BluePath Health Blog

The Real Crisis in Higher Education Is Student Mental Health

by Robby Franceschini

Now is the time of year high school students hear back about their college applications and decide which school is the right fit to pursue their next chapter life. Recent bribery scandals have put integrity of this college admissions process under a microscope. But other recent headlines highlight a much bigger problem in higher education: rising student mental illness.

A widespread problem

College students today increasingly suffer from mental health issues and face many barriers to accessing the care they need. Disordered eating and sleeping are on the rise among college students, and over one-third of college students report having trouble functioning over the past year due to depression. In surveys, almost a third of students reports feeling frequently overwhelmed. And these health access problems don’t account for the financial burdens imposed on students that may negatively affect their well-being.

Exacerbating these problems is a lack of access to needed supports and services. A national survey of counseling directors found that the average university has one counselor for every 1,737 students, even though the recommended ratio is one counselor for every 1000 to 1500 students. Students also report stigma, busy schedules, inconvenient hours of counseling service and a lack of information on services as barriers to care.

Schools slowly offering students digital mental health tools

Several schools are testing out various apps to support student health and well-being. Colorado State University, University of Wisconsin, and other schools are using the GRIT Digital Health YOU at College app to connect their students to resources on campus and push health-related content to students. Students who use the app report being better able to manage stress and learning about campus resources. UC Davis has utilized Healthy UC Campus funds to pilot the Kumanu app. Kumanu’s platform purports to improve personal well-being through the use of the science of “purpose,” with the goal of using this behavioral science to improve population health.

Another emerging solution is TAO (Therapy Assistance Online), which offers live video CBT visits and a digital library of tools to help augment strained college counseling centers. Several universities have turned to TAO to meet student needs, including Arizona State University, University of the Pacific, and Florida International University.

Schools have an incentive to adopt tools, but adoption trend is unclear

Given the headlines and statistics around youth mental health, it doesn’t appear that this mental health crisis will subside in the near-term. And colleges have an incentive to keep their students healthy and enrolled in school: institutions lose an average of $16 billion annually due to student retention failures. However, college uptake of various technological tools is uneven, and the target buyer isn’t always clear, given that each school administration is set up differently. In response to this crisis, advocates and innovators alike should work to educate higher education administrators and counseling directors on the digital health landscape for higher education and the solutions that may improve student health and well-being.


E-consults save time, money, and lives by avoiding long specialist waits

by Robby Franceschini

Electronic consultations — or “e-consults” — first launched in 2005 by San Francisco General Hospital and the San Francisco Health Network, connect primary care providers and specialists through electronic communications to deliver efficient and effective care. Today e-consult’s multiple benefits, which include expanded specialist care access, lower costs, improved care quality, and more, are now being used by large health systems. MORE


Teens need “headspace”: How teen drop-in centers provide brick-and-mortar and virtual access points to youth mental health services

by Robby Franceschini

March 11, 2019 — Teen mental illness, substance abuse, and suicides are on the rise across the globe, yet there are only a few stand-out companies tackling this population’s mental health problems. To address adolescent mental health needs, Australia’s National Youth Mental Health Foundation created an innovative model called headspace that combines the traditional teen drop-in center with contemporary features such as virtual mental health therapy, job counseling, and substance use/abuse resources. Similar distressing mental health trends among Silicon Valley’s youth are being addressed by Stanford Medicine’s Department of Psychiatry and Behavioral Sciences which has secured funding from the Robert Wood Johnson Foundation and the Santa Clara County Department of Behavioral Health Services to design and implement headspace-like models, recently branded “allcove”, throughout the county. To support the spread of the headspace/allcove model across California, Sen. Jim Beall (D-San Jose) has co-introduced a bill that would allocate state mental health dollars towards the effort to establish drop-in centers across California. MORE

Health Policy & Legislative Lowdown: Can California move closer to universal coverage by lowering costs and expanding access to coverage?

by Robby Franceschini

February 22, 2019 – With national calls for “Medicare for All” and “Medicare for Some” and breakdowns of what single payer is (and what it isn’t), the ins and outs of health policy and government’s potential role in providing health coverage have captured America’s attention. Californians are equally engaged in the health reform debate since Governor Newsom promoted single-payer healthcare during his 2018 campaign. However, at the same time Newsom hedged on California’s potential adoption of single- payer system, saying noting it would take “years” to implement and that it involves “a lot of mythology.”

To establish a single-payer system California faces significant federal obstacles, including obtaining a CMS waiver to reallocate Medicaid funds and an ERISA exemption to regulate the large group employer market. Given the significance of these barriers, to move healthcare reform forward in California state lawmakers are instead introducing legislation to lower the cost of commercial coverage and expand public coverage, building upon the Affordable Care Act’s aim of universal coverage. MORE

As Adolescent Mental Health Concerns Rise, Digital Health Companies Try to Tackle the Problem

by Robby Franceschini

February 19, 2019 – As noted in a previous blog, many digital health tools and services do not have offerings for adolescents despite the increase in mental health issues for this population. Vendors and entrepreneurs will benefit from addressing this market need and engaging this population at an early age, given that Gen Z and their millennial peers are currently voicing support for providers who offer digital capabilities and will soon make up a majority of the population. Our review of current digital mental health offerings, which include virtual visits as well as CBT and mindfulness digital tools, reveals an adolescent appetite for digital solutions and a need for more clinical, provider-to-patient treatment solutions. MORE

Digital Mental Health Isn’t Focusing on Those Who Need Help Most: Adolescents

by Robby Franceschini

February 7, 2019 — From widespread anxiety and depression to alarming suicide rates, emotional suffering is overwhelming American youth, making adolescent mental health a growing public health issue. In fact, suicide is the second leading cause of death for children and youth ages 10 to 24 and an estimated 3.1 million adolescents ages 12 to 17 (12.8%) had at least one major depressive episode in 2016. Experts and commentators have proposed a number of solutions to solve this crisis, including digital health tools.

Despite the growing market of digital mental health services and products, few are focusing on adolescents due to perceived issues on tech’s impact on teen mental health as well as consent, reimbursement and other utilization concerns. However, our research and experience shows that these barriers, like many others in digital health, can be and are being overcome.

Mental health tech tools for teens: helpful or harmful?

Recent reports and headlines have raised concerns about the negative consequences of teen use of technology. These include findings that smart phone use may increase anxiety and be associated with depression and suicide-related outcomes. At the same time, teens are utilizing digital resources to access health information, providers and resources, and researchers have noted that depression and smartphone use may not be statistically significant. This aligns with the common definition of today’s adolescents as “digital natives” who are more comfortable using mobile platforms connected with the world. Skeptics might also argue that, with decreased stigma around mental health, more teens are getting screened and diagnosed suggesting that, in tandem with the rise in smart phone use, the two may just be correlated. MORE

The Year of Telehealth Must Also be the Year of Virtual First

by Timi Leslie

January 29, 2019 — Will 2019 be the year of telehealth? Increased telehealth adoption by providers, payers, policy makers and consumers appears to substantiate this industry-wide prediction (1). Yet, virtually every statement on the future ubiquity of telehealth includes an ‘if” statement: IF services are reimbursed, IF policies and regulations are supportive, IF consumers adopt, and so on.

At BluePath Health, we see formidable barriers arise consistently as we work with clients to implement telehealth programs. What is clear to us is that for telehealth success, every entity involved needs to be on the same page from the start. That page is virtual first. Like mobile first, which transitioned from a unique strategy to table stakes for any new product or service, virtual first is becoming the path to high-quality, cost-effective care delivery. MORE

1. “The 4 key traits of today’s telehealth patients, according to our 5,000-patient survey,” Advisory Board, April 2018

Mental Health Features Prominently in California Governor’s Proposed Budget

Telehealth Can Help Expand Access

by Robby Franceschini

January 24, 2019 — The Triple Aim has defined the shape of health policy reform since the Institute for Healthcare Improvement first developed the model in 2007. Its enduring impact plainly came through in Deputy Finance Director Vivek Viswanathan’s testimony during a California Senate budget hearing on January 17.  Viswanathan began with an outline of Governor Newsom’s health care budget priorities saying, “The administration has three broad goals when it comes to health care, it’s improving access, reducing cost, and improving quality. And what we’re proposing through all of our programs is finding a way for all of these goals to fit together.”

In listening to Viswanathan’s full testimony, it became clear that mental health, and specifically access to mental health, is of particular concern to the administration. Telehealth can help bridge California’s mental health access gap due to the state’s provider shortage. MORE