BetterHelp Can’t Have It Both Ways
Can a company care about your mental health? If you ask BetterHelp, an online therapy platform, the answer is emphatically yes. But our mental health is deeply personal, and companies like BetterHelp are (obviously) looking to make a profit. So, truthfully, the answer should be that it’s complicated. Moreover, with recent revelations of sketchy data practices and unprofessional, if not downright harmful, therapists, it seems BetterHelp has the potential to do more harm than good. Their core idea is great: convenient, accessible therapy. But if BetterHelp wants to follow through with its supposed dedication to mental health and improving its user’s lives, it needs to make a decision: the users, or the data. It can’t claim to care about its customers while simultaneously exploiting them.
Here’s a quick glance into the world of BetterHelp: soothing shades of green, a flowing user interface, inspirational quotes, positive testimonials, smiling photographs of certified therapists, and infographics boasting the company’s popularity and effectiveness. It’s a website that performs inclusivity and accessibility, and to the average user it’s a welcoming difference from the typical world of social media, riddled with upsetting news stories and images designed to make you crave something better than what you have. BetterHelp is supposed to be different.
Imagine it’s been a rough day, and you need to talk to someone about it. This is the website you can turn to. Away from the noise of your busy, stressful daily life, the BetterHelp therapist is available for you, and able to text or chat at any time of the day or night. They linger permanently on your computer, rendering irrelevant the days of commuting to a therapist’s office and sitting in a waiting room for your turn. You can get comfortable on your own couch, press a few buttons, and have instant connection through your laptop screen. Convenience in this day and age is huge, especially as much of the working population has realized, post-Covid, that their jobs can be done just as, if not more, efficiently at home and online. If that applies to your job, why not to other aspects of your life? Why not talk to a therapist through a colorful, attractive, easy-to-use platform like BetterHelp?
But as soon as you begin to chat with your BetterHelp therapist, it’s possible third-party sources are receiving that information and noting it for later, essentially building a profile of you as a potential customer (i.e. as someone who logs onto BetterHelp at the end of the day for a chat with a therapist, someone who struggles with their mental health, etc.).
In 2020, Jezebel first reported on this practice, breaking the shocking news that BetterHelp had been selling user data to companies like Facebook and Google. Even as soon as users finished BetterHelps introductory questionnaire, a requirement for using the service and being matched with a therapist, data was being collected and filtered out to third-party companies (Osberg and Mehrotra).
The tricky thing about BetterHelp, as Jezebel pointed out, is how it appears to be following all the rules: each of its divisions (including Faithful Counseling and Teen Counseling) fall within HIPAA (Health Insurance Portability and Accountability Act) guidelines, therapists are correctly certified and follow typical confidentiality practices in the industry, conversations are encrypted, and you can even delete past messages.
Past the supposed rule-following is the unfortunate reality. *Privacy Not Included is a buyer guide created by the Mozilla Foundation to aid purchasing choices through the lens of privacy and information sharing. Their analysis of BetterHelp points out that the company doesn’t explicitly tell users it won’t sell personal data, and such personal data is collected immediately and extensively with, for example, their introductory questionnaire. Any company that doesn’t explicitly disclose their data usage practices should be a red flag for users concerned about their privacy.
Furthermore, an NPR article offers tips on how to protect yourself from exploitative telehealth companies like BetterHelp. But that one needs a manual on how to avoid unethical practices while using a platform that supposedly advocates for accessibility and inclusivity is, frankly, rather ironic.
Ethical data practices are essential to creating the inclusive environment that BetterHelp supposedly strives for. Examples of such practices can be found in the Manifest-No, which was written by a group of feminist data scholars, and details various promises centered on ethical practices in the use of data. For example, they “refuse the expansion of forms of data science that normalizes a condition of data extractivism and is defined primarily by the drive to monetize and hyper-individualize the human experience.” That monetization of the human experience is exactly what BetterHelp specializes in as it sends over data to Facebook and the likes: a person struggling mentally, and therefore more likely to open the BetterHelp app, is targeted with advertisements aimed at depressed individuals, for example, or depicting products they’ve bought before and might be more susceptible to re-purchasing now, in a time when they’re particularly vulnerable (Osberg and Mehrotra).
I’m one of millions who has benefited from therapy. I went to my first session during my freshman year of college, and I was nervous beforehand. What helped me was knowing the inherent rules of therapy. Privacy and confidentiality are key tenets of the practice, for example. They are what make the situation so unique — perhaps you can vent to your best friend about work drama, but at the end of the day, they’re a human being with biases and a stake in the game. Your therapist, while also obviously a human being, is far outside your inner circle and is inherently unbiased. Moreover, the therapy space traditionally provides a guarantee of confidentiality, except in the case of providing information that leads your therapist to believe you or someone else is at risk of harm. Whatever one says will stay in that room: this is soothing information for the therapy-skeptic (like eighteen-year-old me). I believe true, productive therapy work cannot exist without trust in the privacy and confidentiality that your therapist provides; that disappears completely when a third-party is paying attention to your therapeutic habits in the hope of selling you products.
Thus the BetterHelp therapist, not just the company itself, is put into a questioning light. Why would a therapist, who seemingly has learned of these privacy requirements of the practice in the process of receiving degrees and certifications, expose their clients to such practices? How can a truly safe space be offered by a therapist on BetterHelp if Facebook is involved? Since I’ve benefited from therapy personally, I recommend it to all my friends and family. But I wouldn’t feel comfortable recommending BetterHelp. It seems the costs outweigh any potential benefits, and mental health is too precious to mess around with.
To be fair to BetterHelp, it’s offered public responses to its various problems. For example, after a series of controversies involving YouTube advertisements, one of BetterHelp’s founders, Alon Matas, published a piece on Medium. He addressed directly some claims similar to what I’ve described here, and rather flippantly announces them to be totally false, without proving how. He writes, “We are in the counseling business, not in the data business.” Perhaps the post was an attempt to impress with transparency and a direct interaction with controversy from the company; but it failed to achieve any sort of alleviation of the anxieties sources like Jezebel and the Mozilla Foundation have pointed out.
We can return to the Manifest-No here. What if companies like BetterHelp made similar pledges? It would be a radical move for sure. It certainly seems unlikely, but perhaps we’re holding them to a low standard, expecting and almost accepting harmful practices, especially when it comes to our data, as we are used to from most other companies and platforms with which we interact. But BetterHelp can still turn a comfortable profit even without selling our data. After all, their business model relies upon a population that struggles mentally; in this day and age it seems that population will always be plentiful. Moreover, given that BetterHelp already attempts to align itself with a more ethical business practice, or at least the appearance of it, a radical dedication to data transparency would certainly boost the company’s perception in the eyes of customers and potential customers alike, as well as therapists hesitant to join the platform. After all the scandal BetterHelp has faced, largely due to the nature of the service they provide, a little positive PR wouldn’t exactly hurt. Of course, the downside here for the company is less access to lucrative information on its customers. So BetterHelp has to decide what it really wants to do — otherwise it will continue to exist in ethically murky waters.
