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First Episode! All About Single Session Interventions
54 Plays4 months ago
What if we are doing youth mental health all wrong? What if there is a better way? My first guest is Dr. Jessica Schleider, Director of the Lab for Scalable Mental Health at Northwestern University. She has been exploring these provocative questions for over a decade
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Transcript
Introduction to Podcast and Host
00:00:01
Speaker
Hello, welcome to Favorable Thriving Conditions, a podcast that explores how policies and programs promote or prevent thriving children, families, and communities. My name is Jay Chaudhry, and I'm your host. I'm currently a senior fellow at Sagamore Institute in Indianapolis, Indiana based think tank. I previously spent five years running and rebuilding the state behavioral health system for the state of Indiana.
Is the Current Approach to Youth Behavioral Health Flawed?
00:00:29
Speaker
What if we were doing youth behavioral health all wrong? What if there was a better way? That is the provocative question that our first guest has been exploring for more than a decade.
Introducing Dr. Jessica Schleider and Her Work
00:00:40
Speaker
Dr. Jessica Schleider is a clinical psychologist and researcher who runs the lab for scalable mental health at Northwestern University. Her research on an implementation of single session interventions could create significantly more access to evidence-based mental health care if the system will listen.
00:00:59
Speaker
I talked with Dr. Slider about her research and experiences, trying to tell anyone who will listen that there might be a better way.
00:01:10
Speaker
Hi, Jessica. Hello. Welcome to the inaugural edition of my podcast. Thanks for joining me. My pleasure to be here. Thanks for the invite. Okay. And like I said before we started recording, if you just bear with me as a very novice podcast host, I'd appreciate it.
00:01:28
Speaker
So before we get started, why don't you just kind of tell us who you are, where where you're working, and and then we can dive right in. Happy to. I'm Jessica Schleider. I'm trained as a child and adolescent clinical psychologist. And I am currently an associate professor at Northwestern University in the the departments of medical, social sciences, pediatrics, and psychology.
Understanding SSIs and Their Importance
00:01:54
Speaker
I know it's a mouthful. And I direct the Lab for Scalable Mental Health, which I founded back in 2018. The Lab for Scalable Mental Health is a group of about 30 of us now.
00:02:06
Speaker
who are working together to bridge gaps in the mental health care ecosystem by trying to create, evaluate and disseminate interventions that bridge gaps that other kinds of psychotherapies and treatments were never built to. and We focus a lot on single session interventions, which I can talk about forever if you want, but we'll try to keep it brief today, which are really any structured programs or services that could be either self-guided or human delivered that are designed to exert clinically meaningful impact in a single encounter. The reason I think these kinds of interventions are so important is because the vast majority of about 80% of youth with mental health needs never access services. The most common number of sessions
00:02:51
Speaker
when they do access services that they actually receive happens to be one. And yet our field, my field has spent decades developing interventions that are far too long and too cumbersome and too expensive to fit what people are actually using and doing in terms of their patterns of access to care. So we're trying to create new kinds of interventions that can fill gaps that other treatments can't and figure out how to make them as effective and accessible as possible. All right, great. Thank you. A couple of follow-up questions there. so Would you explain the sort of self-directed and with facilitators kind of framework a little bit more? Absolutely. So there are two delivery mechanisms or modes of delivery that any kind of a therapy can take. This has gotten more and more common in ah in terms of the kinds of options that people have for treatment with advances in technology.
00:03:46
Speaker
digital mental health, mental health apps, and folks are very familiar with those. But what I mean when I talk about self-guided versus human facilitated single session interventions are SSIs that can either be fully completed independently, usually a self-guided computer program or web app that takes between five and 20 minutes to complete, depending on the program, versus a single session encounter with somebody who's trained to deliver support.
Expanding SSI Focus Beyond Youth
00:04:17
Speaker
That person may have a license to practice psychotherapy. They may be a trained professional, but they could also be a peer specialist. They could also be a nurse with no background in mental health. They could be a helpline responder or a crisis line responder who uses the single session approach to structure their encounters with folks who call in crisis.
00:04:37
Speaker
So different kinds of single session interventions are amenable to be delivered by folks either with or without professional training, which is by design because that makes them more scalable. Absolutely. And then you mentioned youth. or Is your work exclusive to youth or is it sort of an all ages thing?
00:04:56
Speaker
Our work is primarily focused on youth. That's where I started this work. That's where a lot of my heart is in this work. But given the needs across the lifespan, our team has increasingly expanded the scope of what we do to include adults, including parents, including college students, including all sorts of underserved populations for whom the current system in mental health is just failing miserably.
00:05:22
Speaker
So because the needs are everywhere, we haven't been able to contain our work to just youth. ah But that is where a lot of it started and is is continuing now. All right. Let's ask the literally billions of dollar question here. Do SSIs work and how do we know? Love this question. And that's what I've spent the past decade trying to figure out.
00:05:47
Speaker
So yes, and we know for multiple reasons that they work. First of all, what does it mean for an intervention to work? That's an important question. Usually, psychologists and researchers are going to define an intervention as working when a certain kind of symptom or problem that it's designed to target, like depression, let's say, significantly reduces in a way that's detectable to the person receiving this treatment and that affects their quality of life.
00:06:15
Speaker
And we can measure this through standard measures that we validated through psychometrics research, like the PHQ-9, the patient health questionnaire, and a variety of other really widely used questionnaires. So when I say an intervention or an SSI works, in this context, I'm talking about the intervention results in a clear and significant reduction in distress symptoms or problems related to a specific type of issue, like depression.
Efficacy and Impact of SSIs
00:06:43
Speaker
So I started this investigation back in grad school when I got really fed up with the fact that I was being trained in these multi session therapies, but the families I'd see in my training clinics.
00:06:57
Speaker
would not be able to return due to no fault of their own. but They couldn't afford to stay. Travel was two hours each way and they couldn't make it. Or it just, they came for the initial assessment, got asked questions for three hours and didn't come back because that's not what they came for. I started thinking, you know, what can we do for these families who aren't going to come back? The many families who won't be able to. And I started looking into whether one session interventions had been studied and Turns out I was not at all the first person to have this idea. Back in 2016, when I first ran this analysis, there were already 50 randomized controlled trials testing single session interventions for youth mental health problems, including depression, anxiety, and behavior problems. When I say randomized controlled trials, I mean comparing a single session intervention to some kind of comparison or control group so that we can be sure any symptom changes we see are due to the SSI, not just time passing.
00:07:55
Speaker
So we aggregated or combined statistically all 50 of those clinical trials in a process called a meta analysis. And we were able to estimate an overall on average effect for single session interventions. I'll give you the number, but I'm going to unpack what that means. So we found an effect size, a standard effect size of 0.32, which is totally meaningless to anyone outside of my field.
00:08:19
Speaker
What that means basically is that there's a small to medium effect of giving somebody a single session intervention relative to giving them some kind of sort of active control group, like just spending time with them in ah in in a nice way for an hour. That means there's a about a 60% chance that somebody who receives a single session intervention will be better off in terms of long-term symptoms than somebody who didn't receive a single session intervention.
00:08:47
Speaker
That may not seem like a huge number, but if we look at how what the effect size is for full length therapy that lasts on average 16 sessions and evidence-based protocols, the effect size is really not that much bigger. And I know this because my graduate mentor who is my co-author on this meta analysis is the leading researcher on multi-session psychotherapies in the country and has done the largest ever meta analysis on this topic. So that I gotten it wrong, but yeah.
00:09:17
Speaker
So clarifying question. So the comparison was between SSIs and this control group and then multi-session in this control group. So there hasn't been like a head to head, I don't know how you'd even do that, but I had to head comparison of SSIs versus, which I don't, I don't like that word, but like versus multi-session therapy or has there been?
00:09:38
Speaker
Get this question all the time, and I'm happy to actually have an answer. So fast forward to now, 2025. This was back in 2017. This meta-analysis was first published called Little Treatments Promising Effects. And we actually did an updated umbrella review that synthesizes all the literature that's ever been published on single session interventions. We're now up from 50 trials in 2017 to 415.
00:10:08
Speaker
um in 2025. And there were four that actually had compared single and multi-session therapies. And they did not differ in their performance in three out of four of those cases. In one of the cases, single session interventions outperformed the multi-session intervention.
00:10:27
Speaker
So there's not good evidence that there's a superiority of multi-session treatments, but that doesn't mean that nobody should get multi-session treatments. Sure, of course. What that means is that they can both be helpful for different people under different circumstances, and they both need to be part of a full-scale mental health system that meets people where they're at.
Challenges in Mental Health System and Role of SSIs
00:10:45
Speaker
Absolutely, which is a great segue you know into sort of the the next thing I wanted to talk about. So I think i you you know my background. I was the state mental health director for Indiana for five years.
00:10:57
Speaker
You know, during a pretty interesting time, like my month six for me was March of 2020 and things kind of went haywire for everybody right after that, right. And, you know, a consequence of that was I think for probably the first time there was real pressure and awareness at the sort of state government level of youth mental health needs. and You know, historically states have been in the kind of severe mental health space.
00:11:24
Speaker
But there was you know this this pretty pretty ferocious and and understandable and warranted pressure to you know do something right about the youth mental health crisis that you know we, I don't know if if it emerged during the pandemic, but we certainly became more aware of it um as a result of the pandemic. And so given that background, you know some of my biggest challenges, i would sort of I'll name three of them and then let you kind of react.
00:11:52
Speaker
you know to to them and how SSIs you know could or would help. I mean, number one, you know this is any conversation about behavioral health begins and ends with workforce, right? And you know I'm a little skeptical. like it' There's some nuance into the into the concept of workforce challenges. like I don't know if if it's you know if if we have enough evidence to say straight up, blanket, we have a workforce shortage. What we know is that we have a workforce mismatch, like some of the neediest kids and adults that need the the most care are often on, you know, three, four, five, six, seven month waiting lists. Like there's definitely a scarcity issue there. And every you know strategy we would explore would just run right up against this challenge. Like in this county, we wanted to improve youth access to mental health. Well, good luck hiring a therapist, right? Is sort of sort of the answer we'd get. So that that was kind of number one. Number two is one that,
00:12:51
Speaker
you know Fortunately for us during the pandemic, we had quite a bit of federal money that we could we could tap into. um But this is something we're going to start to see a lot more of at state levels, which is just concern about costs. right As much as people care about mental health, youth mental health, you know there is a lot of attention and focus and pressure on state budgets right now, especially as that federal aid expires.
00:13:15
Speaker
and You know, we started to get the question towards the end of my tenure and it will continue to be a really pressing question. You know, this is really important. We all understand, but look, we don't have enough money to do it. Right. Um, and then the, the, the third problem, which is one that I yeah tried to make some headway in solving didn't get very far was just, just like the, the administrative and, and, and just otherwise just burden on both providers and patients for access and care. You kind of touched on that earlier.
00:13:45
Speaker
And so, you know, as as I think about those three big problems, you know, it drives me crazy, I'll be honest. I did not hear about your work until like the very end of my time there because I think I would have made some so some different decisions. And so, you know, but before we go into an unpack kind of like why it it took me that long, you know, do you want to comment on those problems and maybe how SSIs could help? Absolutely. So,
00:14:13
Speaker
Those were the eight frustrations that drove me to this work in the first place. The inefficiency and the opaqueness of the current system that makes it impossible for people without a PhD in clinical psychology to navigate is very upsetting. And the funding issues are evergreen. right They're going to get worse as we move forward and we're temporarily relieved a little bit during COVID because of just the obvious immediate massive scale need. But they're not going to go away and they're always going to be top of mind for for state government allocations in mental health. I do think that investing in supports like single session approaches is smart for multiple reasons.
00:15:00
Speaker
single session interventions can have multiple positive effects that together can decrease, I think, system-wide burden and lower costs overall. So not only do we know from this umbrella review that we just completed that I mentioned earlier that single session interventions can have impact at least for some people in some circumstances, on mental health problems like depression and anxiety. But they can also motivate people to engage with services that they need but might otherwise not have pursued. And that, because single session interventions are so easily accessible, the people who can access them are at an earlier stage of distress when they actually use one.
00:15:44
Speaker
What this ends up doing downstream is catching people earlier at points of need rather than at points of desperation and urging them to either adopt coping skills to help them successfully cope on their own so their problems don't progress or motivate them to get help sooner and increase hope that help can actually be useful to them so that they don't end up in the emergency room five months later.
00:16:10
Speaker
So single session interventions, I think, as a first line support with no barriers that's accessible to folks whether or not they're engaged with a provider without even having to call somebody. That's, to me, an ideal approach for promoting population mental health in a sustainable way, while being able to then like use the funds that you have left over to hire more workforce and to expand in that way.
00:16:37
Speaker
Yeah, that's that's exactly right. and And that's I think I want to I want to just double click on the population health piece of this because i I think that the single biggest takeaway, you know, for me, which I, you know, realized right away and then, you know, got really frustrated because it took me so long. But it was that if you are a person or a group or an entity that's responsible for the health of a population, right? So whether you're a managed care company or a state or you know a health some other sort of health, there's you you know a million different convoluted arrangements in the American healthcare care system. But if if you know if you're responsible for population health of a specific population and you're looking for a relatively sort of like low barrier, low cost and scalable approach to mental health, it seems to me like a no brainer.
Resistance and Acceptance of SSIs in Mental Health
00:17:29
Speaker
that that SSI should be part of it. Now you agree, this is your job, but I'm sort of reflecting you know reflecting back to you you know the the kind of epiphany I had, which you know kind of leads into you know the the the next thing I wanted to talk about, which you know I'm going to just go ahead and call, you know why the hell aren't SSIs everywhere? Why is it that as ah you know a leader in the field, and and when I talk to other leaders in the field, I get the same response,
00:17:59
Speaker
you know either have not heard of SSIs or if they've heard of SSIs or don't know a lot, and then if if if if they know a lot, then there's a bunch of reasons why they don't think so. so i would i just I want to dive into this. and you know I sent you before and I offered some you know some theories and and you know we can we can talk about them or whatever whatever you want to.
00:18:23
Speaker
But the you know the the kind of first theory I offered, and and what I will say, and and you know my sister's going to kill me. My sister's a therapist. um And I'm going to go ahead and say, like when I mentioned you know SSIs to her and sent her a link to your work, you know she initially, I would say, got pretty defensive. right And you know i think I think she, you know so again, after exploring a little bit more, thinking a little bit more, I think i think that you know moved on from her initial reaction. but you know Tell me about your your approach to you know perceptions that this so-called easy button is devaluing the profession or threatening the profession of clinical therapy.
00:19:03
Speaker
I think that gets to the heart at why there's been so much inertia about this issue or this topic. Well, there are a lot of reasons, but this this particular one, the very understandable jump to defensiveness among folks who spent their lives and careers supporting people through traditional models of psychotherapy is a barrier. I will say the same thing happened when digital mental health solutions were first introduced.
00:19:30
Speaker
I want to say 15, 20 years ago therapists were worried that apps and, you know, web-based programs would replace therapists and there was a lot of backlash against them. Now they're beyond ubiquitous. They're everywhere to a fault. And that's maybe a different podcast conversation. But for single session approaches, it's counter to everything that I was taught.
00:19:54
Speaker
in graduate school. It's counter to everything that every single evidence-based practitioner is taught. Because the science of this was has only been formalized really in the past 10 years. Before that, single session therapies were being practiced internationally. And in fact, they're widely scaled in countries like Canada and Australia successfully.
00:20:17
Speaker
But they never really made it into the science and the the sort of the psychology zeitgeist of models that we have as go to options for treatment. And of course, therapists are going to based on their own experience with legitimately treating challenging clients who don't make change quickly and who do have trouble engaging and who do need that extra support. Of course, single session interventions aren't going to be a quick fix for everyone.
00:20:46
Speaker
So the way that I've approached conversations about this, which I've been having since day one of doing this research, is by emphasizing that this isn't a quick fix or a replacement for anything that's already out there. There is no quick fix or replacement for anything that's already out there. What it is, is a missing piece of a puzzle that we know doesn't complete its itself. um And in order to really acknowledge and tackle the public health problem that is mental illness,
00:21:15
Speaker
in a tiered way that's going to catch everybody regardless of the holes they fall through. We have to be creative and have multiple options for how and where and what people can access for support. um and it makes you know And it makes so much sense when you just take a second and compare this to all other types of healthcare, care right? I mean, yeah theres there's so much dosing and and and and matching of sort of acuity and severity to the therapy, right? Yeah.
00:21:45
Speaker
and and so that's and And I always say you know like you know silver bullets are mythical.
Barriers to SSI Adoption
00:21:50
Speaker
right They're not real. And so you know and you're not saying that. and I think that's something that is worth worth ah talking about. you know The other side of the coin on the the the feelings and perceptions and k you know contradictions of the education is is just you know sort of like the the structural setup right of our healthcare system.
00:22:14
Speaker
Um, you know, especially, you know, the reimbursement incentives and like a fee for service system. So have you seen that be a barrier as well? A hundred percent. Um, so if you look at how, you know, reimbursement for psychotherapy works, um, by design, at least if you're going through public insurance, there has to be an intake session that is usually pretty long and structured before there can be a diagnosis given to a person, which opens the door to get them you know, covered treatment for a longer period of time. But if you acknowledge the fact that that first assessment session is many people's last session, but you're not actually allowed to reimburse for a treatment in that first session because you haven't done the diagnostic assessment yet, that eliminates any possibility of giving a single session intervention when it would be needed most, which is at that first clinical encounter.
00:23:10
Speaker
So the system is designed to disallow single session interventions where they would be most helpful, which is a struggle that we've had with many of our implementation partners. But I will say in in one pilot that we're doing in Pennsylvania, we actually managed to get a waiver from the state to pilot this approach, specifically offering single session interventions to folks in Medicaid funded clinics on waiting lists for treatments.
00:23:36
Speaker
without having to go through that diagnostic assessment first. So we got a waiver and a new code to pilot it out. We'll see how that goes. I think our pilot so far internally is going well, but we're hopeful that the results will support a more permanent code to make that into a reality that other states can use. Yeah, absolutely. And and I think that, you know, a couple, a couple of takeaways. I think I wanted to sort of double, double tap on the idea of the the average number of sessions or the modal number of sessions that any person in behavioral health usually has is one right is that is that that a statistic I've heard. is that Is that your understanding as well? Backed up pretty well by research. I would say that's the most common number. So the modal number, not the average because there are some people who are in treatment for years and years.
00:24:20
Speaker
I'm a, I'm a recovering lawyer, not a statistician. So I trained in stats. I have to make the difference. Um, so, but most people are going to interact with support once. And that support is usually not going to be structured or evidence-based and it usually won't even be by a trained mental health professional. So primary care is a perfect example. Somebody might have a brief encounter with a family medicine doctor that touches on mental health, but doesn't actually treat anything in particular.
00:24:50
Speaker
Yeah, absolutely. the The last thing is a little bit sort of more esoteric, but I think it's it's probably worth touching on at least. you know i have Have you ever encountered the idea? and The answer may be no, but I bet it's not. that you know, therapy is supposed to be hard, right? Like it's supposed to be a slog. Has that ever come up in, in you know, some of your interactions? Okay, say more about that. yeah The most common way I've heard this phrase is therapy is a journey. And self discovery and change inherently takes time and practice and patience and nothing happens overnight.
Personal Impact and Feedback on SSIs
00:25:32
Speaker
And there are kernels of truth in that. Of course, change is always happening and it's a process and you'll continue to change over the course of your life. And of course, there are journeys that can be had in recovery and mental health. I think anybody who's recovered from a mental health problem can attest to that. But it can also be true at the same time that any moment can be an opportunity for some change.
00:25:56
Speaker
and that a change that happens in a moment, which some people experience as a turning point or an aha moment in their journey towards recovery, those can be facilitated through single session interventions. So that's not to say that a single session intervention is going to bring you from zero to 100 in terms of functioning and well-being.
00:26:17
Speaker
but it can bring you from two to six. And maybe that was the jump that you needed to be able to get to seven, eight, nine, 10. So, you know, it's all about expectation matching to the intervention. Not saying that this is going to solve everything overnight, but it can pivot you in a different direction that might have otherwise felt really difficult. Yeah. Yeah. But before we leave the SSI piece of it, you know, you do you have any stories of, of,
00:26:46
Speaker
you know, an example of how this has helped somebody that you, you know, you would share with us. Sure. So many. I'm sure you have millions, but like, you know, on the spot, pick one. Yeah. So I think one of the most striking that comes to mind is actually it was, it's it's through a written feedback that we received from teenagers who've completed our digital single session interventions.
00:27:13
Speaker
We often or we we always ask, you know, how did you like this intervention? What can we do to make it better or worse, which is optional for teens to answer at the end. But because our interventions are publicly available for anybody to use, we get a lot of traffic through them. And going through the comments from teens who've been through these interventions, which are 20 minute activities that teach one coping skill in particular.
00:27:38
Speaker
i one One response that really stood out to me, a teen wrote that they felt heard and understood for the first time, even though there was no person on the other end of the intervention. One of the aspects of our interventions that we include are lived experience narratives from others who've been through coping and recovery for a particular problem.
00:28:03
Speaker
And this teenager saw themselves so deeply in one of those stories that we included in the intervention that they told us they felt like maybe they could go on and maybe they should stick around for longer. um And it's feedback like that from anonymous teenagers who just happened to find our interventions through social media platforms that makes this, it it reinforces to me and to my team that this is worthwhile.
00:28:32
Speaker
Similarly, I'll occasionally just get emails from teenagers who've completed one of our interventions who said this was the only thing that I could access or could use because I can't talk about my mental health concerns to anybody and I found this website and I just want to say thank you for making this for us. So feedback like that makes it worth it and really reinforces commitment to the work.
00:28:56
Speaker
Yeah, absolutely. well and you know i Look, I'm far from an objective objective observer here. I think I've been so much slider-pilled on SSIs. But i you know I just think that the work you're doing and the impact you're having is is really incredible. And and you know without sort of spoiling or sharing, you know I think we are we're hard at work on a way to maybe bring SSIs to Indiana and so looking forward to to keeping that going as well.
00:29:25
Speaker
and you know the The last thing I wanted to wanted to talk to you about is is a slight a bit a a bit of a turn, but I think it's it's related in a lot of ways too. um You know, you've recently done quite a bit of work on or study on the issue of parental consent for, you know, minors to access mental health care. And this is a hot button issue ah right now. There's, there's bills and in multiple legislatures that are both that are kind of doing both or are they're making it easier for for teens to to access mental health without consent, and then also making it harder for teens to access mental health care without consent. So can you tell us about your research and what you found?
00:30:02
Speaker
Absolutely, so I didn't start this work thinking I would ever study consent law. That was not on my radar when I began treatment research or SSI work. But what we quickly learned when we started to disseminate particularly our digital self-guided single session interventions was that the main barrier that teens kept reporting to us anecdotally at first was needing to have parent permission to try this brief online activity.
00:30:32
Speaker
because there was some association of the activity with therapy. you know And that's not allowed for them to access on their own. So in the beginning, we addressed this primarily by obtaining waivers of parental consent requirements from ethics review boards at our universe at the universities that we worked at. We've been able to do this at universities all across the country arguing that, well, it's not ethical to remove what could be the only option for treatment that a lot of teenagers are going to have access to. So we have to provide this without requiring parent permission. But we started doing more qualitative work on this to start getting really hard data. And hundreds of teens who participated in our trials also took part in quick qualitative interviews with us.
00:31:20
Speaker
where we ask them, you know, if you've had trouble accessing treatment before, what's gotten in the way of that? And what we found was that in in two papers now, we report this in different samples, a third to half of the reasons that teens listed first for why they couldn't access mental health care was their parents. And that was really distressing. It was so much more common than issues like the ones that you think of initially, like finances, expenses, or stigma.
00:31:48
Speaker
It was really that teens don't always feel comfortable asking their parents for help. They don't feel like they can disclose these issues to parents and be taken seriously. A lot of teens with minoritized identities share that this just isn't something my family talks about. It's not words that ever come up and I cannot start now. Or the reason I want treatment is because I'm struggling with identity and I can't talk. It's not safe at home for me to talk about these things.
00:32:17
Speaker
but Another big cluster of reasons that teens said they couldn't talk to their parents wasn't because they were afraid to or worried about how it will be received, but because they didn't want to burden their parents because they already had so many problems to deal with. This was especially potent during the pandemic.
00:32:32
Speaker
when teens could see their families struggling in so many different ways. They didn't want to add to the pile of stuff that they had to deal with with this too. So regardless of the reason, parents can be a barrier, whether they mean to be or not. And usually they don't mean to be. these but This barrier is not something that parents can necessarily control.
00:32:53
Speaker
But more recently, we found that that qualitative research wasn't quite enough to convince policymakers to change anything. So we conducted a policy mapping study because different states in the US have vastly different laws as to whether and how teens can independently access mental health treatment.
00:33:12
Speaker
So we use publicly available data from SAMHSA to examine empirically, do states that have more strict laws about teens having to get parent consent for treatment, if those teens have depression, are they more or less likely to access treatment based on the law in their state? And we found a 10 percentage point difference in states that require versus don't always require parental consent.
00:33:36
Speaker
About 37% of teens in states that do require parental permission, 37% of teens with depression access treatment in those states. The number is closer to 47% when the law is more favoring teen autonomy um in being able to consent independently. And that one law contributing to a 10 percentage point difference in something like that is really remarkable. And we're hopeful that that study, which was just published, will start to shift the conversation.
00:34:06
Speaker
Absolutely. And 10% is significant. And, you know, I, you know, my, my, my sense of consent is, is complicated and nuanced, right? You know, I'm a parent myself of a almost teen, you know, and, and I think I would probably feel some kind of way if, if, if I learned that, uh, you know, my child was, was seeking care without me. I think at the end of the day, I would probably want them to get the care no matter what, but you know, there would be some feelings in fall. I think it's also important to note that, you know, large part, these are family.
00:34:35
Speaker
issues, right? I mean, usually from from what I've seen, especially on the more severe side of the state, I mean, these are entire families trying to go through this and navigate it to the other, but I do think it's important to to to at least take a look at some of some of these other situations that may not be as cut and dried. So I would say, you know let's let's keep that conversation going. I think it's ah it's a really important and nuanced one, and hopefully we can come to a you know a reasonable place with it and not get kind of caught up in and you know some of the emotion and politics that unfortunately ah ah colors our ability to do what's evidence-based and best, right? Yeah, 100%. So, well, Jessica, this was great. I hope it was okay for you. you know Like I said, first podcast, I hope it was fine. you know we'll ah Anything else you want to add before before we wrap up?
00:35:29
Speaker
No, I appreciate the opportunity to chat about these topics, which I could chat about forever, but this was quite succinct. Okay, you were very succinct. Thank you. I appreciate that. All right. Well, thank you so much, Jessica. Thank you.