Case Study: Lowell Public Schools
Lowell Public Schools Students See 61% Drop in Suspensions with Cartwheel Partnership
61% reduction in suspensions for students
receiving Cartwheel services
34% reduction in chronic absenteeism
Clinically significant reductions in depression and anxiety
Lowell, Massachusetts
14,000 students
across 27 schools
29% of students multilingual learners
69% families low income
Comparison group: Students who did not receive Cartwheel services did not see improved attendance
Sample size: n=263 students who were referred to Cartwheel telehealth services in a 14,000 student suburban district (69% families low income) during the 2023-24, 2024-25, and 2025-26 school years.
First chart: First bar shows average number of suspensions per student per year for students that received at least one suspension before starting Cartwheel services. Second bar shows the average number of suspensions per student per year after starting Cartwheel services for that same cohort of students.
Second chart: First bar shows number of students who were chronically absent in the school year they started therapy, and for whom we have data in at least one subsequent school year. For the same cohort, the second bar shows the number of students who remain chronically absent in at least one year after starting Cartwheel services. Chronic absenteeism is defined as missing 10 percent of school days within an academic year.
First chart: First bar shows average number of suspensions per student per year for students that received at least one suspension before starting Cartwheel services. Second bar shows the average number of suspensions per student per year after starting Cartwheel services for that same cohort of students.
Second chart: First bar shows number of students who were chronically absent in the school year they started therapy, and for whom we have data in at least one subsequent school year. For the same cohort, the second bar shows the number of students who remain chronically absent in at least one year after starting Cartwheel services. Chronic absenteeism is defined as missing 10 percent of school days within an academic year.
Suspensions per Student per Year
Before vs. After Cartwheel
Number of Chronically Absent Students
Before vs. After Cartwheel
Clinical outcomes that support academic success over the course of the Cartwheel partnership
↑ 4 point
Improvement
in depression and anxiety symptoms
(PHQ-9 and GAD-7)
(PHQ-9 and GAD-7)
1,000+
Students
referred across 22 Lowell schools since
the start of the partnership
11
Sessions
average therapy sessions completed
per student
86%
Students
receiving services are uninsured or on
Medicaid—served at no cost to families
“We didn’t set out to reduce suspensions—we set out to get kids the mental health support they needed. The fact that suspensions dropped by 61% tells you that behavior is downstream from overall wellbeing.”
Why Lowell Needed a Different Approach
Like many large, urban districts, Lowell recognized growing student mental health
needs and the barriers that prevented families from getting timely care.
6+ month waitlists for outside providers
Students faced months of delay before connecting with a licensed clinician.
Transportation and scheduling conflicts
Families faced compounding logistical barriers to reaching in-person providers.
Language and cultural barriers
With 29% of students as multilingual learners speaking 70+ languages, finding clinicians who could communicate with families was a challenge.
Overwhelmed school-based teams
Surging demand for mental health support was outpacing in-school counselor and social worker bandwidth.
The consequences showed up in the data: elevated suspension rates, rising chronic absenteeism, and students falling behind academically. Without timely intervention, unmet mental health needs were contributing to disruptions in learning across the district.
“The biggest piece for us was increasing access and minimizing wait times to get mental health care to our students. We were seeing very long wait times, as everyone can relate to, and the use of Cartwheel has really made a significant difference in being able to provide access relatively quickly for a large portion of our students.”
What This Means For Lowell Public Schools
More Instructional
Time
Fewer suspensions and absences mean more students in seats learning—with stronger accountability metrics across the district.
Improved School
Climate
Reduced behavioral incidents mean less disruption for every student and teacher in the building.
Better Resource
Allocation
School counselors and social workers have more bandwidth to focus on tier 3 supports.
Stronger Family
Engagement
Multilingual, culturally matched therapists help immigrant and EL families engage with care and reduce stigma.
What Makes Cartwheel Different
Lowell Public Schools partnered with Cartwheel to remove barriers, integrate with school teams, and address the root causes of attendance and behavior challenges.
Specialized for school outcomes
Therapy, psychiatry, and family support focused on school avoidance, anxiety, depression, and behavioral challenges.
Rapid access to care
Students are matched with clinicians in 7–10 days instead of waiting months.
Integrated with school teams
Ongoing collaboration with counselors and social workers, shared strategies, and real-time progress updates.
Sustainable through insurance
No costs for families on Medicaid; in-network with military and commercial insurers.
Multilingual care
Students are matched with a clinician who speaks their native language.
“What’s made this work is that Cartwheel doesn’t operate separately from us, they operate as an extension of us. Our social workers trust them and our families trust them.”
