Consumer advocates are calling on the privacy regulator to investigate “Uber of therapy” platform BetterHelp as it expands in Australia, following a US ruling that the company shared sensitive customer data with third parties.
BetterHelp, known to many as the second largest podcast advertiser in Australia, claims to offer affordable and flexible online therapy. But experts have warned that the commercialization of healthcare in Australia could compromise patient data and reduce the quality of care therapists provide when acting as “workers”.
In 2023, the US Federal Trade Commission (FTC) required BetterHelp to pay $7.8 million ($11.8 million) to customers to resolve charges it shared email addresses. , IP addresses and answers to customers’ personal health questions with platforms like Facebook and Snapchat, despite promising to keep the data private.
In a report released Tuesday, Consumer advocacy group Choice said Australia lacked the necessary regulations to cover online mental health platforms like BetterHelp. The growth of the platform coincides with the growing demand for mental health services.
Choice found BetterHelp had increased its advertising on social media and podcasts, including offering Australians a free session if they sign up in June. The platform has also closed deals with Australian influencers and posted job ads on LinkedIn to hire local counsellors, psychologists and social workers.
Choice consumer data advocate Kate Bower and former privacy commissioner Malcolm Crompton said BetterHelp’s overseas wrongdoing meant the Australian information commissioner should investigate whether the company had breached local privacy laws.
“Australian consumers deserve to know what BetterHelp has been doing with their data here and we urge the Privacy Commissioner to investigate any potential misuse,” Bower said.
BetterHelp has changed the way it informs users about its data sharing practices following the FTC action. The company acknowledges in its extensive privacy policy that it shares an encrypted version of a customer’s email. direction with advertising partners.
That means if a BetterHelp customer uses the same email address when setting up a social media account, the social media account will know if the user has accessed the mental health service, Bower said.
This helps BetterHelp target its social media advertising spend because social media platforms can inform which other users may have similar characteristics and therefore be more likely to purchase BetterHelp.
Crompton told Choice he believed the data collected and shared by BetterHelp with Facebook would be classified as “health information” under Australian law and considered “sensitive information” under the Privacy Act.
Dr Piers Gooding, a La Trobe University researcher on disability and health issues, said BetterHelp’s model was the “Uber of therapy” – connecting patients with therapists on demand.
However, referring to the FTC’s findings, Gooding said, “When a company seeks to expand its market reach at the expense of deceiving customers as an acceptable cost, then alarm bells should ring.”
Gooding warned that the platform could reduce counselor pay and reduce service quality over time to maximize profits, much like Uber puts downward pressure on driver pay.
BetterHelp charges an initial monthly fee of AU$90 to AU$120 per week, allowing users to access one 30- or 45-minute live session with a therapist per week and send messages to their therapist. There’s also an in-app journaling feature, webinars on mental health topics, and worksheets assigned by your therapist.
Frances Carlton, a clinical counselor in New South Wales, said she was paid $145.22 ($219.91) for seven 45-minute sessions with clients on the BetterHelp platform.
For therapists who work five hours or more in a week, BetterHelp pays $35 an hour. The rate is $40 an hour for those who work more than 10 hours, $45 for more than 15 hours and up to $70 for 40 hours a week.
Carlton said his seven sessions lasted more than 45 minutes, but because the platform does not pay therapists overtime and deducts pay if a client logs on late, his weekly total was less than five hours, giving him They paid a rate of $30 per hour for their week. work.
Carlton, who in his private practice charges $150 an hour for patients he typically sees biweekly, said, “I was paid less for four clients than I would have been paid to see one client in my office.”
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Carlton said therapists would need to see 48 clients in a week to work 40 hours. “As a doctor, there is no way to provide good service and good customer care with that volume of work.”
A 2021 survey by the Counseling and Psychotherapy Federation of Australia found that most counseling and psychotherapy rates ranged between $100 and $160 an hour, while the Australian Psychologists Association’s recommended rate for a psychologist is from $315 for a standard 40 to 60 minute consultation.
Carly Dober, a psychologist and director of the association, said the recommended fees reflected the true cost of the psychologist providing the service, while BetterHelp’s fees “put tremendous pressure on the person to put in many hours to earn a reasonable living.” “.
“This is what the gig economy looks like,” Dober said.
Carlton stated that “the only doctors who would sign up for BetterHelp and stay with them are newly graduated doctors who can’t get a job but need to gain experience with clients.” She argued that they were not necessarily the best fit “because they need to have regular supervision and get ideas across to people.”
A BetterHelp spokesperson said: “We value our therapists and understand the importance of fair compensation.”
The spokesperson said therapists were offered competitive compensation of up to A$137,410 a year based on 52 work weeks, but actual earnings varied due to conversion rates, caseloads and client engagement. platform.
“We are confident in the quality and safety of our offers.”
BetterHelp also said: “Private information such as member names or clinical data from therapy sessions that BetterHelp members share with their therapists via text, phone or video calls is never shared with a third party and is never has been shared.”
“Following the FTC settlement, we have implemented additional measures to improve data privacy and provide clear information to our users about how their data is used,” the spokesperson said.
BetterHelp said its data sharing practices met Australian legal standards and prioritized consumer privacy with an opt-out feature.
Dr Elizabeth Deveny, chief executive of Australia’s Consumers Health Forum, said: “I think this push by a foreign mental health provider provides us with another example of how the Australian health system continues to be commercialized by private organisations.
“We are really concerned about the cases of illegal sharing of patient data that we have seen abroad. Patient data is sacred in Australia and must remain so,” Deveny said.
Guardian Australia has previously run BetterHelp adverts on its podcasts.