Before the pandemic, 4.4 million children suffered from anxiety. Now with the additional stress of not seeing friends, trying to learn through online-only classes, and absorbing their parents’ pandemic-related frustrations, there’s concern that even more kids are having a tough time emotionally.
Two companies, Brightline and Sprout, are trying to create more access through their online counseling platforms. Brightline in particular has moved quickly to expand coverage. The company, an employee benefit that connects kids ages 6 to 17 with psychiatrists, therapists, and coaches, launched its service last year in California. It’s rolled out in 14 states and plans to be available in all 50 by the end of the year. The company has also provided coaching and educational resources for parents to help them work with their children. Another company, C8 Sciences, is hoping that its brain-teasing exercises can help kids build the mindset they need to bounce back from the pandemic.
The great need for mental and behavioral health services has drawn attention from investors. CB Insights reports that funding for mental health startups is already up in 2021. In the first quarter of this year, investors poured $852 million into mental health care startups across 64 deals, up 56% from the quarter prior. For all of 2020, venture capitalists invested just shy of $2 billion into the category. Brightline cofounder and CEO Naomi Allen says the company just closed a $72 million funding round led by GV (formerly Google Ventures) after raising $20 million last year, bringing the company’s total funding to $100 million.
The kids aren’t alright
It is hard to calculate the exact mental health toll that the pandemic has taken on children, but there are some signals. Between April and October 2020, the Centers for Disease Control and Prevention recorded a significant uptick in the number of emergency room visits related to mental health for kids ages 5 to 17, with teens being the most affected. The agency also reported an increased percentage of child-abuse-related trips to the ER. Since overall visits to the ER were down for kids during this time frame, it’s hard to tell how much more children were and are suffering than usual.
What is known is that school-based counseling, traditionally a huge source of support for kids, has largely been unavailable. The CDC says that reports to child protective services went down 20%-70% across the country during the pandemic, meaning that children also had less access to help outside their families than they typically do. Meanwhile, 40% of adults have had to manage their own increases in anxiety, depression, suicidal ideation, and substance abuse, in addition to childcare challenges and, potentially, unemployment. Such issues are likely to filter down to minors in a household.
Outside the more severe manifestations of suffering, there is evidence that many kids are feeling less at ease. In a May 2021 Kaiser Family Foundation survey, more than a fifth of parents reported an overall worsening of their children’s mental health. Notably, children may not be experiencing diagnosable mental health conditions so much as just not doing well in a noticeable fashion.
Dr. Jessi Gold, assistant professor of psychiatry at Washington University in St. Louis, noticed that several students she saw during the pandemic were dealing with an added layer of stress that caused depression-like symptoms but wasn’t clinical depression. “You can tell they don’t look psychologically good, but they also don’t look diagnostically depressed,” she says. However, she adds that because kids are experiencing certain symptoms—lack of sleep, inability to concentrate—they might test positive for certain mental health issues if they were to fill out an assessment survey. This strange pandemic-related malaise makes it difficult to assess students’ mental health needs, because there is no ready treatment. “You need to do something,” she explains, “maybe change hobbies for the month, because they’re in a rut of sorts.”
Providing more mental health counseling could help, but there was a shortage of mental health practitioners before the pandemic and now, with many people scrambling to get into therapy, the list of available practitioners is bound to be even smaller. Mental health platforms such as Brightline and Sprout offer an opportunity to connect available therapists with patients living in the same state.
Better living through gaming
A less-considered approach is building resilience through brain training. C8 Sciences is a tiny company in New Haven, Connecticut, with just $1.7 million in funding. Its computer games assesses kids and train them based on their ability to remember, think flexibly, exert self-control, and sustain attention. When these so-called executive functions are working well, kids tend to succeed in school.
Executive functions “predict academic outcomes more powerfully than IQ,” says Dr. Bruce Wexler, professor emeritus and senior research scientist in psychiatry at Yale School of Medicine and the founding scientist behind C8 Sciences. In addition to helping students with grades, strong executive functioning can also help them regulate their emotions. However, children who grow up in stressful environments and who may also suffer from depression, anxiety, or other mental health issues, may not develop such functions as well. There is a concern that the pandemic may lead to similar outcomes for a broader number of kids, especially those in impoverished areas.
There are several studies backing C8 Sciences’ program, showing that it helps kids improve executive functioning and academic performance while stopping them from engaging in risky behavior. Tens of thousands of students have used the program, Wexler says. Despite its reported success, schools may have a hard time investing. During the pandemic, several schools that C8 Sciences works with had to pull back on the program because of a lack of funding.
School finances for the 2020-21 year aren’t looking as bad as economists predicted. But embracing a program like C8 Sciences’ may require more than just purchasing software. Five years ago, the Evansville school district in Indiana, which has around 22,000 students in 40 schools, decided to start testing the program in some of its elementary schools in conjunction with a neuroscience-based protocol called Growth in Academics Through Innovation and Neuroeducation, or GAIN. The program requires training teachers on how to consider an individual student’s executive functioning as curriculum materials are designed. It also helps to facilitate the C8 Sciences program to help students strengthen their abilities.
“When we’ve been able to implement it with fidelity, our students have made gains,” says Susan Phelps, director of neuroeducation at the Evansville Vanderburgh School Corp. But it’s not easy, she emphasizes: “You’re asking [students] do something that’s challenging, and they can’t inherently in that moment be successful and you need high support to support them through that challenge.”
Before the pandemic, Phelps had been overseeing a new multiyear pilot that would have put the program in nearly all the elementary schools in the district. The goal was to see how a majority of students could best benefit from the program. “All that data is lost,” she says. The move into virtual classrooms effectively killed the project because students weren’t engaging with it at home. But Phelps is starting a new pilot this fall.
In the meantime, a lot of students already have access to mindfulness training or meditation, Phelps says, noting that such practices have helped some of them stay resilient during the pandemic. The training even seems to be making its way back to parents. Phelps says: “I’ve had lots of parents share with me that [when they’re stressed] their children will walk them through their mindfulness exercises.”