Questioning the ethics of profit driven online mental health services

Questioning the ethics of profit driven online mental health services

20 December 2021

Nine-year-old Ezra Blount was the tenth victim of the horrifying crowd crush at Travis Scott's Astroworld music festival held early last month in Houston, Texas.  

Video footage, taken by concertgoers, depicted a congested crowd, with up to 50,000 people in attendance. During Scott's performance, the crowd began to surge; and people were crushed and trampled as the event spun out of control. Security and medical staff struggled to access the injured and unconscious people in the crowd. Photos showed desperate attendees attempting CPR on their peers as they waited for medical attention. One concertgoer climbed a camera tower, begging for the show to be stopped, declaring a person had already died in the crowd. The show continued, and the outcome horrendous and traumatic for all involved.

In the days following, Scott announced a partnership with mass marketed and fast-growing Betterhelp – an online counselling and therapy service that offered one month of free access to any of the 50,000 Astroworld attendees.  While it was critical that Astroworld survivors received mental health care following such a traumatic experience – there is doubt over the ethics of such a partnership. 

US therapist, Jeff Guenther (@JeffGuentherLPC) took to social media to question whether Travis Scott was, in fact, profiting from the deaths at Astroworld through personalised referral codes to Betterhelp. Further to this, he called into question the ethics of Betterhelp itself – a for-profit mental health provider that profits from mining and selling clients' private mental health data to third-party advertisers.      

The accessibility, affordability, and flexibility of online mental health services present a promising alternative to face-to-face therapy. In recent years, the market for digitally delivered mental health treatment has been flooded with a plethora of online apps and services. While possibly providing some personal benefit to users, these kinds of services, of which only a small proportion are evidence-based, do not protect clients’ privacy in accordance with the traditional client/therapist confidentiality model.  

While a face-to-face therapist is required to treat any information shared by their client with the utmost privacy, many of the digital mental health apps and services publicly available are not held to the same (or any) privacy legislation regarding private and sensitive user data.

While touting concern for the health and wellbeing of its users, most online mental health apps sell on sensitive user data to third-party advertisers, information which or may not be included in the fine print. That data is then reengineered to bombard the user with targeted advertising.

With Betterhelp, and possibly Travis Scott himself, set to profit from this tragedy, the need for online mental health services to be accountable to their clients, rather than their bottom line, is starkly highlighted.

Mental health treatment needs to be accessible, affordable, and flexible – everything that draws users to Betterhelp and other similar services – but the price need not compromise the privacy and ultimately the wellbeing of those seeking treatment.

Lee Valentine, research fellow In digital youth mental health, Orygen Digital.