Future of Healthcare Workforce Series: 1
This is part one of the Future of Healthcare Workforce Series. This series will explore how technological advances such as artificial intelligence, machine learning, and robotics may impact the healthcare workforce.
There is a mental health crisis in the United States.¹ According to the National Alliance on Mental Illness (NAMI), one in five adults experienced mental illness in 2021. The prevalence of poor mental health is even more drastic for young adults and teenagers. The Centers for Disease Control and Prevention (CDC)’s Youth Risk Behavior Survey Data Summary and Trends Report: 2011-2021 shows that increasingly more youth report experiences of violence, persistent levels of hopelessness, and suicidal thoughts and/or behaviors.
In 2021, nearly three in five U.S. teen girls experienced persistent feelings of sadness or hopelessness
In 2021, females and LGBTQ+ students were more likely to experience suicidal thoughts than their male or heterosexual peers
Over the decade, youth across all racial and ethnic groups experienced high and worsening levels of persistent sadness or hopelessness.
This data tells us that we need more mental health services and professionals to mitigate this crisis. However, training and obtaining licensure in any healthcare profession is not easy or quick. How can we address the problem today while also developing solutions for the future? Can technology help alleviate the issue?
State of mental health in Michigan
Michigan’s schools received 6 billion in federal COVID funding to expand mental health programs. However, funding for some of these programs is ending, and schools won’t be able to afford to retain much-needed mental health professionals. Michigan has a severe school counselor shortage. Our state has the second-highest counselor shortage in the country with a student-to-counselor ratio of 598:1, whereas the American School Counselor Association recommends a ratio of 250:1.
In her proposed FY 2025 budget, Governor Whitmer announced that $300 million is allocated for student mental health. She is also budgeting $193.3 million for new Certified Community Behavioral Health Clinics⁷ and $7.3 million to set up a Michigan Crisis and Access Line to support people experiencing behavioral health crises. There are also programs like Mi-ELSIS, where graduate-level trainees in the fields of school social work, school psychology, and school counseling receive a stipend in exchange for a minimum one-year commitment to working in high-need schools after they graduate. Promoting and funding school mental health worker pathways are critical steps toward mitigating the youth mental health crisis.
Can technology help?
Artificial Intelligence (AI) promises access to mental health services in a safe and convenient way. Today, there are over 10,000 apps for mental health and well-being on the market, and some of them are specifically designed to help teens. This year, California introduced two free apps for teens, young adults, and their families as part of a $4.7 billion investment in mental health and substance-use support. These apps aim to support users in different ways - from connecting individuals with an online therapist to offering them access to an AI-powered chatbot that can provide support whenever necessary.
Personal therapy apps like Talkspace, Wysa, and Woebot allow users to “talk to someone” immediately without making an appointment. A 2021 survey listed common reasons people use chatbots; reasons include being affordable, easy to use, and accessible anytime. Other apps like BeMe and Earkick are designed to help people “find well-being” and boost their mood with daily affirmations.
There are risks, too
While AI apps and chatbots are growing, their potential consequences must be considered. A study of more than one million teenagers worldwide suggests that as their interaction with smartphones grew, so did their feelings of loneliness. Smartphones may not be the cause of teens’ poor mental health, but some research shows that smartphones and social media have significant roles. A literature review also notes that depressive symptoms in adolescents have increased considerably as technology has become more accessible.²
But if people, especially youth, are suffering from negative emotions - whether due to harmful peer interactions or perceived social isolation - is it a good idea to turn to AI to alleviate that pain? Experts raise ethical issues regarding AI chatbots and the cultural competency they often lack. Although several research papers point to the positive benefits of these applications, there seems to be no clear evidence of their effectiveness, particularly in the long term.³
School mental health programs are still vital
Even though AI and mental health apps are promising solutions to the youth mental health crisis, research has documented the value of comprehensive school mental health programs. These programs improve students’ academics and build their social and emotional skills, increase their self-awareness and engagement at school, and connect them to caring school staff.⁴
The Department of Education echoes these themes in its report: receiving mental health services in school is not only more convenient but also alleviates some of the barriers to accessing care, such as a family’s lack of knowledge of mental health conditions and how to get their child appropriate care, perceived stigma, and long travel times to see providers.
Apps like Alongside can be integrated into a school's mental health service offerings. Many schools use the multi-tiered system of support (MTSS) framework, and Alongside positions itself as part of the Tier 1 support,⁵ helping students before they see a social worker or counselor.⁶
Technology is here to help, not replace
Concerns about youth mental health will be around for a while. As we develop innovative technological solutions to tackle various aspects of this problem, it is important to remember that the need for authentic human connection remains unwavering, both now and in the future.
Endnotes
The White House. “Fact Sheet: Biden-Harris Administration Announces New Actions to Tackle Nation’s Mental Health Crisis.” The White House, May 18, 2023. https://www.whitehouse.gov/briefing-room/statements-releases/2023/05/18/fact-sheet-biden-harris-administration-announces-new-actions-to-tackle-nations-mental-health-crisis/.
Fagan, Eilís, Ellen Grenen, and Michaela McGlynn. “Social Work in the Digital Age.” Advocates’ Forum, June 1, 2018. https://crownschool.uchicago.edu/student-life/advocates-forum/social-work-digital-age.
Abd-Alrazaq, Alaa Ali, Asma Rababeh, Mohannad Alajlani, Bridgette M Bewick, and Mowafa Househ. “Effectiveness and Safety of Using Chatbots to Improve Mental Health: Systematic Review and Meta-Analysis.” Journal of Medical Internet Research 22, no. 7 (July 13, 2020): e16021. https://doi.org/10.2196/16021; He, Yuhao, Li Yang, Xiaokun Zhu, Bin Wu, Shuo Zhang, Chunlian Qian, and Tian Tian. “Mental Health Chatbot for Young Adults With Depressive Symptoms During the COVID-19 Pandemic: Single-Blind, Three-Arm Randomized Controlled Trial.” Journal of Medical Internet Research 24, no. 11 (November 21, 2022): e40719. https://doi.org/10.2196/40719; Rahman, Md. Ashrafur, Evangelos Victoros, Julianne Ernest, Rob Davis, Yeasna Shanjana, and Md. Rabiul Islam. “Impact of Artificial Intelligence (AI) Technology in Healthcare Sector: A Critical Evaluation of Both Sides of the Coin.” Clinical Pathology 17 (January 22, 2024): 2632010X241226887. https://doi.org/10.1177/2632010X241226887.
Durlak, Joseph A., Roger P. Weissberg, Allison B. Dymnicki, Rebecca D. Taylor, and Kriston B. Schellinger. “The Impact of Enhancing Students’ Social and Emotional Learning: A Meta‐Analysis of School‐Based Universal Interventions.” Child Development 82, no. 1 (January 2011): 405–32. https://doi.org/10.1111/j.1467-8624.2010.01564.x; Hoover, S, N Lever, N Sachdev, N Bravo, J Schlitt, O Acosta Price, L Sheriff, and J Cashman. “Advancing Comprehensive School Mental Health Systems: Guidance From the Field.” National Center for School Mental Health, September 2019. https://www.schoolmentalhealth.org/media/som/microsites/ncsmh/documents/bainum/Advancing-CSMHS_September-2019.pdf; Youth.gov. “School Based Mental Health.” Accessed June 21, 2024. https://youth.gov/youth-topics/youth-mental-health/school-based#_ftn.
Tier 1 supports are preventative and promote “positive social, emotional, and behavioral skills and overall wellness for all students.” From Centers for Disease Control and Prevention, Division of Adolescent and School Health. “Promoting Mental Health and Well-Being in Schools: An Action Guide for School and District Leaders,” December 2023. https://www.cdc.gov/healthyyouth/mental-health-action-guide/pdf/DASH_MH_Action_Guide_508.pdf.
Alongside. “Buyer’s Guide: A Comprehensive Resource for Evaluating School Mental Health Solutions.” Accessed June 21, 2024. https://www.alongside.care/pages/pdf-buyers-guide?utm_campaign=LeadWell&utm_medium=email&_hsenc=p2ANqtz-_BeYL0JsYxSBWAtS7RMIxZ8nzXAut2LTpyCkYhZTq33qq4Hl_SgG3f7nFLG6gkfWfuMc0VNqTIPBBr2L5e9t3MuKBGXA&_hsmi=302752728&utm_content=302752728&utm_source=hs_automation.
Directory of Michigan's Certified Community Behavioral Health Clinics (CCBHCs)