The Covid-19 pandemic hit behavioral health hard: Rates of anxiety and depression, substance use disorder, self-harm, and other conditions rose as the virus upended daily life. Clinicians, facing a growing demand for mental healthcare, were forced to rethink how they could safely—and more effectively—deliver those services.
Among them was Amy Mezulis, a clinical psychologist who was helping develop Joon Care’s teletherapy platform for teens and young adults when the pandemic hit. Mezulis and Joon co-founder Josh Herst opened the telehealth platform earlier than planned to help patients virtually connect with therapists. Joon, which now serves patients in almost a dozen states, offers one example of how telehealth could help bridge the gap between patients and providers.
Mezulis, the company’s co-founder and chief clinical officer, spoke with Healthcare Brew about Joon and how the teletherapy model is shaping behavioral healthcare.
This interview has been lightly edited for length and clarity.
Tell me more about how Joon works.
Joon is using technology to innovate in both the delivery and receipt of outpatient mental health care for teens and young adults. We only offer teletherapy—for 13- to 24-year-olds—taking an evidence-based, personalized approach to mental health care for this population. We’ve built a therapist platform that really empowers therapists to make data-informed decisions and use evidence-based therapy techniques with their clients.
Why teletherapy? And why focus on teens and young adults?
Our biggest challenge in mental health is around connecting supply with demand. When you can pool supply across, for example, an entire state, you smooth out some of the bumpiness of waitlists. In my area in Seattle, if you want your adolescent to see an in-person therapist within 15 minutes of your home for an afternoon or weekend appointment, you’re looking at a three- to six-month waitlist most of the time. [With Joon] I can take a teen in Seattle who needs a therapist and match them with a therapist who’s out in eastern Washington.
This age group—especially with Covid—is just really used to using technology to access services; this is very native to them, very familiar. Teletherapy is as effective, and in some cases, more effective than in-person therapy. Who are those cases? Teens and young adults with anxiety and depression. Why is that? They’re a difficult-to-engage population. They don’t really like sitting with an adult they don’t know for 50 minutes in an office. Younger teens hate the car ride to and from the therapist’s office with their parents—hate it with a passion. You get teens much more willing to try therapy and to show up when you offer them teletherapy.
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Who are Joon’s therapists?
They’re licensed clinicians—there are a variety of licenses, mostly master’s level licenses. We predominantly operate on a contractor model: For the most part, therapists are offering us four to eight hours of clinical time a week. We are hiring clinicians who have other full-time roles or responsibilities but who have a clinical license that’s probably underused and don’t necessarily want to go through the effort of setting up a private practice.
We also have a large number of folks who moved states or whose family constraints—their spouse’s work schedule or their childcare schedule—are such that it’s ideal for them to work 4pm to 8pm and on weekends, which are our typical hours for teen and young adult clients.
How long does it take Joon patients to get a teletherapy appointment?
Our typical timeframe from referral to your first intake appointment with your matched therapist is a week. That’s important to payers, but it’s also particularly important for this demographic because teens are not the most forward-thinking humans. Teens and young adults tend to be reaching out for services the day they’ve had a massive panic attack. The service has to be there at the time the person is asking for it.
How does Joon safeguard patient privacy and data?
There’s a lot of legal and ethical issues involved in doing clinical care with anybody, in particular with teens. We have a pretty careful consent and privacy policy that—if they’re minors—we walk clients and their parents through. Our engineering team has ensured that our video platform is secure. We have two-factor authentication for both clients and therapists at various points. And the data on our back end is kept in a HIPAA-compliant manner.
How much does Joon cost?
If you’re paying out of pocket, it is roughly $500 a month for weekly therapy, plus the app—and those fees can scale. We are working with payers so that we can be in network. We have both a direct-to-consumer customer acquisition model and a payer-network model.