BetterHelp, Cerebral, and other digital mental health companies are failing to offer quality care due to unprofessional therapists, a pressure to grow, and more
Heavy advertising and other strategies from Silicon Valley's playbook boost providers' growth but not the quality of care Tweets: @weemelter , @damseldystopia , @moominmarxist , @modernistwitch , @americanatheist , @psych_hype , @americanatheist , @veryfinanceguy , @mr_bellis , @jsadinolfi , @fmanjoo , and @veryfinanceguy Tweets: Lee Hurley / @weemelter : I looked at signing up with BetterHelp. I did not go ahead when they wanted me to pre-pay a minimum of £240 (and spend that every month) before I could even view therapists properly. Looks like that wasn't the only problem, far from it. https://twitter.com/... @damseldystopia : [CN: homophobia, conversion therapy] BetterHelp, an online counselling sevice, apparently sent at least one gay man to a conversion therapist. https://twitter.com/... Martha / @moominmarxist : it's been proven over and over that betterhelp is an absolute disgrace of a company. it's ridiculous that there's still so many podcasts promoting it. https://twitter.com/... Jes Skolnik / @modernistwitch : it has gotten so i will straight up turn off podcasts with ads for betterhelp and shit like it as well as all those security/surveillance systems https://twitter.com/... @americanatheist : Our research found that almost a quarter of nonreligious LGBTQ people experienced discrimination in mental health services — and were 55% more likely to experience discrimination than their non-LGBTQ peers. Our full report is here: https://www.secularsurvey.org/ lgbtq https://twitter.com/... @psych_hype : Man, who could have predicted that? https://www.wsj.com/... @americanatheist : This is, unfortunately, extremely common. While we don't know what Mr. Hill's religious affiliation is, religiously motivated discrimination in mental health services against LGBTQ people — nonreligious and religious alike — is widespread. https://twitter.com/... @veryfinanceguy : Unbelievably bleak https://twitter.com/... Rich Bellis / @mr_bellis : After being kicked out of the house for coming out, a 22-year-old sought an LGBTQ+ therapist on @betterhelp, which instead sent him to Christian counselor who told him to try and stop being gay. More from @WSJ on VC-backed mental-health treatment apps: https://www.wsj.com/... @jsadinolfi : I feel like a lot of people have probably experienced this to some degree, whether it's been with one of these providers or somebody else (maybe even more traditional ones). Definitely an all-around great piece. https://www.wsj.com/... Farhad Manjoo / @fmanjoo : wow the online therapy service BetterHealth told one patient to “stop being gay” when he went to them after his conservative family kicked him out https://www.wsj.com/... https://twitter.com/... @veryfinanceguy : The state of mental health treatment in this country is beyond shitty but anyone who tells you there is a role for startups is both a charlatan and a giant cuck
Context & Ripple Effects
The Wall Street Journal's reporting lands at the end of a long paper trail rather than opening a new one: clients were complaining about bad service, high prices, and misleading free-trial advertising at text-therapy services as far back as 2018, and a 2021 look at the downsides of virtual therapy apps found Talkspace and BetterHelp promising more than they could deliver amid booming demand. What the WSJ adds is a systemic framing — unprofessional therapists and pressure to grow as features of the model, not bugs.
The quality story also converges with an earlier privacy one: Jezebel's reporting showed these apps notifying third parties when an app was opened, even flagging suicidal thoughts, former Talkspace staff described a burner-phone scheme for fake app reviews, and the arc culminated in Teladoc's $7.8M FTC settlement over sharing BetterHelp users' data with Meta and Snap. Growth-first playbooks are now being audited on both the care and the data fronts.
First-order effects
- BetterHelp's parent Teladoc and Cerebral face direct reputational and commercial exposure: the reported £240 prepaid minimum before users could view therapists, and the referral of a gay patient to a conversion therapist, give both current subscribers and prospective ones concrete reasons to walk away from exactly the heavy-advertising funnel that built their user bases.
Second-order effects
- Rivals like Talkspace, already carrying the burner-phone and privacy baggage from earlier reporting, get pulled into the same scrutiny by association — every player selling therapy-by-app now has to defend its vetting and pricing against the pattern the WSJ documented, not just its own record.
Third-order effects
- If the pattern holds, investor-funded teletherapy consolidates around whoever can prove clinical quality and data restraint — the FTC's data-sharing settlement suggests regulators will keep supplying the enforcement half of that filter, pushing the sector from consumer-acquisition economics toward something closer to accountable care delivery.
The trend: Digital mental health is moving from Silicon Valley-style growth-at-all-costs consumer apps toward regulated, quality-audited care delivery, with privacy enforcement and clinical accountability setting the new bar.