From Schwartz Media. I'm Daniel James. This is seven am. If you listen to podcasts, and let's be honest, there's a fair chance that you do, it's likely that you've heard ads for a thing called Better Help. It's an app offering flexible, affordable therapy whenever you need it, kind
of an uber for therapy. Now, the American based Downers are expanding the app further into Australia, recruiting Australian psychologists to try and capitalize on the failings of a mental health system which could be difficult to navigate and one which is buckling under the weight of demand. So we
actually better off with Better Help and apps like it. Today, on the show the Ubification of Mental health Care in Australia, doctor Ahuna Gouer is a clinical and forensic psychologist specializing in complex trauma, and she tells us why a gig economy for a psychologist isn't the answer to our flailing mental health care system. These are her views only, and we're glad she shared them with us. It's Friday, August sixth day. Doctor Rahina, when did you first start hearing a bit of help?
I think i'd say I first heard a bit Better Help about ten years ago, and that was just when I was listening to a range of podcasts back in my pre psychology days when I had more time.
This show was sponsored by Better Help.
You know, Mitch, I have some self care non negotiables.
I never skipped leg day and I never skipped therapy day.
Wow, it's good for you.
Better Help as an online counseling service, okay.
It offers licensed professional counselors who specialize.
In issues like depression, stress, anxiety, relationships, sleeping, anger, family conflict, self esteem and more.
And I didn't have a boyfriend of text anymore, so I was like, might as well text a therapist and it was really, really a great experience. So we have an awesome offer for people who listen to the Daily Detectives.
So kind of vaguely been aware of them for a while and certainly knowing that they've been a very very big digital mental health provider in the States because they don't have the same healthcare system as we do here. But in terms of when I realized I started to see them more in the Australian market, look, I'd say
that was probably about two to three months ago. I started to just see ads coming up, both on LinkedIn because they were trying to advertise for clinicians, and then also on my social media where it looked like they were trying to target clients. So I was quite alarmed, honestly to see it start to creep into the Australian market.
I was starting to wonder whether this would be attractive to clients who wouldn't really be stopping to maybe think through the implications of signing up for a tech entrepreneur based app like this.
So from a patient's perspective, what's the difference between logging onto this app and seeking treatment through that app as compared to going and seeing someone like yourself.
So I'm a clinical psychologist and I work in both the public and the private mental health spaces, and obviously I can't speak for the entire public mental health system, but effectively, when you come into either of these services, you're typically referred by someone else, usually a GP, sometimes another healthcare provider. You come in, you'll do a range of assessments where we get a really good history as well.
So it's quite detailed, it's quite intensive. It's usually assessment based initially because it's not that I'm trying to diagnose and stop labels onto people, but it's more that that helps me provide better treatment once I've identified what a person's issues are, so my understanding of better health. What you do is you sign up. You fill out a question just like you know I've done for my dog's pet food delivery, but slightly slightly different.
Starting your therapy journey has never been easier with betterhelp. When you first come to the site, we'll ask you some questions about yourself and what you're looking for in therapy. We use this information to match you to one of our licensed therapists.
I don't really know how they actually match and triage, but I can say that both in the public and the private mental health systems, you're thinking through things like the complexity for clients needs, the seniority of a clinician, the type of intervention, and whether you're well matched and well suited to each other.
You'll get an email once you've been matched. This usually takes less than forty eight hours.
So you're matched, and then you have a shorter session of wait thirty to forty five minutes based on how much you're paying their charges. At this point in time are Australia ninety dollars or one hundred and twenty and if you pay the higher rate, you get the capacity to basically text your psychologist. Been quite an unlimited capacity, and you're told that they'll log in twice a day to respond.
As soon as you're match to, your therapist will introduce themselves and ask you some questions to get to know you better. This is your chance to get acquainted with your therapist.
So it's really subscription based, kind of like Netflix for mental health net Netflix.
It's good for mental health, isn't it?
Well? I suppose it depends on what you're watching, but from the perspective of a clinician, it's more like uber or psych You know, it's really starting to bring the gig economy into what is traditionally not a gig economy space at all.
Yeah.
Right, It's pretty easy to see why a gig economy around mental health has opened up. Affordable and timely access to mental health professionals is a pretty appealing proposition, isn't it.
Look I do agree. I think we have a very very tricky mental health landscape across the world. You're in a reasonably unique situation here because we do have access to Medicare. Look, we certainly know that waitliss a spiral and especially for more specialty services. But I do know that absolute better help can't actually provide services to people who are seeking assessments and things like that in the
fine printers vary. The KB it that they can't write let us for cod they can't do medical legal reports, and they obviously can't prescribe medication. Now when you see a psychologist here, we also can't prescribe medication. But what often happens is we work as a care team, especially
for more complex mental health issues. You know, if you're thinking something like PDSD, serious media depressive disorder, psychosis, bipolar, we all work together to effectively coordinate some of our interventions. And my understanding is that app based platforms like better Help just don't allow access for that because there's no
contact outside of session with a person's treating team. And indeed, I believe that users can remain anonymous, which I think is very ethically mablematic because if there's a crisis, you know, therapist is left holding that and doesn't know who to contact.
So there's a series of larm bells related to these type of apps, But the mental health system that we have isn't perfect either, and people are continually falling through the cracks. Shouldn't we embrace the disruption of it all?
So I'm not saying that app based services don't have their place. There's been very little research into the actual effectiveness of most app based services, and most that have been assessed for effectiveness in terms of reducing symptoms with things like text messages have been shown that they don't
actually work. So there is hope to try new approaches and absolutely acknowledging that the mental health state in Australia is terrible and I don't feel like there's a lot of federal political will at this point in time to improve that. But therapy is not one eight hundred for a friend, you know. It's really about helping you talk through your symptoms when you're there in session, and building
ways to cope outside of therapy. And I really do worry that that kind of constant possible contact leads to a level of dependence and people just never exploring or actually using the skills. You know, we have to be cautious, we have to test, we have to work based on the data and not on what sounds like a good idea or on what's going to help this app make money?
Should you be worried about your data when using one of these apps that's coming up, doctor Ahona, Patient data and it's privacy is paramount any sort of healthcare setting. Absolutely, when it comes to mental health, particularly, there's differently an expectation that what you say is private between you and your practitioner. What does the app actually do with the information that you give it?
I don't know. So I know that there's been a very very big case brought against Better Help.
All right, we're keeping an eye on your wallet tonight. You may be entitled to a refund if you used online therapy through Better Help because they're accused of selling information about your mental health.
The company agreed to a seven point eight million dollars settlement. This is what the FTC. The agency says Better Help promise to keep users information private, But the FTC says your information was given to Facebook, Snapchat, Pinterest for advertising purposes.
They sold consumers private data. So we're talking things like email addresses and responses to the mental health questions that people complete as part of the intake. So they sold that to third party advertisers so that they could better target.
Ads better help.
Says the settlement with the Federal Trade Commission is not an admission of wrongdoing and adds that what they did is a standard for the industry.
Data privacy is absolutely paramounted healthcare. Who owns the data, things like case notes, who has access to it. These old things that when you attend a psychology led service are pulled through very very carefully. If you are a registered health practitioner here, you're bound by an entire host of laws, effectively meaning that you can only shake information either with consent for the purposes of providing healthcare or in certain key situations where where you're mandated to, like
if a court asked for access to information. So there's so many protections. And when you're giving your data to a third party, non clinically led company that operates overseas, you have very very few data privacy provisions.
You mentioned earlier that they're recruiting psychologists in Australia. I'm just looking at one of these ads now, the saying that you can be quite an independent contractor and are in between one hundred and eleven one hundred and thirty five grand a year offering flexibility with no overheads. What do you make of that as someone who knows the inside of the industry. Is it tempting for someone like you?
Yeah, look, there's absolutely nothing about that that is tempting for me in the current Australian landscape. I suppose my view just looking at the pay that they offer. They have a bit of a tiered model, So it looks like it's thirty USD if you do under thirty hours a week, and that's not thirty hours of overall work. That is thirty hours of clinical work, so clinical engagement with a client, and if you're over that, then you make the higher rate of forty five USD, which is
similar to what clinicians and public mental health gat. But we also have access to and will leave sickly professional development and quite a host of other entitlements, and all of our time is not clinical time. So if you're working thirty to forty five hours a week in just seeing clients back to back for that, as appearsed to be the model, you will burn out very very quickly. It might be attractive to clinicians who might just be starting out, who might be trying to build up a
bit of air referral base. But honestly, if I was going to have to work for that amount of time, I'd probably be finding work in a different industry podcast host, podcast host, Except that also sounds like very hard work where you're talking to people all the time.
So can I ask about your work? Then? Because you're working both the private and public sectors, you would never work for a platform like better Help. But do you worry about the impact this sort of tech disruption could have on clinicians less experience than yourself and the industry overall.
Look, so I work in quite the point to end across both my role. So within my public mental health role, we assess and we treat people who have been identified as possibly being at high risk offending, you know, the types of behaviors that they might be engaging and at things like arson, stalking, intimate partner violence, sex offending, general violence, and metan threats. And then in my private work, I see a lot of trauma and complex trauma as well
as mood and anxiety disorders. I usually see you know, anywhere between five to seven clients a day, and outside of that, I do things like obviously making session notes, spending some time reflecting on session tracking how we are going. So all of this is outside of session work that you know usually happens after hours, So the mental health
profession isn't flux. I think I'm certainly POSTCOVID noticing a lot of almost a moral injury, a lot of burnout, a lot more people trying to find passive income and ways of trying to move into other spaces. And I think I am concerned about things that I'm seeing even outside better help, things like using AI. Would you're starting
to rely more on machines. There's a couple of patient note taking software things which actually listen in to your sessions and then just transcribe a note for you, and I know of a few people in private practice starting to use that. But just all kinds of implications from
a privacy perspective. But I also think fundamentally, as you know, psychologists, we have to have a good grasp of why a person behaves the way that they do, and if we're relying on machines to give us those answers, we're going to lose some really essential case conceptualization skills.
So I've finally given what we do know and what we don't know. What advice would you be giving anyone that's considering signing up for one of those apps?
I would say, bier, beware, know what you're signing up for. I would ascertain whether your mental health conditions are mild to moderate. So if you're not hugely distressed, if there's maybe the one issue that you want to talk through and it is an overly severe then that might be okay. But I'd be looking through carefully the fine print, and I'd also be asking questions about the person you're seeing
and what the what their qualifications are like. So approaching with a lot of caution if you do choose to approach, would probably be my suggestion. And then if you do have maybe slightly more severe difficulties, or if there's a lot of distress or more more complex issues, say you have PDSD, understanding that what better help offer our only thirty or forty five minute sessions? You know the capacity to do things like cognitive processing therapy for four PDSD
or maybe EMDR. You can't do any of that and thirty or forty five minute session, so you're better off, I would say trying to establish whether you can see a practitioner, even if it's viatally health with a more traditional therapeutic setting where you are offered I guess the longer sessions which are usually fifty to sixty minutes, and also continuity of care and maybe more wrap around care.
Doctor Aherna, thank you very much for.
Your time, pleasure, thanks for having me.
Also in the news in Parliament, the last sitting day of the week has been consumed by headed debate over visas to Palestinians fleeing Gaza. Opposition leader Peter Dutton suspended standing orders to debate his argument that there should be a blanket ban was Independent MP Zali Stegel calling on the opposition leader to quote stop being racist before withdrawing
the comment. And there's calls for the new South Whalest Liberal state director to resign this week after the party failed to meet the deadline to enroll candidates in the upcoming councilor elections. They failed to nominate one hundred and thirty six candidates across seven A councils, meaning currently no Liberals will stand in the areas like Camden, Northern Beaches and Woollongong. In the mid September elections. Seven Am is a daily show from Schwartz Media and The Saturday Paper.
It is produced by Shane Anderson, Zultan Fecho and Zaia Antangral. Our senior producer is Christine Gate. Our technical producer is Adigus Bastow. Sarah mcveie is our head of audio. Eric Jensen is our editor in chief. Mixing by Travis Evans, Adigus Bastow and Zultanfecho. Our theme music is by Net Beckley and Josh Hogan of Envelope Audio. I'm Daniel James. This is seven Am. See you next week.