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Is Online Therapy Dying?

I’ve been on record that we need technological tools like remote therapy because we don’t have enough therapists in all the same places to meet the need of everyone who wants and needs to be seen.

So it is a little alarming to see this Times article this week:

The Online Therapy Bubble Is Bursting

My initial reaction as I read it was just “Ugh.” The article outlines the problems with some mental health startups and the practices that have left many therapists working for them disappointed and looking to go elsewhere. Frankly, as I read stories like this, I would agree that these services do need to go away completely.

Others in the industry have also grown disillusioned by the intersection of business and mental health. Jason Meisel, a New York City-based nurse practitioner, formerly worked at Ahead, a virtual mental-health provider that shut down in June. He says patients often got “lost in the shuffle,” and multiple days sometimes passed before they heard back from a provider. He also felt that the platform wasn’t careful enough with its hiring decisions, bringing on clinicians who were fresh out of school and unprepared for the workload.

Unfortunately, the article has a few stories that make it evident that some of these tech startups acted like, well, tech startups. Putting growth and valuation above all else. Patient care and qualified therapists who were enabled to do quality work for those patients; were shorted in service to bring in more appointments. That’s not really how health care of any kind works, let alone mental health treatments. I might believe that technology can be part of the solution, but that assumes that the people running these technology companies act in the patient’s best interest, not their business interests.

As much as I hate to admit it, this quote from the lobbyist rang true to me:

For Torous, skepticism about certain telepsych companies is separate from his belief in the promise of telehealth as a whole. Studies have repeatedly shown that virtual mental-health care can work, and that both patients and providers like the experience. The problem isn’t with telehealth as a concept, he argues, but with the way it’s being implemented by startups trying to maximize profits. Squeezing in as many appointments as possible might deliver on that goal, but it won’t fulfill promises made to patients, Torous says.

There is some vested interest in the statement above. That doesn’t mean it’s false, though. Even though some companies might have gotten this all wrong, we still have the same issues we’ve had with mental health services that we’ve had for years. It’s too difficult for too many people to access. Technology can help eliminate some hurdles preventing people from getting help. That is worth doing when it’s done right. Those services can and should go away when it’s not done right. The fact that many are indicates that chasing money is not the way.

That shouldn’t ever be the way. It doesn’t mean online therapy itself is a bad idea, though. We must be careful to get it right.

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