek professional help.¹ Commanding academic and social pressures are largely to blame for poor mental health,^2,3 and a variety of barriers discourage those affected to seek care.

Mental health disorders were the leading cause of disability and poor life outcomes in young people even before the pandemic began.⁴ In the decade from 2009 to 2019, the proportion of high school students experiencing persistent feelings of sadness or hopelessness increased by over 40%, jumping from 26.1% to 36.7%.⁵ Suicide rates in the 10–24 age demographic increased by 57% from 2007 to 2018,⁶ enough to cement itself as the leading cause of death in that age bracket.⁷

Disruptions to daily life due to the COVID-19 pandemic have continued to accelerate the growing rates of psychological distress experienced by young people.⁴ Case in point: In May 2020, social isolation was a leading cause for feelings of anxiety and depression, with 61% of teens disclosing that COVID had increased feelings of loneliness.⁸ In 2021, 44% of students reported feeling persistently sad or hopeless during the past year—a 14% increase from the 2019 figure.^{5, 9} Still other research has found that symptoms of anxiety and depression doubled during the pandemic.⁴ Approximately half of children with any treatable mental health disorder do not receive adequate treatment,⁴ and we are failing to make resources readily available. Understaffing in schools is part of the issue: While the American-School-Council-Association-recommended student-to-counselor ratio is 250-to-1, the national average for the 2021–2022 school year was 408-to-1.¹⁰ 20% of high schools do not even have a single school counselor.¹¹ Teachers, who are students’ primary points of contact throughout the school day, do not receive enough training in identifying and providing support to students with mental health needs.¹² A variety of barriers to care also exist at the individual level, including cost and a lack of time.^{13, 14}

Mental health issues in adolescents cause direct harm to those experiencing them and also have knock-on effects. Youth who struggle with mental health perform worse academically and are at increased risk of both absenteeism and dropping out of school.^{5, 15} They also may experience problems with their physical health.⁵ Mental health issues that are not addressed at an early age can go on to impact an adolescent’s entire adulthood,¹⁶ so it is vital that these issues are addressed early on.

Introducing Counslr: Unlimited Text-Based Mental Health Support, Available 24/7/365

Counslr is a New York-based startup founded in late 2019 with the mission of making mental health support more accessible for students, to better reach the traditionally unreachable.

Counslr partners with high schools to provide all students with unlimited access to text-based mental health support from licensed counselors at no direct cost. Accessible via a HIPAA, FERPA, and NYS-2D compliant mobile app, students can engage in live sessions on-demand in under 2 minutes, or by scheduled appointment. With a member satisfaction rate of 95%, and a counselor retention rate of 98%, Counslr is meeting the needs of both its counselors and users. The Counslr mobile app is available on iOS and Android devices.

How Counslr Helps Schools Reach The Traditionally Unreached

Electronic mental health services have gained popularity because of their advantages in accessibility, efficiency, and effectiveness.¹⁷ These services should be utilized for young people specifically because of their high risk status, improbability of seeking help,¹⁷ and comfort with technology.

Text-based support has been endorsed by counselors and young service users ages 10–24 alike.^{13, 17-19} Adolescents value text-based support for primarily safety and accessibility reasons.¹ Namely, adolescents have expressed a sense of comfort knowing that they cannot be overheard¹³ (as is the case with phone and video) and a preference for faster access to support.¹ What’s more, because of increased anonymity from the counselors, users can feel safer in their conversations¹³ and therefore feel encouraged to disclose more honest, embarrassing, or sensitive information.^{20, 21} With teenagers’ preference for texting over face-to-face communication²² and 91% of teens ages 14–18 owning a smartphone,²³ Counslr is a solution that will be accessible for the vast majority of adolescents. Furthermore, as Counslr is free to students and requires no insurance information, a significant hurdle to care is completely eliminated.

There is ample evidence that text-based support is effective, even more so than phone services in some respects.^{19, 24} In a study comparing a phone help line to a text-based chat service, the text service increased adolescents’ sense of well-being and decreased their perceived problem burden more than the phone service did.¹⁹ The chat conversations were also evaluated to be superior in the dimensions of “taking child seriously’’, ‘‘making child feel at ease’’, ‘‘comprehensible to child’’, and ‘‘encouraging child to think along."¹⁹ A text-based service is the ideal complement to existing school counseling centers.

The most frequent complaints about text-based support services are poor timeliness in response to service requests and unavailability at night.^{1, 18} For some 24-hour hotline services, wait times can reach up to three hours.¹³ However, Counslr nullifies this complaint because of its 24/7/365 availability. While other services may claim to be 24/7, response times can be as long as hours or days.^{25, 26} Meanwhile, Counslr guarantees a sub-2-minute response time at all hours of the day, 7 days a week.

Early intervention is critical for maximizing health outcomes as it can prevent years of suffering and alleviate long-term disability.²⁷ Because Counslr’s unrivaled accessibility and efficacy allows users to address mild symptoms in a timely manner before they evolve into something more severe, the Counslr solution lends itself well as an early intervention.

*Funding for mental health programs like Counslr may be available through the Elementary and Secondary School Emergency Relief Fund Program (ESSER III) program. For more information on ESSER funding, please visit your state’s Department of Education website.*

References

1. Navarro et al., 2019: Exploring Young People’s Perceptions of the Effectiveness of Text-Based Online Counseling: Mixed Methods Pilot Study
2. Horowitz and Graf, 2019: Most U.S. Teens See Anxiety and Depression as a Major Problem among Their Peers
3. Schaeffer, 2022: In CDC survey, 37% of U.S. high school students report regular mental health struggles during COVID-19 pandemic
4. Vivek Murthy, 2021: Protecting Youth Mental Health: The U.S. Surgeon General’s Advisory
5. CDC, 2020: Youth Risk Behavior Survey Data Summary & Trends Report 2009–2019
6. Curtin, 2020: State Suicide Rates Among Adolescents and Young Adults Aged 10–24: United States, 2000–2018
7. CDC: WISQARS Leading Causes of Death Visualization Tool
8. Harris Insights & Analytics, 2020: Teen Mental Health
9. CDC, 2022: Mental Health, Suicidality, and Connectedness Among High School Students During the COVID-19 Pandemic — Adolescent Behaviors and Experiences Survey, United States, January–June 2021
10. American School Counselor Association: School Counselor Roles & Ratios
11. NASSP: Mental Health in Middle Level and High Schools
12. Panchal et al., 2022: The Landscape of School-Based Mental Health Services.
13. King et al., 2006: Online counselling: The motives and experiences of young people who choose the Internet instead of face to face or telephone counselling
14. Walker et al., 2015: “Insurance Status, Use of Mental Health Services, and Unmet Need for Mental Health Care in the United States
15. NITT-TA: Mental Health and Academic Achievement
16. NAMI: Mental Health in Schools
17. Navarro, 2020: Exploring Mental Health Professionals’ Perspectives of Text-Based Online Counseling Effectiveness With Young People: Mixed Methods Pilot Study
18. Gibson and Cartwright, 2014: Young people's experiences of mobile phone text counselling: Balancing connection and control
19. Fukkink and Hermanns, 2009: Counseling Children at a Helpline: Chatting or Calling?
20. Leibert and Archer Jr, 2006: An Exploratory Study of Client Perceptions of Internet Counseling and the Therapeutic Alliance
21. Callahan and Inckle, 2012: Cybertherapy or psychobabble? A mixed methods study of online emotional support
22. Common Sense Media, 2018: Social Media, Social Life: Teens Reveal Their Experiences
23. Common Sense Media, 2021: The Common Sense Census: Media Use by Tweens and Teens
24. Dwyer et al., 2021: Suitability of Text-Based Communications for the Delivery of Psychological Therapeutic Services to Rural and Remote Communities: Scoping Review
25. Talkspace, 2019: Talkspace announces first university partnership with Williams College
26. Mejia, 2023: Talkspace Online Therapy Review: Cost, Benefits And Features
27. NAMI: Mental Health By the Numbers

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