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ST. GEORGE — The growing rate of depression and anxiety in the Beehive State and across the nation — and a shortage of mental health professionals — has led schools, businesses and leaders to search for innovative ways to reach the youngest generations.
In southern Utah, one company has looked to one of the biggest ways teens communicate — text messaging.
About four years ago, several suicides happened in area high schools, said Iuri Melo, a licensed clinical social worker and therapist in St. George. His friend, a principal, reached out to him for ideas to deal with the "tremendous pressure" he faced trying to respond to tragedy in his school.
"And I want to do more. I have to be more proactive, I have to be more preventative," Melo recalled the principal telling him.
The therapist and others began brainstorming ways to reach students who need help.
SchoolPulse — a program that students can opt into to receive resources geared to them, weekly mental health check-ins, and even individualized text interactions — was born.
Reaching teens 'how they wanted to be reached'
Teens today are facing issues they've always faced, as well as some new ones, said Desert Hills High School Principal Justin Keate.
A landmark study in 2019 by the Kem C. Gardner Policy Institute showed 14.9% of boys ages 15-17 and 28.5% of girls "seriously considered attempting suicide" between 2015 and 2017. But almost 40% of youth ages 12-17 with depression received neither treatment nor counseling, researchers said.
"I think a lot of kids are just struggling with the challenges of life in general. Certainly some of these obstacles and challenges that have come along with the COVID situation and the pandemic and how we run things at school and how they interact with each other have been challenging," Keate said.
Through a pilot program, Desert Hills, located in St. George, became the first school to use SchoolPulse.
Keate said many kids are connected with their cellphones and social media, but they're "disconnected with each other."
"This is a way to connect with them and also encourage them to build those relationships," Keate said.
In his nearly 20 years of working as a therapist, Melo said he could "count on one hand" the number of teenagers who willingly walked into his office on their first visit. For many, it's difficult to seek help.
"We knew that we needed to find a way to reach them in the way that they wanted to be reached, and that was text," Melo said.
Students join the program by using their cellphones to scan a QR code placed on posters around their schools. Student governments, Hope Squads and sport teams help encourage their peers to join the program. They then receive three texts per week, which are "meant to be interactive, they're all meant to be educational, and they're all meant to increase their emotional awareness," Melo said.
Just a few years into launching, 25 schools across seven states now participate, seven of which are in Utah. More than 25,000 students are active users. Middle schools see between a 60-70% participation rate, and high schools get 40-50% participation, said Trent Staheli, who manages technology for SchoolPulse.
For schools, pricing is based on total enrollment and costs $12 per year per student. For parents who sign their kids up independently, It's $25 per year for each student.
The service is geared toward junior high and high school students, as they are more likely to have cellphones than their younger peers. The students are able to track their individual well-being with a dashboard they can access through text, which shows them their responses throughout the year and all the podcasts that have been recorded by SchoolPulse.
"We have hundreds and hundreds of text interactions that we're dealing with throughout the nation, and they're constantly asking questions all the way ranging from 'I'm stressed out, I'm falling behind, how do I not procrastinate? What's the purpose of life? How do I deal with my boyfriend?'" Melo said.
We knew that we needed to find a way to reach them in the way that they wanted to be reached, and that was text.
–Iuri Melo, licensed clinical social worker and therapist
Schools are required by law to implement suicide prevention programs and social and emotional learning programs. SchoolPulse's approach seeks to meet all those needs, as well as intervene directly with students who are struggling, Melo said.
Utah already has an app, called SafeUT, that provides direct text communication with residents. But that app is geared toward those in crisis, Melo noted. He and his colleagues wanted to find a way to reach out to all students, even those who are doing "extremely well," to help them stay in that place.
While text counseling services like Talkspace and Better Help exist on the market, those programs can cost hundreds of dollars each month. Those with SchoolPulse said their goal is to help students who reach out needing advice or assistance for day-to-day problems, while also pointing them in the direction of resources in their communities.
SchoolPulse now has four employees who respond to student texts. Though small in number, the team can respond quickly to those most in need with the help of algorithms that prioritize those experiencing a more urgent need based on tone analysis and other factors, Staheli said.
"So that way, we can start to float the conversations that need to happen in a more timely manner to the top," Staheli said.
Other than Melo, the counselors don't have counseling licensure but get trained to the standard of those who work within other suicide prevention programs, Melo said.
"We're all interacting, all the messages are completely open so that other school counselors can see them, and whenever there are messages that they feel are a little bit more critical, then they flag those specific messages and I respond to those directly," he said.
The company plans to eventually add other licensed counselors to the team. Through the program, schools that want their own counselors to respond to texts can do so.
On Mondays, SchoolPulse usually sends out a short podcast or video based on questions teens ask each week, Melo said.
"Kids ask us everything. And we respond to them via text, and we also get to these questions and I provide these things on Monday. This is what we call our social and emotional learning Monday," he said.
On Wednesdays, SchoolPulse runs a short survey to all students registered in the program, which gauges stress, anxiety and general wellness. The students respond with a number rating and immediately receive a text back from SchoolPulse meant to normalize and validate what they're feeling, according to Melo.
Counselors then end up conversing with the students and asking them what's going well and what's not going well in their lives, he said.
On Fridays, SchoolPulse sends a text asking students to share things like their favorite inspiring quote, what makes them laugh or their favorite joke. The program also shares personality quizzes to help students understand themselves better.
"And kids reply by the hundreds and hundreds," Melo said.
Melo said the program's goal isn't to treat students in isolation but help lead them to working with their parents and other resources. That can include encouraging students to reach out to their school counselor.
"All of these interactions ultimately lead to us creating a relationship of trust, a place where they feel safe, and because they know that every text that comes to us is completely 100% anonymous, it's confidential, it's private, and probably most of all it is absolutely convenient, that's why we are getting the record numbers of interactions that we are," he said.
Some teens send in "smart alec" remarks, like asking how to make a paper airplane, noted Justin Lund, an emotional health ambassador with the program. But SchoolPulse sees any interaction as positive, and those kids often later ask for help with dealing with the pressure of finals, Lund said.
"And to have a place where they can say, 'My sister is using drugs and fighting with my parents. Every day it's bad at home. I don't know what to do.' I don't know that that kid would feel comfortable saying that to their school counselor who also probably knows who the parents are and also knows who the sister is, and that might be a dramatic and scary conversation to start. But they're able to get that through this anonymous source that's always uplifting, that's always positive," Lund said.
Gathering data on student well-being
Through the program, school officials also receive a dashboard that shows aggregated, schoolwide data to help determine the "emotional pulse of the school, day to day, month to month, week to week, year-long," Melo said.
Keate said the work complements the efforts being made by teachers and counselors, and helps school officials get insight into students' mental health through the weekly check-ins.
Counselors still meet with students, and Desert Hills has a "wellness room," but SchoolPulse helps the school reach more students — the whole student body — at once.
"It helps, more than anything, drive our intervention efforts with students," Keate said. "It gives us a good idea, it helps drive our intervention efforts because we kind of know how kids are feeling about life and about things, so it helps us know if the intervention that we're doing, if we're heading in the right direction."
Because students sign up for SchoolPulse anonymously, data doesn't get sent to parents. If parents want to see their child's conversations, they need to look at their phone. Parents do get notified when schools implement SchoolPulse.
Ahead of this school year, Lund said the team reached out to thousands of counselors to share the program with them. Many said they sit in front of their webcam for four to six hours each day during the pandemic, waiting for students to show up to speak to them.
"The things they're doing are amazing. But the common thread that we hear from all of them is, 'But it's not enough, it's not working. I'm losing touch, they're getting further and further away. I haven't heard from most of these kids for six months,'" Lund said.
He said many also feel "out of gas" from changing education plans and going back and forth between virtual and in-classroom learning.
Keate said he believes the program has had "an overall positive impact on the student body."
He called SchoolPulse a "proactive solution" to help students who choose to opt in. In his years involved in school administration, he said he "got tired of being reactive."
Keate said he wants to give students a quality academic education, "but I also want every one of those students at my school to know that they matter, that we care about them."
Within the first month of implementing the program, Keate said school officials noted dozens of conversations each day taking place between students and SchoolPulse counselors, meaning kids were "talking and being open about the things they're struggling with."
"Schools can do more for their students in relationship to social-emotional learning and mental health struggles for the kids. We don't need to be reactive, we can go on the proactive approach with students and this is one of those solutions," Keate said.
The Utah Department of Health offers suicide prevention help at utahsuicideprevention.org/suicide-prevention-basics. The national crisis hotline is 1-800-784-2433.
Suicide Prevention Resources
- Utah County Crisis Line: 801-691-5433
- Salt Lake County/UNI Crisis Line: 801-587-3000
- Wasatch Mental Health Crisis Line: 801-373-7393
- National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
- Trevor Project Hotline for LGBTQ teens: 1-866-488-7386