Questions linger about the online mental health therapy industry

I haven’t given the online mental health therapy industry much thought, except insofar as hearing their ubiquitous ads on podcasts.

But KHN has an interesting article up taking a look at the industry’s growing presence in the mental health therapy sphere.

Concerns include:

  • The effectiveness of online therapy vs. the in-person kind;
  • The fact that many online therapists tend to be less experienced;
  • Online therapists being pressured to respond via text to patients 24 hours a day;
  • The prescribing of powerful controlled substances without even a video meeting with patients.

Says KHN reporter Harris Meyer:

There also are concerns about online companies whose clinicians prescribe psychiatric drugs — either controlled substances that are potentially addictive such as Adderall, or antidepressants such as Zoloft that are not addictive but have potentially dangerous side effects.

Federal law requires doctors to see a patient in person before prescribing controlled drugs, which are those tightly regulated by the government because they can be abused. The federal government waived that provision under public health emergency rules issued early in the covid pandemic. Officials are considering whether to extend that waiver whenever the public health emergency period is over.

That review has been roiled by recent law enforcement actions following news reports in March. The Justice Department and the Drug Enforcement Administration are investigating Cerebral, a San Francisco online-prescribing company, for possible violations of the Controlled Substances Act for its prescribing of Adderall. The company told news organizations it has not been accused of violating the law and it would pause prescribing Adderall and other controlled drugs for attention-deficit/hyperactivity disorder. In a statement to KHN last month, it said, “Cerebral is fully cooperating with the Justice Department investigation.”

The DEA declined to comment on the probe, and the Department of Justice did not respond to KHN.

In a letter to the editor responding to a Bloomberg News article describing practices at Cerebral that included short patient appointments, aggressive advertising, and pressure on providers to prescribe drugs, Cerebral’s founder and CEO, Kyle Robertson, said his company did not give quotas or targets to clinicians to prescribe drugs. Cerebral “follows clinical prescribing guidelines based on the latest research,” he wrote.

The company’s directors removed him from his position in May.

You can read the rest of the article here.

San Francsico-based online mental health provider Cerebral is reportedly under investigation by the DEA and Justice Department for its prescribing practices. The company removed its CEO in May.

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