For college students, obtaining healthcare when and where they need it can be a never-ending challenge. One company, Caraway, is addressing the current tsunami of health care needs college students are experiencing. Caraway provides on-demand access to mental, physical and reproductive healthcare that is tailored to Gen Z women and individuals assigned female at birth. Below is a conversation between our CEO Solome Tibebu (ST) and Caraway's Chief Health Officer Dr. Cheryl Baggeroer, M.D. (CB).

ST: Why is access to mental and women's+ health particularly useful for this population and age group?

CB: Navigating healthcare in the US is an onerous task for everyone, and particularly stressful for those doing so on their own for the first time. Most women+ face this daunting challenge in or soon after the college years when many common mental, physical and reproductive health concerns arise. 

Access to developmentally appropriate and culturally sensitive mental health care is essential to this group as women struggle with double the rate of depressive disorders, have nearly twice the likelihood of being diagnosed with an anxiety disorder, and two-to-five times greater likelihood of eating disorders. Confidential, consistent and judgment-free birth control options as well as STI testing are equally essential for this patient population. They also need care for common physical concerns like migraines and UTIs, which affect women+ students more often than their male peers. 

Gen Z women+, in particular, are facing additional challenges with their mental health and reproductive health.  They are  growing up in an age with higher stress and anxiety levels than prior generations with intense academic pressures, climate change, social unrest, gun violence and social media as their childhood backdrop. The social isolation, health anxiety and grief elicited by the COVID-19  pandemic added further stressors. With pauses in and closures of high schools and colleges, many are now playing emotional, social and intellectual catch up. According to a recently released report by Gallup and the Lumina Foundation, mental health is now one of the top reasons many college students are considering dropping out of school.

Following the recent Dobbs v. Jackson decision, young women also find themselves worrying about accessing reproductive healthcare including birth control, emergency contraception and abortion services. Per a recent Best Colleges survey, 43% of college students are questioning whether they want to remain in the state where they attend school or transfer in response to lack of access to reproductive healthcare, yet another disruptive and often anxiety-provoking experience. 

Still, despite the very clear healthcare needs of this patient population, there is a dearth of women+-focused solutions for mental, physical and reproductive health - and an even larger gap for solutions at the intersection of all three. 

At this critical moment of developing their independence, Gen Z women often don’t know where to turn when they have a problem, have trouble getting appointments for routine health needs, spend days waiting for appointments at student health, or wait hours at urgent care facilities or ERs inconveniently located far from campus. Often students must decide between taking the time to take care of their health or keeping up with their classes and college activities.

At Caraway, our purpose is to redefine healthcare for a generation of women+ — to no longer allow the healthcare system to overlook or underestimate their needs, to care for them mentally and physically, to help uncover early diagnoses and reduce the risk of future health conditions, to support the development of their own health care agency, and to set the course for lifelong health care habits. 

ST: Help our audience understand some of the uniqueness of Gen Z patients and what they’re going through. How do you address those specific challenges? 

CB: Gen Z has grown up with phones in their pockets, and when it comes to receiving content and services, immediacy is the norm. On-demand everything - including healthcare - can lead to positive and negative consequences. Caraway is striving to address both with evidence-based care and information provided directly by medical professionals. 

For example, for a Caraway patient anxious about a possible STI, our 24/7 chat feature allows them to immediately text with a clinician to discuss symptoms, have an at-home STI testing kit sent directly to them to collect the samples needed, send the kit back, and then when ready, discuss the results and ask any follow-up questions —all from the privacy of their dorm room.

Simultaneously, Caraway is challenging the steady stream of health misinformation a patient may encounter when seeking immediate answers on “Dr. Google,” Instagram, or TikTok. The gynecologists, adolescent medicine doctors, family practice clinicians, therapists and consulting psychiatrists who make up the Caraway Care Team use social media as well as in-app content to separate fact from fiction on health topics currently circulating online.  

Thankfully, Gen Z women+ also appear to be more willing to talk about and seek help for their mental health, and more often view mental health and physical health as inextricably linked. Our 24/7 chat feature allows students to connect with an actual human clinician to get answers immediately and avoid the all-too-common health anxiety spiral. Our integrated care model offers multiple opportunities for both mental health and physical health needs to be addressed and connections between the two to be explored.   

Much more so than prior generations, Gen Z expects to receive healthcare on their own terms – an experience that is personalized, equitable and digitally accessible. From the beginning, Caraway has had a robust presence of Gen Z leaders within our company. Caraway was built with and for Gen Z women+ and incorporates their feedback directly into our care model. 

ST: How is Caraway doing things differently from other student wellness solutions?

CB:  Most student health centers mirror traditional health care settings with mental health and medical health in separate locations. Despite evidence showing better outcomes when care is integrated, changes to these systems are slow and complicated. Creating a fully integrated care model with mental, physical and reproductive healthcare available in one “place” was the first priority for Caraway. Every decision since then has been intended to emphasize interactions that allow mental health and physical health to be addressed simultaneously. 

We use the Collaborative Care Model as one of our foundational care components, given its extensive evidence base for improving treatment outcomes for patients with depression and anxiety. Our Care Team includes medical and mental health clinicians from diverse backgrounds, varied care delivery experiences and broad clinical expertise. Both patients and clinicians benefit from our care team’s ability to immediately leverage one another’s expertise. 

Caraway’s virtual health services meet students where they are and at the level they want to engage - from answering general health questions to addressing urgent medical needs to engaging with ongoing mental health care and interactive digital tools. We are proactive in our approach and aim to engage with patients before they get sick or need a higher level of care. When we are not able to address a patient’s needs in a virtual setting, our clinicians work alongside our health advisors to appropriately refer them to in-person settings. 

Another core differentiator for Caraway is our focus on teaching healthcare as a life skill. Each clinical interaction is viewed as a teachable moment and informs future clinical app content. Our health advisors help students get the specific support they need, while also teaching them how to seek their own appropriate support in the future. Given how high the stakes may be in terms of future health and financial outcomes, developing an ability to navigate healthcare may be one of the most important life skills we can offer this patient population. 

ST: What has the feedback been like so far?

CB: We launched the company on July 26th, and we began rolling out the product and services in New York and California and are now in Ohio and North Carolina with plans to continue expanding nationally in 2023. The initial member response has been everything for which we hoped and planned:

• "I'm so glad I was introduced to Caraway because it's difficult for college students to gain access to reliable resources for mental health. It's so great to have that at the tip of my fingers!"
• “I have never experienced a more thorough doctor encounter before.” 
•  "I have been using Caraway for the last few weeks and I have never felt so comfortable when it comes to my healthcare. I love that I can access all the healthcare and support I need just by opening my phone and clicking on an app. It makes me feel empowered!"

Our clinicians have been equally pleased, which is a metric essential to the long-term success of Caraway. All have years of experience working in traditional healthcare systems with siloed medical and mental healthcare. Our doctors, nurse practitioners, and registered nurses love having immediate access to their mental health colleagues and vice versa. Our integrated care model allows them to offer more comprehensive support for our patients and, with the guidance of our health advisors, reduce the likelihood that a patient will fail to get needed care. 

ST:  Where can women, parents and universities learn more? 

CB: Caraway’s healthcare services are available via its mobile app in the Apple App Store and on Google Play.  We are happy to answer any question via our website!  Our care team is instantly accessible for members. For more information, visit us at Caraway.health which includes FAQs and a section specifically for parents. And, you can follow us on LinkedIn and Twitter and on Instagram and TikTok.