In the United States of America, mental health care is a neglected area of healthcare provided to the patients. According to a 2017 report published by Mental Health America, 56.5 percent of adults with mental illness received no treatment¹ . Access to mental health care remained inadequate across the nation. It is often the case that it takes time for people to recognize that what they are experiencing are symptoms of mental health problem. 84 percent of the time between first symptoms and first treatment is spent not recognizing the symptoms of mental illness. Patients typically visit physicians for their physical health but often neglect to take care of their mental health issues until it becomes major disruptor of their daily lives. Lack of access to enough mental health clinicians is another reason that affect this behavior. The Covid-19 pandemic has exacerbated the severity of this already fragile situation² . As people around the country are asked to shelter-in-place or work and study from home, their anxiety and stress about the future of work and personal relationship got elevated. This situation caused both young and old to look for mental health practioners or counselors for care and healing. As a result, demand for mental health counselling soared stretching the already inadequate system to the point of breakdown.

The impact on mental health is more noticeable among the young students of higher education. Mental health among students in higher education has declined markedly even in recent years. In a 2016 survey by the American College Health Association, 52.7% of students surveyed reported feeling that things were hopeless and 39.1% reported feeling so depressed that it was difficult to function during the past 12 months. In a May 2020 survey by The Healthy Minds Network which includes 18,764 students on 14 campuses, 60 percent of the students indicated that the pandemic has made it more difficult to access mental health care³ . Relative to fall 2019, the prevalence of depression increased, and a higher proportion of students reported that their mental health negatively impacted their academic performance.

Students in Colleges and Universities are looking to get help from their campus counselors to tackle their mental health problems like anxiety, depression and relationship related issues. Students are often far away from homes and have lower affiliation with a primary care physician (PCP). Over 55 percent of college students have a PCP, which means nearly 45 percent do not. Additionally, about 1.7 million university students don't have access to healthcare coverage. Surge in mental health care demand caused long delays to get the required care. This lack of adequate access could have negative consequences to the student’s health and performance. In extreme cases absence of a timely intervention could also lead to students harming themselves.

To address the shortage of timely on campus, mental health care counsellors in Colleges or Universities are adopting tele-mental health platforms like Doko that are augmenting the College's ability to provide the required care using their own provider network. Such tele-mental health platforms are proving to be instrumental when a student urgently requires a mental health care provider to discuss their issue. Systems can assign a licensed mental health care provider to the requesting student within a few hours of creating a request by matching the student with a provider from their network. The matching algorithm is based on a preliminary assessment survey of the student to understand his or her demographics and preferences. It is also advisable that appointment requests can be triaged by a licensed clinical worker or a "care navigator" who would be able to understand urgency of the request better and send to the appropriate level of care provider. For example, while in one case a Licensed Clinical Social Worker (LCSW) would suffice for counselling, a psychiatrist intervention would be required in another. Doko follows this approach to bring the "human touch" in the overall process instead of relying on algorithm- based triaging approach.

Once connected to the care provider the student and his or her care provider can develop a trusted relationship with the care provider keeping all documentation on a secure HIPAA complaint cloud-based platform. This enables continuity of care when the counselling requires multiple sessions. Tele-mental health software platforms thus provide necessary capacity expansion for Colleges and Universities and provide timely mental health intervention to a large number of students.