缺乏咨询师，美国学校转向在线心理健康服务或远程治疗

Public schools in the United States are increasingly employing online mental health services, or teletherapy, for students.

美国的公立学校越来越多地为学生提供在线心理健康服务或远程治疗。

At least 16 of the 20 largest American public school systems are offering online therapy to reach millions of students, reports the Associated Press. In those systems alone, schools have signed provider contracts worth more than $70 million.

据美联社报道，美国20所最大的公立学校系统中，至少有16所正在为数百万学生提供在线治疗。仅在这些系统中，学校就签署了价值超过7000万美元的供应商合同。

The business model is making so much money that venture capitalists are investing in new companies as the market grows. However, some experts have raised concerns about the quality of care offered by fast-growing tech companies.

这种商业模式赚了很多钱，以至于随着市场的增长，风险资本家开始投资新公司。然而，一些专家对快速发展的科技公司提供的医疗服务质量表示担忧。

But educators say teletherapy works for many kids and is meeting a large need. Schools are also experiencing shortages in on-site therapists. Online help has made therapy more easily available to children, especially poorer students and those in rural areas. Schools let students connect with online counselors during the school day or after hours from home.

但教育工作者表示，远程治疗对许多孩子都有效，并且满足了很大的需求。学校也面临着现场治疗师短缺的问题。网络帮助使得儿童，特别是贫困学生和农村地区的儿童更容易获得治疗。学校允许学生在上学期间或下班后与在线咨询师联系。

Ishoo is a mother of two in Lancaster, California. She struggled to help her second-grade daughter deal with severe anxiety.

Ishoo是两个孩子的母亲，住在加州兰开斯特。她努力帮助二年级的女儿应对严重的焦虑。

Last spring, her school district started a teletherapy program and Ishoo signed up her daughter. During a month of weekly video sessions at her home, the girl opened up to a therapist. The therapist gave the student tools and techniques to reduce anxiety.

去年春天，她所在的学区启动了一个远程治疗项目，Ishoo与她的女儿签约。在一个月的时间里，这个女孩每周在家里接受视频治疗，她向一位治疗师敞开了心扉。治疗师给学生提供了减轻焦虑的工具和技巧。

"She learned that it's OK to ask for help, and sometimes everyone needs some extra help," Ishoo said.

“她学会了寻求帮助是可以的，有时候每个人都需要一些额外的帮助，”Ishoo说。

The 13,000-student school system, like many others, has counselors and psychologists on staff. But it is not enough to meet the need, said Trish Wilson, the Lancaster supervisor of counseling.

和许多其他学校一样，这个拥有1.3万名学生的学校系统也有辅导员和心理学家。但这还不足以满足需求，兰开斯特咨询主管崔西·威尔逊说。

Therapists in the area have full caseloads, making it impossible to offer students immediate care, she said. Students rarely have to wait long for an online session.

她说，该地区的治疗师工作量很大，不可能立即为学生提供治疗。学生很少需要为在线课程等待很长时间。

Students and their parents said in interviews they turned to teletherapy after struggling with feelings of sadness, loneliness, stress and anxiety. For many, returning to in-person school after distance learning was very difficult.

学生和家长在接受采访时表示，他们在与悲伤、孤独、压力和焦虑的感觉作斗争后，转向了远程治疗。对许多人来说，远程学习结束后重返学校非常困难。

Schools are using federal pandemic relief money to pay for help as experts have warned of worrying rates of youth depression, anxiety and suicide. Many school districts are signing contracts with private companies. Others are working with local health care providers, nonprofits or state programs.

学校正在使用联邦流行病救济资金来支付帮助费用，专家们警告说，青少年抑郁、焦虑和自杀的比例令人担忧。许多学区正在与私营公司签订合同。其他人则与当地医疗服务提供者、非营利组织或州项目合作。

Mental health experts welcome the extra support but warn about possible risks. For one, it is getting harder to employ on-site school counselors and psychologists. Competition with telehealth providers is not helping.

心理健康专家对这种额外的支持表示欢迎，但也警告可能存在的风险。首先，聘请现场学校辅导员和心理学家变得越来越困难。与远程医疗服务提供商的竞争也于事无补。

"We have 44 counselor vacancies, and telehealth definitely impacts our ability to fill them," said Doreen Hogans. She is supervisor of school counseling in Prince George's County, Maryland. Hogans estimates 20 percent of school counselors who left have taken teletherapy jobs. The jobs often provide more favorable working hours than the schools.

“我们有44个顾问空缺，远程医疗肯定会影响我们填补这些空缺的能力，”多琳·霍根斯说。她是马里兰州乔治王子县的学校咨询主管。霍根斯估计，离开学校的辅导员中有20%从事了远程治疗工作。这些工作通常比学校提供更优惠的工作时间。

The quick growth of the companies raises questions about the quality of the therapists, and their experience with children and privacy, said Kevin Dahill-Fuchel. He is executive director of Counseling in Schools, a nonprofit that helps schools improve traditional, in-person mental health services.

凯文·达希尔-富切尔说，这些公司的快速发展引发了人们对治疗师的质量、他们治疗儿童的经验和隐私的质疑。他是学校咨询的执行董事，这是一个帮助学校改善传统的、面对面的心理健康服务的非营利组织。

One of the biggest providers is San Francisco-based Hazel Health. It started with telemedicine health services in schools in 2016 and expanded to mental health in May 2021, CEO Josh Golomb said. It now employs more than 300 therapists providing teletherapy in over 150 school districts in 15 states.

最大的供应商之一是总部位于旧金山的Hazel Health。该公司首席执行官乔希•戈洛姆表示，该公司于2016年开始在学校提供远程医疗健康服务，并于2021年5月扩展到心理健康领域。现在，它雇佣了300多名治疗师，在15个州的150多个学区提供远程治疗。

Other providers are getting into the space. In November, New York City started a free telehealth therapy service for teens to help end barriers to access, said Ashwin Vasan, the city's health commissioner. New York is paying the company TalkSpace $26 million over three years for a service permitting teenagers to download an app and connect with therapists.

其他供应商也在进入这一领域。纽约市卫生专员阿什温·瓦桑说，去年11月，纽约市开始为青少年提供免费的远程医疗治疗服务，以帮助消除获取服务的障碍。纽约将在三年内向TalkSpace公司支付2600万美元，用于一项允许青少年下载应用程序并与治疗师联系的服务。

Unlike other cities, New York is offering the service to all teens, whether attending private, public or home schools, or not in school at all.

与其他城市不同的是，纽约向所有青少年提供这项服务，无论他们是在私立学校、公立学校、家庭学校上学，还是根本不在学校上学。

"I truly hope this normalizes and democratizes access to mental health care for our young people," Vasan said.

瓦桑说:“我真的希望这能使我们的年轻人获得精神卫生保健的机会正常化和民主化。”