How is virtual mental health serving Gen Z?

In May 2020, what was supposed to be an extended Spring Break for many Gen-Z students turned into a fully virtual commencement to the academic year.

For Julia Gonsman, a high school senior from Pleasanton, California, senior year did not include attending prom, crossing the stage to receive her diploma or any of the other quintessential landmarks for high schoolers in America. “We went to my friend’s house and got dressed up,” she says, recalling what stood in for the prom experience. “And it was only a small group of us. Our moms had planned it out. We didn’t know. We pretty much had prom in the backyard. It was really sad.”

Three-hundred-fifty miles south, in San Marino, California, Jocelle, another high school senior who declined the use of her name due to stigmas against mental health, had her commencement ceremony virtually. The class of 2020 high school graduate, complimented her school’s efforts to make this pivotal time as normal as possible “Missing out on graduation, definitely was hard,” Jocelle recalls. “But then again, my school went above and beyond to attempt to make it as normal as possible. We literally shot in front of a green screen, so they could Photoshop all of us doing this thing called the Rose toss together.” Jocelle says she experienced a lack of closure, emphasizing how her school put forth a valiant effort to keep the senior traditions alive, such as car painting. “I think if anything, what really affected me and my class the most, was not being able to experience a normal week of school,” she says. “We were able to do our painting cars tradition, but socially distanced. So it wasn’t really a tradition that was being lost. It was more so, having closure and being able to say goodbye to people that were really important in your life for such a long time.”

For Gonsman, missing out on the landmark moments at the tail end of senior year and beginning of college weighed heavily on her, impacting her mental health. “It definitely got way worse because, we all were kind of shocked by the shutdown, but also, just the missing of opportunities, the missing of events like walking across the stage,” she says. “And then going into our freshman year, which was bad because we didn’t really get to acclimate ourselves with all the other freshmen. It was very isolating, especially with going on to Zoom, you feel very disconnected from people. Even though you’re talking to them, it’s just not the same.”

Jocelle shared a similar sentiment about her own decline in mental health during the COVID-19 shutdowns and the challenges of meeting with her mental health care provider virtually. “In person, you know, I would be crying right in front of her, and she would hand me a tissue,” Jocelle says. “Therapists don’t really hug people. That’s not really what they’re supposed to do, but even the handing of a tissue meant a lot to me.” Although the transition to virtual mental health care was initially difficult for Jocelle, she now appreciates it for the convenience but still has some reservations especially about privacy while living with others. “I live in a sorority house, it’s hard to get privacy there, and in the dorms, that was hard, and in my apartment, that was hard,” she says “It’s just hard to schedule therapy at a time where you know you’ll have complete and utter privacy.”

Gen Z students were especially affected by the repercussions of the pandemic. Not only did they miss out on many monumental life moments they were also expected to transition into college during this time of societal upheaval. Students were expected to acclimatize to new environments, all while dealing with the academic rigor of college courses and the challenges of the pandemic. It’s no surprise that rates of psychological stress for young adult populations reported a 95% increase in 2021, following the pandemic.

Dr. Quade French, who serves as the Associate Dean of USC Dornsife, Chief Diversity Office, and who is also a clinical psychologist, says, “More students are reporting anxiety and depressive symptoms than ever before.” Although there has been a significant increase in reporting symptoms, French also notes that we should be cautious with this new data. “A big part of it as well, is that more students don’t feel stigma,” French says. “They feel freer, and less shame, to talk about these sorts of things. It’s not the whole picture by any means, but I think that’s a significant part.” He finds it encouraging that mental health has become less stigmatized with Gen Z and that it has become a part of their common language.

The impact of the pandemic on the mental health of Gen Z students is a topic Dr. Broderick Leaks has also been studying. Leaks, who is Vice Chair for Student Mental Health with the Department of Psychiatry and Behavioral Sciences, the Director of Counseling and Mental Health at USC and a psychologist says, “We were trying to match the students’ needs with the kinds of programming that we had available,” Leaks says. “There might be a mental health crisis, and of course, they’re going to see a therapist to help them.” Not every student is in crisis though. Leaks has spearheaded the need for different models of care. “There are other students who maybe are going through something that doesn’t rise to the level of needing to actually see someone in person,” he says. Accordingly, USC has partnered with OASIS, a mental health app that allows students to chat with a mental health support worker. They have also partnered with a UAE College that offers modules and interactive learning tools around mental health support for students, to provide another alternative. Leaks says that these technological solutions have been a major investment for USC as an approach to best serve and provide tools to the diverse student body.

Having multiple resources is important in addressing mental health needs and being able to serve students in the best way possible, but it’s not just about having the resources at your fingertips. French says that it’s important to know why one is seeking mental health resources. “It’s that first question: ‘What are my needs?’” French asks. “And I think that's where it can be a little tricky for people to figure out to really understand.” French emphasizes that it is essential to ask if a student can have their needs met effectively through an app. He says that regardless of the avenue of mental health resources pursued, if students don’t have the right “why” they’re unlikely to find the remedies to be successful. Instead, French encourages students to “take [their] time, and put some work in really trying to understand what the underlying causes of your distress are. Because it's a painful path, to engage in support services, if you're addressing the wrong questions.”

As for the validity of these virtual mental health resources, French does have some concerns, particularly about the quality of care. “There's a whole machine of wellbeing and wellness that’s out there that I think really does frame it in a real kind of consumer sort of perfection model,” he says. Mental health advertising via social media portrays therapy as a necessity of well-being and serving oneself, and although the discussion has been opened, French still has reservations. “I think that also puts a lot of pressure on students. It’s like, oh, well, if I’m not seeing a therapist, then I’m not doing everything I possibly can.”

Other experts agree. Dr. Michael Dunbar, a clinical psychologist with the RAND group, says, “For me the most important consideration is, are the services that people are accessing and that telehealth providers are offering, are they actually high-quality services that address the needs of people who seek and in many cases pay for them?”

Because so many colleagues in the mental health field share concerns for quality of care and patient privacy, Leaks says that USC conducted an intense vetting process with virtual mental health services to ensure safety, privacy, and a high quality of service for students. As student safety was at the forefront of the process, Leaks detailed the vetting process he and his team went through with about 20-30 companies out of the hundreds that had reached out to him. “You have to really have a strong vetting process to make sure that any partner that we connect with has high quality, good outcomes, and then also just from a legal and risk perspective, that they have everything in place to make sure that our community is protected,” Leaks says.

Calm, a meditation app that is popular among teenagers.

Ultimately, mental health providers say it is too soon to decide whether or not mental health resources will sink or swim in the virtual space, French says. “It’s like with Facebook, everyone got on Facebook, because they just thought it was so amazing, and it was revolutionary in many ways. Then there was a period where it’s like, no, I don’t want to do this anymore.” French thinks that we could see the same fluctuation with mental health services, especially through the virtual space. “I think people are like, Oh…mental health…well-being…let me go and find a therapist. And let me go online and go on one of those, like, on an app or something.” Regardless of this potential drop off, French says these resources are a net good, but greater adoption of them just may take some time.

About 10 miles northwest of USC, Jocelle sits in her sorority house in Westwood. Her roommate is at class, and Joelle is about to log on to see the same therapist she has been seeing since her senior year of high school. She says that the convenience of meeting online is helpful as she now lives about 20 miles from her therapist’s office. “Transitioning back to going in person would just be, not really feasible for me,” she says. As Gen Z emerges from the isolation of the pandemic, one thing is clear. The availability of virtual mental health resources has opened the door to students like Gonsman, Joelle and other Gen Zers to continue accessing mental health resources.

Both Julia and Joelle say they look forward to walking across the stage in 2024 at UC Berkeley and UCLA respectively. An achievement they’ve dreamed of for so long, and no doubt have online mental health treatment options to thank in part for helping them get there.