It's a challenging time to be a young person. Study after study has shown that stressors such as social media, bullying, loneliness and the pandemic are causing or exacerbating a wide array of mental health challenges among high school and college kids. Healthcare resources are not always readily available to help them. Among some recent stats: 

• There are never-before-seen levels of hopelessness and suicidal thoughts among teens, according to a report from the CDC.

• 71% of college students are experiencing mental health issues such as stress, anxiety and depression, according to a report from TimelyCare.

• The oldest members of Generation Z (born in 1997 or later) turn 26 this year, making them officially ineligible for coverage under their parents’ health plan.

• Healthcare decisions weigh heavily on the minds of Generation Z members, considering 75% of Generation Z members are concerned about their health, compared with only 63% of baby boomers, according to a report from the American Heart Association and American Diabetes Association.

Those mental health statistics are quite important, because of the mental health professional shortage in the United States, which is where telemedicine can come in.

Luke Hejl is CEO of TimelyCare, a virtual health and wellbeing offering for college students. The company helped more than 500,000 students in the fall 2022 semester alone. We interviewed Hejl to talk about how Gen Z is changing healthcare delivery and how tech must evolve to their preferences.

Q. Because 71% of college students are experiencing mental health issues, and there are never before seen levels of hopelessness and suicidal thoughts among teens, how is this situation changing healthcare delivery?

A. It is concerning to see such high levels of emotional and mental health challenges among college students. Fortunately, at the same time, Gen Z has revealed itself to be very open about mental health challenges and willing to access care and support. Nearly four out of 10 Gen Zers were likely to seek professional mental health support, compared with 28% of Gen Xers and 16% of baby boomers.

This may be due to the fact that a majority of Gen Z have accessed such services before arriving at college. Survey results we released in May show that nearly six in 10 of active college students first accessed mental health services during their K-12 years and 42% experienced their first formal care in high school.

What’s concerning, though, is that those same survey results showed more than three-quarters of college students reported they have a friend who is experiencing mental health challenges or issues. This is understandable, given Gen Z college students face a world that includes all the same pressures as previous generations, such as academics, finances and living independently, which have been combined with profound new societal issues, such as the pandemic, mass shootings and economic uncertainty.

Thanks in part to early access to behavioral healthcare, Gen Z understands how mental health affects physical health and vice versa. They are changing healthcare by managing their health holistically, recognizing their care journey is unique and needs to be personalized to their goals.

This openness to care and growing mental health challenges requires healthcare leaders to place a greater emphasis on the availability of services and support. Higher education must also emphasize creating cultures where mental healthcare is accessible and designed to meet students where they are and recognize them for who they are, affirming their race, ethnicity, religion, worldview, ability, sexual orientation, and gender identity and expression.

Q. How do you think healthcare technology must evolve to successfully treat these young consumers?

A. “Consumer” is the perfect term here because Gen Z does view healthcare as a service that should be as accessible, cost-transparent and personalized to their needs as any other service they have used. Likewise, healthcare technology needs to meet Gen Z’s consumer-driven expectations by offering a variety of highly flexible care options that can be accessed on their terms and their own time, while helping them achieve their health and wellness goals.

Mental and behavioral healthcare, for example, have historically and continue to be delivered through one-on-one therapeutic relationships between clinicians and patients that typically involve a series of counseling sessions lasting nearly an hour.

While effective for many young adults, not every member of Gen Z is ready or willing to access care and support in that way, and that’s okay. There are numerous other evidence-based mental health and wellbeing care methods that can be accessed through technology alone that involve interactive exercises, video, audio or text-driven therapies where young adults can progress at their own pace and in their own space.

There also are online group therapy opportunities where Gen Z can connect with others facing similar mental health challenges that still enable them to protect their privacy, which encourages them to openly share feelings and concerns.

Although anonymous, peer group therapy sessions enable a sense of social connection, which affects our wellbeing and many areas of our physical health. The CDC reports, for example, that social connection is associated with healthy eating and physical activity, improves our sleep, reduces the risk of violent behavior, and even helps manage and prevent death from chronic conditions.

The U.S. Surgeon General recently released a report aptly titled “Our Epidemic of Loneliness and Isolation.” This generation – always connected to others through technology – is particularly vulnerable to feeling alone, so healthcare must meet them where they are to ensure they have expanded access to care that appeals to them.

Different care options are crucial for building short-term and long-term engagement in mental health and wellness, which tends to result in better outcomes and more successful transitions for students as they enter careers, start families, or simply advance to the next phase of adulthood.

Q. The oldest members of Generation Z are starting to fall off their parents’ health plans. And it has been shown that healthcare decisions weigh heavily on their minds. How can health IT like telemedicine play a part in helping Gen Z with the insurance drop-off and their health concerns?

A. Aside from severe injuries or illnesses, virtual care will likely be Gen Z’s first choice when accessing care once they have to make more healthcare financial decisions on their own. In fact, 44% of Gen Z and Millennial AHA survey respondents said they would switch providers if they did not offer a telehealth option.

Regardless of their health coverage status, Gen Z values the convenience of care access from any location. Direct-to-consumer virtual care providers also often offer lower-cost options for uninsured patients, which would appeal to Gen Z if they lose their parents’ coverage or obtain a health plan with large out-of-pocket spending limits.

Access and cost are also key decision factors for college students under their parents’ health insurance in accessing care. Despite their parents’ coverage or school-mandated student insurance plans, many college students are functionally uninsured if the providers around their school are out-of-network and require much larger out-of-pocket spending.

Not only is using community-based physical and mental health resources often inconvenient, such costs can discourage students from accessing needed care and instead turn to social media where they could then self-treat using ineffective or potentially dangerous methods.

As a colleague told The New York Times, oftentimes college students are in search of a diagnosis in order to receive services or an accommodation on campus.

That is part of the reason why higher education is increasingly supplementing their in-person, on-campus health and wellness offerings with comprehensive virtual care options whose services can be accessed around the clock with no out-of-pocket costs.

As a result, campus leaders encourage students to access the care they need instead of ignoring the problem before it has a more devastating effect on their academic performance, workforce development, close relationships and overall well-being.

Q. How does enabling the younger generation to have tools to grasp their mental health affect the healthcare system as a whole?

A. There is no question anymore that one’s mental health is as important to achieving a successful life as their physical health. That is why equipping young adults with the tools to help manage their mental health and well-being early on can only have a positive effect on the healthcare system, their generation and society as a whole.

If our mental and emotional health problems are ignored or self-managed in harmful ways through misuse of drugs, alcohol or risky behaviors, it will likely cause or contribute to physical health problems, emergency department visits and hospitalizations.

After all, the U.S. Surgeon General’s and the CDC’s reports and guidance about youth mental health stated they view the issue as a public health crisis that will have far-reaching impacts if not confronted now.

Our nation’s economic future and global competitiveness are directly linked to the health and wellbeing of college students today. A sharp decline in the number of Americans going to college has dire economic consequences for the U.S. long term – and yet the No. 1 reason students leave college is for mental health reasons.

The need for 24/7 access to high-quality care has never been more important. In addition to the data shared by the federal government, according to the American Council on Education, student mental health is the top concern of college and university presidents. A recent survey found eight out of 10 students said there is a full-blown campus mental health crisis.

Colleges and universities, however, do not have the capacity to meet all of a student’s health and well-being needs on campus, with wait times that often stretch into several weeks, putting both students and institutions at risk. 

Even though campus leaders can’t staff their way out of the mental health crisis, there are things they can do right now to help individual students be well, stay in school and achieve their goals, and expanding access to much-needed mental health services is at the top of that list.

After reaching their mental health and wellbeing goals in college, students will feel more empowered to navigate their own healthcare, access necessary support and thrive after they graduate and enter the workforce.

Follow Bill's HIT coverage on LinkedIn: Bill Siwicki
Email him: bsiwicki@himss.org
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