Online Therapy Is Cheap Because Your Mental Health Data Is The Product

Mental health issues have spiked for young people, especially young women. With one in three high school girls saying they’ve contemplated suicide, and the pandemic worsening loneliness, isolation, and depression for just about everyone, interventions like prescription medications and talk therapy can barely keep up with the demand from an increasingly depressed, anxious, and mentally unwell country.

The number of Americans receiving treatment or counseling for their mental health has more than doubled since the early 2000s, and therapists are struggling to keep up. As a result, a lot of people are turning to online therapy as a more accessible and more affordable form of counseling. Especially now that there’s a huge push for everyone to have a therapist, the demand is pushing many to Zoom therapists, who, aside from being accessible from the comfort of your own home, are often more likely to work with your insurance. But are these platforms more affordable because they’re making their money another way? The results of one recent lawsuit suggest that may be the case.

Bad Therapy

Online therapy company BetterHelp was fined by the FTC for selling users’ data to social media companies for profit. This wasn’t just a common case of selling users’ email addresses and other contact information, either. BetterHelp, despite promising patients that their sensitive data would only be used for therapeutic purposes, turned right around and sold patients’ IP addresses and information from their therapy questionnaires to Big Tech companies. Facebook, Snapchat, and Pinterest were among the buyers, as well as Criteo, an advertising company that specializes in advertisements displayed online. 

When selling this data, BetterHelp also didn’t restrict how third parties could use it, meaning the sale made it fair game to use patients’ mental health data however these companies wanted. Facebook was also helping BetterHelp recruit even more patients, by comparing Facebook profiles of those who’d received therapy in the past and pushing out BetterHelp advertisements to profiles who might be similar. Then, the FTC claimed in the suit, the companies together “pushed consumers to hand over their health information by repeatedly showing them privacy misrepresentations and nudging them with unavoidable prompts to sign up for its counseling service.” Some patients also say that the virtual nature of the platform means that the therapists themselves compromise patient privacy by taking therapy calls with other people in the room or in public places. 

Sanity for Sale

Since digital therapy relies more on a high quantity of patient sessions than quality, BetterHelp relies heavily on targeted advertising and influencers to market itself to young people, especially those who are uninsured or have a difficult time affording traditional mental health services. Due to the number of controversies, however, many influencers have gotten fed up with digital therapy and refuse to support BetterHelp, no matter how much they try to pay. 

“I don’t think we want to run mental health the same way we run Uber,” Dr. Ali Mattu, a clinical psychologist, said of the platform in an interview, “When it comes to healthcare, when it comes to people’s lives, we can’t approach things the same way we’ve approached social media.” 

Some influencers have become so openly critical of the platform that it’s blatantly obvious they aren’t trying to encourage people to sign up, a trend that’s evolved into a punchline with those critical of the company.

Talk Ain’t Cheap

In the end, it cost the online therapy company $7.8 million to settle the lawsuit, but privacy researchers at Mozilla say that the sketchiness with the talk therapy platform runs deeper than just the advertising. The problem is in the business model. Platforms like BetterHelp can’t afford to provide you with the services they do for the prices they charge. In part because the service is digital-only, patients expect more in terms of flexibility and availability. BetterHelp offers unlimited chatting with your therapist by text, phone, or video, something that sounds as unsustainable as it is therapeutically excessive. 

BetterHelp has come under fire in a slew of Better Business Bureau complaints for charging users’ cards without authorization or charging them for therapy even with no available therapists. Some patients have even taken to TikTok to complain about their therapists missing meetings entirely or focusing so much on pronouns that they’re unable to listen.

In-person therapists have also criticized the company’s effect on their industry, saying that the business model is not only ineffective but potentially harmful to clients. Jeff Guenther, a popular therapist on TikTok, spoke about BetterHelp’s business model, saying that therapists on the platform receive less than a third of a typical hourly rate and are often put in the difficult situation of providing clients free service or ignoring them and not replying, since they aren’t paid for the “24-7 care” BetterHelp promises its users. 

More importantly, though, Guenther says the whole model is therapeutically wrong. “We don’t think you should have 24-hour access to a therapist,” Guenther explained in a now-deleted TikTok. “That’s going to create an expectation for you that we should always be there. That’s not going to create self-reliance.” This self-reliance issue is, in many ways, the core problem: On-demand therapy is creating a dependence that actively undermines people’s mental health. 

Privacy Not Included

Mozilla researchers say the problems that have come up in the BetterHelp controversy aren’t unique to the platform. They’re inherent in many mental health apps in general, which can’t stay afloat without mass marketing their services to get the most amount of patient data possible. In a Reddit post about the Mozilla project “Privacy Not Included,” lead researchers Jen Caltrider and Misha Rykov called out several of the worst offenders by name, saying, “Apps including BetterHelp and Talkspace routinely and disturbingly failed our privacy policy checklists. Most ignored our requests for transparency completely. … Some of the worst apps include BetterHelp, Talkspace, Youper, NOCD, Better Stop Suicide, and Pray.com.”

While these apps may have all begun with genuinely good motives, the fact that they require more patients in order to survive and profit means they have no incentive to cure patients. In fact, the ideal situation for mental health apps is if everyone were in therapy forever, chatting with on-demand therapists who are paid per text instead of becoming self-reliant or turning to real-life relationships to get through hard times that otherwise wouldn’t constitute mental health crises.

Closing Thoughts

Therapy can be extremely helpful for the right people, and many people may need it temporarily at some point in their lives. Certainly for those with clinical mental health problems, there are real and established therapeutic techniques to help meaningfully treat serious issues. But large-scale digital talk therapy isn’t for serious issues. The profit model is built on getting everyone and their mother into therapy to sell our data and charge us a subscription for the emotional support we should be providing each other for free.

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