A third-party analysis found that Hazel Health's school-based teletherapy program significantly reduced symptoms of depression and anxiety in 75% of students.
Hazel Health, the nation's largest school-based telehealth provider, today released the results of a third-party analysis demonstrating the clinical effectiveness of its proprietary teletherapy program for K-12 students, H.E.A.R.T™ (Hazel Early Assessment Response Treatment).
Conducted by the Clemson University Learning Institute's Center for Behavior Analysis, the analysis was performed on a sample of 3,500 middle and high school students from 11 states — making it one of the largest studies assessing the clinical efficacy of school-based teletherapy interventions to date. The sample was also notably racially and ethnically diverse, with roughly 50% of participants identifying as people of color. Each student-patient was scored for symptom severity pre vs. post-treatment (via the PHQ-9 for depression and the GAD-7 for anxiety). The duration of the evidence-based treatment program was individualized to each participant, depending on their specific clinical needs at intake.
After a thorough review of Hazel's data, Clemson found: "the Hazel Health protocol resulted in reducing symptoms of anxiety and depression, as demonstrated by the change in severity levels observed for both the PHQ and GAD assessments. Not only did the overwhelming majority of participants report a reduction in depression and anxiety symptoms, but there were similar consistent results between the PHQ outcomes and GAD outcomes. On both assessments, 75% of the participants fell into a lower level of severity following treatment." — William Edwards, PhD, BCBA, Director of the Center for Behavior Analysis at Clemson University Learning Institute.
Key findings from the Clemson Center for Behavior Analysis include:
- The overwhelming majority of participants experienced a clinically significant reduction in depression and anxiety symptoms — with 75% falling into a lower level of clinical severity (as defined by the PHQ-9 and GAD-7 scales) following treatment.
- The largest improvements were experienced by participants who exhibited more severe symptoms prior to treatment. At intake, 60% of participants in the sample exhibited moderate to severe symptoms, per the PHQ-9 and GAD-7. At discharge, only 30% of the sample exhibited moderate to severe symptoms. In other words, after completing treatment, nearly 70% of the sample exhibited only minimal to mild symptoms that placed them in the "green zone" that is considered below the clinical threshold for a depressive or anxiety disorder).
- While treatment duration was individualized to each participant's clinical needs, the vast majority of participants (88%) received between 6 and 10 teletherapy sessions prior to being discharged from the program. The most common treatment duration (representing 57% of participants) was 7 sessions. A minority of participants (12%) received 11+ sessions. There was no significant correlation found between the degree of clinical improvement and treatment duration, indicating that treatment duration was appropriately matched to severity level at intake.
Beyond the scope of Clemson's evaluation, Hazel Health's internal analytics team performed additional analyses on the same data set to dig deeper into the program's clinical outcomes cut by different demographic groups:
- The clinical impact of the program was equitable across racial and ethnic groups. Non-white participants experienced similarly significant improvements as white participants — with Asian, Black, and Hispanic groups demonstrating the largest average reduction in PHQ-9 and GAD-7 scores. "This data indicates that Hazel's approach of employing a provider force that reflects the diverse communities we serve — 50% of our providers identify as BIPOC, and 40% are bilingual, speaking over 19 languages — is core to our ability to drive equitable engagement and outcomes among groups who have historically faced the highest barriers to care, particularly in mental health," said Dr. Travis Gayles, Chief Health Officer at Hazel Health.
- The clinical impact of the program was equitable across genders. While females presented with higher average severity at intake, Hazel's program drove similarly significant improvements in depression and anxiety symptoms across females and males.
"When we first co-designed Hazel's mental health solution with our school partners, our hope and hypothesis was that doubling down on schools into a central access point for healthcare could drive meaningful, equitable outcomes for young people," said Josh Golumb, CEO at Hazel Health. "We are thrilled by the data validating this hypothesis — and by the evidence that school-based interventions can produce better clinical outcomes across a wide spectrum of acuity, including in higher-severity cases. It makes clear the clinical and moral imperative of continuing to invest in this channel as a key lever to address the youth mental health crisis."
As for the company's future research plans, "This is just the beginning," said Dr. Travis Gayles, Hazel's Chief Health Officer. "This initial analysis focused on the adolescent segments of Hazel's K-12 patient population due to the age-appropriateness of the PHQ and GAD screeners. But a growing body of research on youth mental health is clear: the earlier we intervene, the more we can impact a student's psychosocial and academic trajectory. With over 40% of Hazel's patients in elementary school, early intervention is a foundational tenet of our clinical model — and we will continue to conduct research that enables educators, providers, and policy-makers to meet the evolving needs of our children across developmental stages."
