Mammography AI Can Cost Patients Extra. Is It Worth It?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
As I checked in at a Manhattan radiology clinic for my annual mammogram in November, the front desk staffer reviewing my paperwork asked an unexpected question: Would I like to spend $40 for an artificial intelligence analysis of my mammogram? It’s not covered by insurance, she added.
I had no idea how to evaluate that offer. Feeling upsold, I said no. But it got me thinking: Is this something I should add to my regular screening routine? Is my regular mammogram not accurate enough? If this AI analysis is so great, why doesn’t insurance cover it?
I’m not the only person posing such questions. The mother of a colleague had a similar experience when she went for a mammogram recently at a suburban Baltimore clinic. She was given a pink pamphlet that said: “You Deserve More. More Accuracy. More Confidence. More power with artificial intelligence behind your mammogram.” The price tag was the same: $40. She also declined.
In recent years, AI software that helps radiologists detect problems or diagnose cancer using mammography has been moving into clinical use. The software can store and evaluate large datasets of images and identify patterns and abnormalities that human radiologists might miss. It typically highlights potential problem areas in an image and assesses any likely malignancies. This extra review has enormous potential to improve the detection of suspicious breast masses and lead to earlier diagnoses of breast cancer.
While studies showing better detection rates are extremely encouraging, some radiologists say, more research and evaluation are needed before drawing conclusions about the value of the routine use of these tools in regular clinical practice.
“I see the promise and I hope it will help us,” said Etta Pisano, a radiologist who is chief research officer at the American College of Radiology, a professional group for radiologists. However, “it really is ambiguous at this point whether it will benefit an individual woman,” she said. “We do need more information.”
The radiology clinics that my colleague’s mother and I visited are both part of RadNet, a company with a network of more than 350 imaging centers around the country. RadNet introduced its AI product for mammography in New York and New Jersey last February and has since rolled it out in several other states, according to Gregory Sorensen, the company’s chief science officer.
Sorensen pointed to research the company conducted with 18 radiologists, some of whom were specialists in breast mammography and some of whom were generalists who spent less than 75% of their time reading mammograms. The doctors were asked to find the cancers in 240 images, with and without AI. Every doctor’s performance improved using AI, Sorensen said.
Among all radiologists, “not every doctor is equally good,” Sorensen said. With RadNet’s AI tool, “it’s as if all patients get the benefit of our very top performer.”
But is the tech analysis worth the extra cost to patients? There’s no easy answer.
“Some people are always going to be more anxious about their mammograms, and using AI may give them more reassurance,” said Laura Heacock, a breast imaging specialist at NYU Langone Health’s Perlmutter Cancer Center in New York. The health system has developed AI models and is testing the technology with mammograms but doesn’t yet offer it to patients, she said.
Still, Heacock said, women shouldn’t worry that they need to get an additional AI analysis if it’s offered.
“At the end of the day, you still have an expert breast imager interpreting your mammogram, and that is the standard of care,” she said.
About 1 in 8 women will be diagnosed with breast cancer during their lifetime, and regular screening mammograms are recommended to help identify cancerous tumors early. But mammograms are hardly foolproof: They miss about 20% of breast cancers, according to the National Cancer Institute.
The FDA has authorized roughly two dozen AI products to help detect and diagnose cancer from mammograms. However, there are currently no billing codes radiologists can use to charge health plans for the use of AI to interpret mammograms. Typically, the federal Centers for Medicare & Medicaid Services would introduce new billing codes and private health plans would follow their lead for payment. But that hasn’t happened in this field yet and it’s unclear when or if it will.
CMS didn’t respond to requests for comment.
Thirty-five percent of women who visit a RadNet facility for mammograms pay for the additional AI review, Sorensen said.
Radiology practices don’t handle payment for AI mammography all in the same way.
The practices affiliated with Boston-based Massachusetts General Hospital don’t charge patients for the AI analysis, said Constance Lehman, a professor of radiology at Harvard Medical School who is co-director of the Breast Imaging Research Center at Mass General.
Asking patients to pay “isn’t a model that will support equity,” Lehman said, since only patients who can afford the extra charge will get the enhanced analysis. She said she believes many radiologists would never agree to post a sign listing a charge for AI analysis because it would be off-putting to low-income patients.
Sorensen said RadNet’s goal is to stop charging patients once health plans realize the value of the screening and start paying for it.
Some large trials are underway in the United States, though much of the published research on AI and mammography to date has been done in Europe. There, the standard practice is for two radiologists to read a mammogram, whereas in the States only one radiologist typically evaluates a screening test.
Interim results from the highly regarded MASAI randomized controlled trial of 80,000 women in Sweden found that cancer detection rates were 20% higher in women whose mammograms were read by a radiologist using AI compared with women whose mammograms were read by two radiologists without any AI intervention, which is the standard of care there.
“The MASAI trial was great, but will that generalize to the U.S.? We can’t say,” Lehman said.
In addition, there is a need for “more diverse training and testing sets for AI algorithm development and refinement” across different races and ethnicities, said Christoph Lee, director of the Northwest Screening and Cancer Outcomes Research Enterprise at the University of Washington School of Medicine.
The long shadow of an earlier and largely unsuccessful type of computer-assisted mammography hangs over the adoption of newer AI tools. In the late 1980s and early 1990s, “computer-assisted detection” software promised to improve breast cancer detection. Then the studies started coming in, and the results were often far from encouraging. Using CAD at best provided no benefit, and at worst reduced the accuracy of radiologists’ interpretations, resulting in higher rates of recalls and biopsies.
“CAD was not that sophisticated,” said Robert Smith, senior vice president of early cancer detection science at the American Cancer Society. Artificial intelligence tools today are a whole different ballgame, he said. “You can train the algorithm to pick up things, or it learns on its own.”
Smith said he found it “troubling” that radiologists would charge for the AI analysis.
“There are too many women who can’t afford any out-of-pocket cost” for a mammogram, Smith said. “If we’re not going to increase the number of radiologists we use for mammograms, then these new AI tools are going to be very useful, and I don’t think we can defend charging women extra for them.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Buffed-Up Buffalo Cauliflower
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
This is a tasty snack that also more protein than you’d think, because of the garbanzo bean flour. It also has plenty of health-giving spices, as well as blood-sugar-balancing vinegar, no added sugar, and very little salt.
You will need
- 1 medium head of cauliflower, cut into florets
- ½ cup garbanzo bean flour
- ½ cup water
- ⅓ cup hot sauce (we recommend a low-sugar kind; Nando’s hot sauce is good for this if available where you are, as it has no added sugar and its main ingredient by volume is vinegar, which is good for balancing blood sugars)
- 2 tbsp extra virgin olive oil, plus more for the pan
- 2 tsp garlic powder
- 2 tsp nutritional yeast
- 2 tsp black pepper, freshly ground
- 1 tsp smoked paprika
- ½ tsp MSG, or 1 tsp low sodium salt
For the ranch sauce:
- ½ cup raw sunflower seeds
- ⅓ cup water
- ⅓ cup milk (plant milk being healthiest if you choose one that’s unsweetened)
- 2 tbsp apple cider vinegar
- 2 tbsp extra virgin olive oil
- 1 tsp onion powder
- 1 tsp dried thyme
- 1 tsp dried oregano
- 1 tsp dried dill
- ½ tsp MSG, or 1 tsp low sodium salt
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 400℉/200℃.
2) Blend the ranch sauce ingredients until smooth, and set aside.
3) Mix the buffalo cauliflower ingredients except for the cauliflower, in a big bowl.
4) Add the cauliflower to the big bowl, mixing well to coat evenly.
5) Bake the buffalo cauliflower florets on a baking tray lined with baking paper, for about 25 minutes, turning gently if it seems they are at risk of cooking unevenly.
6) Serve hot, with the sunflower ranch on the side!
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- An Apple (Cider Vinegar) A Day…
- 10 Ways To Balance Blood Sugars
- Our Top 5 Spices: How Much Is Enough For Benefits?
Take care!
Share This Post
-
Health Nut: A Feel-Good Cookbook – by Jess Damuck
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
The author is a classically trained chef (worked with Martha Stewart for a long time!), and while health is the focus here, it’s not the be-all-and-end-all, so there’s a lot of attention given to pleasure also. Which, after all, is not a zero-sum game—we can have both!
So, the title and subtitle together sum up the ethos of the book pretty well.
The recipes themselves are divided into categories by meal-type, snacks, desserts, etc. They’re varied enough to suit most moods and seasons, as well as being equally appropriate for cooking for one, or a family, or entertaining. Many (but not all) of the recipes are vegan, though where they’re not, the substitutions are mostly easy and obvious, or explained, or else alternative recipes are given (for example a vegan “tuna” recipe).
In terms of complexity, these are not very complex, yet include everything they need to to make things interesting. That said, the ingredients are also not obscure, and should be easy to find in any reasonably well-stocked supermarket.
One small downside is that many of the recipes are not illustrated, but the instructions are clear enough that this isn’t really a problem, in this reviewer’s opinion.
Bottom line: if you’d like to broaden your kitchen repertoire with plants-forward cooking from an accomplished chef, then this is a good book for that.
Click here to check out Health Nut, and enjoy the feel-good food!
Share This Post
-
The Purple Parsnip’s Bioactive Brain Benefits (& more)
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
This Root Might Be A Guardian Angel
Sometimes we go searching for supplements to research; sometimes supplements present themselves for examination! In this case, our attention was grabbed by a headline:
Angelica gigas extract emerges as a potential treatment for vascular disease
Angelica who?
Angelica gigas, also called the purple parsnip (amongst other names), is a flowering plant native to Korea. It has assorted medicinal properties, and in this case, it was its heart-healthy benefits that were making news:
❝Ultimately, this study presents clearly evidence that Angelica gigas extract is a promising natural product-based functional food/herbal medicine candidate for preventing or regulating hyperlipidemic cardiovascular complications❞
But it has a lot more to offer…
The root has various bioactive metabolites, but the compounds that most studies are most interested in are decursin and decursinol, for their neuroprotective and cognitive enhancement effects:
❝[C]rude extracts and isolated components from the root of A. gigas exhibited neuroprotective and cognitive enhancement effects.
Neuronal damage or death is the most important factor for many neurodegenerative diseases.
In addition, recent studies have clearly demonstrated the possible mechanisms behind the neuroprotective action of extracts/compounds from the root of A. gigas.❞
That middle paragraph there? That’s one of the main pathogenic processes of Alzheimer’s, Parkinson’s, Huntington’s, and Multiple Sclerosis.
Angelica gigas attenuates (reduces the force of) that process:
❝The published reports revealed that the extracts and isolated components from the root of A. gigas showed neuroprotective and cognitive enhancement properties through various mechanisms such as anti-apoptosis, antioxidative actions, inhibiting mRNA and protein expressions of inflammatory mediators and regulating a number of signaling pathways.
In conclusion, the A. gigas root can serve as an effective neuroprotective agent by modulating various pathophysiological processes❞
Read more: Neuroprotective and Cognitive Enhancement Potentials of Angelica gigas Nakai Root: A Review
Beyond neuroprotection & cognitive enhancement
…and also beyond its protection against vascular disease, which is what got our attention…
Angelica gigas also has antioxidant properties, anti-cancer properties, and general immune-boosting properties.
We’ve only so much room, so: those links above will take you to example studies for those things, but there are plenty more where they came from, so we’re quite confident in this one.
Of course, what has antioxidant properties is usually anti-inflammatory, anti-cancer, and anti-aging, because these things are reliant on many of the same processes as each other, with a lot of overlap.
Where can we get it?
We don’t sell it, but here’s an example product on Amazon, for your convenience
Enjoy!
Share This Post
-
I’ve been sick. When can I start exercising again?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
You’ve had a cold or the flu and your symptoms have begun to subside. Your nose has stopped dripping, your cough is clearing and your head and muscles no longer ache.
You’re ready to get off the couch. But is it too early to go for a run? Here’s what to consider when getting back to exercising after illness.
Ketut Subiyanto/Pexels Exercise can boost your immune system – but not always
Exercise reduces the chance of getting respiratory infections by increasing your immune function and the ability to fight off viruses.
However, an acute bout of endurance exercise may temporarily increase your susceptibility to upper respiratory infections, such as colds and the flu, via the short-term suppression of your immune system. This is known as the “open window” theory.
A study from 2010 examined changes in trained cyclists’ immune systems up to eight hours after two-hour high-intensity cycling. It found important immune functions were suppressed, resulting in an increased rate of upper respiratory infections after the intense endurance exercise.
So, we have to be more careful after performing harder exercises than normal.
Can you exercise when you’re sick?
This depends on the severity of your symptoms and the intensity of exercise.
Mild to moderate exercise (reducing the intensity and length of workout) may be OK if your symptoms are a runny nose, nasal congestion, sneezing and minor sore throat, without a fever.
Exercise may help you feel better by opening your nasal passages and temporarily relieving nasal congestion.
If you have a runny or blocked nose and no fever, low-intensity movement such as a walk might help. Laker/Pexels However, if you try to exercise at your normal intensity when you are sick, you risk injury or more serious illness. So it’s important to listen to your body.
If your symptoms include chest congestion, a cough, upset stomach, fever, fatigue or widespread muscle aches, avoid exercising. Exercising when you have these symptoms may worsen the symptoms and prolong the recovery time.
If you’ve had the flu or another respiratory illness that caused a high fever, make sure your temperature is back to normal before getting back to exercise. Exercising raises your body temperature, so if you already have a fever, your temperature will become high quicker, which makes you sicker.
If you have COVID or other contagious illnesses, stay at home, rest and isolate yourself from others.
When you’re sick and feel weak, don’t force yourself to exercise. Focus instead on getting plenty of rest. This may actually shorten the time it takes to recover and resume your normal workout routine.
I’ve been sick for a few weeks. What has happened to my strength and fitness?
You may think taking two weeks off from training is disastrous, and worry you’ll lose the gains you’ve made in your previous workouts. But it could be just what the body needs.
It’s true that almost all training benefits are reversible to some degree. This means the physical fitness that you have built up over time can be lost without regular exercise.
To study the effects of de-training on our body functions, researchers have undertaken “bed rest” studies, where healthy volunteers spend up to 70 days in bed. They found that V̇O₂max (the maximum amount of oxygen a person can use during maximal exercise, which is a measure of aerobic fitness) declines 0.3–0.4% a day. And the higher pre-bed-rest V̇O₂max levels, the larger the declines.
In terms of skeletal muscles, upper thigh muscles become smaller by 2% after five days of bed rest, 5% at 14 days, and 12% at 35 days of bed rest.
Muscle strength declines more than muscle mass: knee extensor muscle strength gets weaker by 8% at five days, 12% at 14 days and more than 20% after around 35 days of bed rest.
This is why it feels harder to do the same exercises after resting for even five days.
In bed rest studies, participants don’t get up. But they do in real life. Olly/Pexels But in bed rest studies, physical activities are strictly limited, and even standing up from a bed is prohibited during the whole length of a study. When we’re sick in bed, we have some physical activities such as sitting on a bed, standing up and walking to the toilet. These activities could reduce the rate of decreases in our physical functions compared with study participants.
How to ease back into exercise
Start with a lower-intensity workout initially, such as going for a walk instead of a run. Your first workout back should be light so you don’t get out of breath. Go low (intensity) and go slow.
Gradually increase the volume and intensity to the previous level. It may take the same number of days or weeks you rested to get back to where you were. If you were absent from an exercise routine for two weeks, for example, it may require two weeks for your fitness to return to the same level.
If you feel exhausted after exercising, take an extra day off before working out again. A day or two off from exercising shouldn’t affect your performance very much.
Ken Nosaka, Professor of Exercise and Sports Science, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Top 10 Foods That Promote Lymphatic Drainage and Lymph Flow
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Melissa Gallagher, a naturopath by profession, recommends the following 10 foods that she says promote lymphatic drainage and lymph flow, as well as the below-mentioned additional properties:
Ginger
Ginger is a natural anti-inflammatory, which we wrote about here:
Ginger Does A Lot More Than You Think
Turmeric
Turmeric is another natural anti-inflammatory, which we wrote about here:
Why Curcumin (Turmeric) Is Worth Its Weight In Gold
Garlic
Garlic is—you guessed it—another natural anti-inflammatory which we wrote about here:
The Many Health Benefits Of Garlic
Pineapple
Pineapple contains a collection of enzymes collectively called bromelain—which is a unique kind of anti-inflammatory, and which we have written about here:
Bromelain vs Inflammation & Much More
Citrus
Citrus fruits like oranges, lemons, and grapefruits are rich in vitamin C, which can help support the immune system in general.
Cranberry
Cranberries contain antioxidants and anti-inflammatory compounds, which we wrote about here:
Health Benefits Of Cranberries (But: You’d Better Watch Out)
The video also explains how cranberry bioactives inhibit adipogenesis and reduces fat congestion in your lymphatic system.
Dandelion Tea
Dandelion is a natural diuretic and anti-inflammatory herb, which we’ve not written about yet!
Nettle Tea
Nettle is a natural diuretic and anti-inflammatory herb, which we’ve also not written about yet!
Healthy Fats
Healthy fats like avocado, nuts, and olive oil can help reduce inflammation and support the immune system.
Fermented Foods
Fermented foods, such as kimchi and sauerkraut, contain probiotics that can improve gut health, which in turn boosts the immune system. You can read all about it here:
Making Friends With Your Gut (You Can Thank Us Later)
Want the full explanation? Here’s the video:
Click Here If The Embedded Video Doesn’t Load Automatically!
How was the video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
California Is Investing $500M in Therapy Apps for Youth. Advocates Fear It Won’t Pay Off.
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
With little pomp, California launched two apps at the start of the year offering free behavioral health services to youths to help them cope with everything from living with anxiety to body acceptance.
Through their phones, young people and some caregivers can meet BrightLife Kids and Soluna coaches, some who specialize in peer support or substance use disorders, for roughly 30-minute virtual counseling sessions that are best suited to those with more mild needs, typically those without a clinical diagnosis. The apps also feature self-directed activities, such as white noise sessions, guided breathing, and videos of ocean waves to help users relax.
“We believe they’re going to have not just great impact, but wide impact across California, especially in places where maybe it’s not so easy to find an in-person behavioral health visit or the kind of coaching and supports that parents and young people need,” said Gov. Gavin Newsom’s health secretary, Mark Ghaly, during the Jan. 16 announcement.
The apps represent one of the Democratic governor’s major forays into health technology and come with four-year contracts valued at $498 million. California is believed to be the first state to offer a mental health app with free coaching to all young residents, according to the Department of Health Care Services, which operates the program.
However, the rollout has been slow. Only about 15,000 of the state’s 12.6 million children and young adults have signed up for the apps, school counselors say they’ve never heard of them, and one of the companies isn’t making its app available on Android phones until summer.
Advocates for youth question the wisdom of investing taxpayer dollars in two private companies. Social workers are concerned the companies’ coaches won’t properly identify youths who need referrals for clinical care. And the spending is drawing lawmaker scrutiny amid a state deficit pegged at as much as $73 billion.
An App for That
Newsom’s administration says the apps fill a need for young Californians and their families to access professional telehealth for free, in multiple languages, and outside of standard 9-to-5 hours. It’s part of Newsom’s sweeping $4.7 billion master plan for kids’ mental health, which was introduced in 2022 to increase access to mental health and substance use support services. In addition to launching virtual tools such as the teletherapy apps, the initiative is working to expand workforce capacity, especially in underserved areas.
“The reality is that we are rarely 6 feet away from our devices,” said Sohil Sud, director of Newsom’s Children and Youth Behavioral Health Initiative. “The question is how we can leverage technology as a resource for all California youth and families, not in place of, but in addition to, other behavioral health services that are being developed and expanded.”
The virtual platforms come amid rising depression and suicide rates among youth and a shortage of mental health providers. Nearly half of California youths from the ages of 12 to 17 report having recently struggled with mental health issues, with nearly a third experiencing serious psychological distress, according to a 2021 study by the UCLA Center for Health Policy Research. These rates are even higher for multiracial youths and those from low-income families.
But those supporting youth mental health at the local level question whether the apps will move the needle on climbing depression and suicide rates.
“It’s fair to applaud the state of California for aggressively seeking new tools,” said Alex Briscoe of California Children’s Trust, a statewide initiative that, along with more than 100 local partners, works to improve the social and emotional health of children. “We just don’t see it as fundamental. And we don’t believe the youth mental health crisis will be solved by technology projects built by a professional class who don’t share the lived experience of marginalized communities.”
The apps, BrightLife Kids and Soluna, are operated by two companies: Brightline, a 5-year-old venture capital-backed startup; and Kooth, a London-based publicly traded company that has experience in the U.K. and has also signed on some schools in Kentucky and Pennsylvania and a health plan in Illinois. In the first five months of Kooth’s Pennsylvania pilot, 6% of students who had access to the app signed up.
Brightline and Kooth represent a growing number of health tech firms seeking to profit in this space. They beat out dozens of other bidders including international consulting companies and other youth telehealth platforms that had already snapped up contracts in California.
Although the service is intended to be free with no insurance requirement, Brightline’s app, BrightLife Kids, is folded into and only accessible through the company’s main app, which asks for insurance information and directs users to paid licensed counseling options alongside the free coaching. After KFF Health News questioned why the free coaching was advertised below paid options, Brightline reordered the page so that, even if a child has high-acuity needs, free coaching shows up first.
The apps take an expansive view of behavioral health, making the tools available to all California youth under age 26 as well as caregivers of babies, toddlers, and children 12 and under. When KFF Health News asked to speak with an app user, Brightline connected a reporter with a mother whose 3-year-old daughter was learning to sleep on her own.
‘It’s Like Crickets’
Despite being months into the launch and having millions in marketing funds, the companies don’t have a definitive rollout timeline. Brightline said it hopes to have deployed teams across the state to present the tools in person by midyear. Kooth said developing a strategy to hit every school would be “the main focus for this calendar year.”
“It’s a big state — 58 counties,” Bob McCullough of Kooth said. “It’ll take us a while to get to all of them.”
So far BrightLife Kids is available only on Apple phones. Brightline said it’s aiming to launch the Android version over the summer.
“Nobody’s really done anything like this at this magnitude, I think, in the U.S. before,” said Naomi Allen, a co-founder and the CEO of Brightline. “We’re very much in the early innings. We’re already learning a lot.”
The contracts, obtained by KFF Health News through a records request, show the companies operating the two apps could earn as much as $498 million through the contract term, which ends in June 2027, months after Newsom is set to leave office. And the state is spending hundreds of millions more on Newsom’s virtual behavioral health strategy. The state said it aims to make the apps available long-term, depending on usage.
The state said 15,000 people signed up in the first three months. When KFF Health News asked how many of those users actively engaged with the app, it declined to say, noting that data would be released this summer.
KFF Health News reached out to nearly a dozen California mental health professionals and youths. None of them were aware of the apps.
“I’m not hearing anything,” said Loretta Whitson, executive director of the California Association of School Counselors. “It’s like crickets.”
Whitson said she doesn’t think the apps are on “anyone’s” radar in schools, and she doesn’t know of any schools that are actively advertising them. Brightline will be presenting its tool to the counselor association in May, but Whitson said the company didn’t reach out to plan the meeting; she did.
Concern Over Referrals
Whitson isn’t comfortable promoting the apps just yet. Although both companies said they have a clinical team on staff to assist, Whitson said she’s concerned that the coaches, who aren’t all licensed therapists, won’t have the training to detect when users need more help and refer them to clinical care.
This sentiment was echoed by other school-based social workers, who also noted the apps’ duplicative nature — in some counties, like Los Angeles, youths can access free virtual counseling sessions through Hazel Health, a for-profit company. Nonprofits, too, have entered this space. For example, Teen Line, a peer-to-peer hotline operated by Southern California-based Didi Hirsch Mental Health Services, is free nationwide.
While the state is also funneling money to the schools as part of Newsom’s master plan, students and school-based mental health professionals voiced confusion at the large app investment when, in many school districts, few in-person counseling roles exist, and in some cases are dwindling.
Kelly Merchant, a student at College of the Desert in Palm Desert, noted that it can be hard to access in-person therapy at her school. She believes the community college, which has about 15,000 students, has only one full-time counselor and one part-time bilingual counselor. She and several students interviewed by KFF Health News said they appreciated having engaging content on their phone and the ability to speak to a coach, but all said they’d prefer in-person therapy.
“There are a lot of people who are seeking therapy, and people close to me that I know. But their insurances are taking forever, and they’re on the waitlist,” Merchant said. “And, like, you’re seeing all these people struggle.”
Fiscal conservatives question whether the money could be spent more effectively, like to bolster county efforts and existing youth behavioral health programs.
Republican state Sen. Roger Niello, vice chair of the Senate Budget and Fiscal Review Committee, noted that California is forecasted to face deficits for the next three years, and taxpayer watchdogs worry the apps might cost even more in the long run.
“What starts as a small financial commitment can become uncontrollable expenses down the road,” said Susan Shelley of the Howard Jarvis Taxpayers Association.
This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
USE OUR CONTENT
This story can be republished for free (details).
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
