Rates of depression, anxiety and suicidal thoughts are skyrocketing among American teens.
A recent report from the Centers for Disease Control found that nearly one in three girls have seriously considered suicide, and a significant number, 13 percent, have actually attempted suicide.
Psychologists have different theories about the causes of adolescent mental health crises.
Some blame the increased use of smartphones and social media, while others believe isolation during the pandemic has played a big role.
The primary causes of teen mental health problems are not fully understood, but with a nationwide shortage of mental health professionals, the bigger challenge now is finding ways to solve the growing problem.
Jake Sussman, one of four co-founders of the unicorn-sized mental health network Headway, believes his new startup can help solve the growing crisis by offering online group therapy to kids in grades 5 to 12.
After leaving Headway two years ago, Sussman decided to try something completely different: becoming a fifth-grade English teacher at a charter school in Brooklyn. The experience not only gave her a chance to teach kids how to write essays, but it also gave her a firsthand look at why children's mental health care is currently broken.
Sussman said her school had one counselor, but despite her best efforts, she often couldn't provide timely help to students.
“[Counselors] “They're not clinicians. They have huge patient volumes,” Sussman said. “The best they can do is give families a physical PDF of a clinic with a long waiting list.”
He told the story of Jamelia, an orphan who became depressed after her best friend dropped out of school and had to wait three months to see a therapist because she was on Medicaid.
Sussman realized that one way to solve the shortage of mental health professionals was to offer help in a group format.
“Group care has been around for a long time,” Sussman says, “it's been studied thoroughly, and it works.”
Although research has shown that group therapy can be just as effective as individual therapy, this type of treatment is not often offered by mental health professionals.
Although therapists in private practice can make more money from group sessions, Sussman said group therapy is not popular among behavioral health providers because it's a huge administrative challenge: “You can't find 10 kids, coordinate 10 schedules, check 10 insurances. It's just too much work.”
From a logistical standpoint, online group therapy can be more effective than in-person treatment, Sussman said.
“If you have two groups, one is 17-year-old girls who are anxious and the other is 17-year-old girls who are Hispanic and identify as LGBTQ, all else being equal, the latter group is going to be much more effective because it's more specific,” Sussman says. “It's virtually impossible to fill that latter group directly. How do you find 10 people who fit that criteria within commuting distance of where the group is located?”
Marble, which Sussman launched late last year with Dan Roth, another Headway co-founder, claims it solves the logistics of organizing group therapy while helping more students without sacrificing the quality of care. On Friday, the startup emerged from stealth and announced it had raised $5 million in seed funding from Khosla Ventures, Town Hall Ventures and IA Ventures, with participation from Daybreak Ventures and Lorimer Ventures.
Marble's main competitors are school-focused teletherapy startups Hazel, Daybreak and Cartwheel, which work directly with school districts, Sussman said. “Schools have budgets for student mental health, but these budgets are shaky and fairly small,” Sussman said, adding that schools might pay for up to six private therapy sessions, but that's not enough time to treat students.
Marble's approach is different: The company partners with school counselors who have referral authority, Sussman said.
Instead of charging school districts for its services, Marble partners with insurance companies, including Medicaid.
Sussman explained that Marble's approach is financially feasible because Medicaid pays at least $20 per child for a group session. “If you have 10 kids in a group, you can make $200 an hour, which means you can pay the therapist a competitive rate and still have enough money left over to actually launch your business,” Sussman said.
Marble is testing the approach in one New York City school and plans to establish relationships with hundreds of counselors across New York state over the next school year. “Counselors are seeing the magic of not having a waiting list,” Sussman says. “They're finding it's so much better than what they're using now.”
The company will launch in New York and plans to expand to other states.