I Tried a Mental Health Platform — Here's What Happened

Just before the holidays last year, I went through a period of intense anxiety related to a confluence of stressful circumstances: selling my condo and moving to a rental apartment, the darkening winter days and a drug reaction.

I was jittery and nauseous, had no appetite for days and felt very alone in the world. I really needed some mental health counseling NOW. I turned to the app-based platform BetterHelp and was surprised at how much better it made me feel, offering one-on-one counseling and group therapy plus lectures and journaling and worksheet tools.

It helped me get over my immediate crisis, while also imparting some knowledge that has stayed with me. That's not insignificant, since I've spent my career researching and writing about anxiety and other mental health issues and I've seen a variety of therapists over the years.

Here's what I liked about the platform:

First, I got almost immediate assistance. I couldn't have scheduled an appointment with an in-person therapist as quickly as I did with the app, especially around the holidays. I signed on and was instructed to complete an assessment form, providing information on the type of therapist I wanted and my specific mental health concern.

In my case, I was looking for a woman about my age who treated people with anxiety. I was matched with Susan LeClair, a licensed marriage and family therapist in private practice in West Hartford, Connecticut, about 45 minutes away from me. She was able to do a 45-minute online session with me within a couple of days, and talking with her about ways to manage my anxiety symptoms helped to calm me down. (And if I hadn't felt a connection with LeClair, I could have changed therapists.)

Second, the cost was reasonable and I was able to use my health savings account (HSA) to pay the weekly $80 fee. The website says that the fee ranges from $70 to $100 per week, based on where you live and the therapist you're matched with. When I cancelled after two weeks, I was offered a renewal deal at $50 a week.

I really benefitted from the group therapy session for people with anxiety. The Zoom group was led by Fiona Grant, a therapist in England, and drew about 15 people from the United States, the United Kingdom, Israel and other countries who were dealing with anxiety just as I was.

I thought I knew it all when it came to anxiety strategies, but some of the things Grant said and the way she said them were impactful. For instance, she framed anxiety as being about living in the future, dreading and catastrophizing about a bad outcome. The key to managing it is to try and live in the present by grounding yourself and practicing gratitude.

I've heard this strategy a million times before, but during my anxiety crisis it really resonated with me in a profound way. I was, for the first time, able to dismiss my fears about the future — about being alone, about being trapped, about selling my condo and having to move again soon — and convince myself to just focus on the present moment. I might be having a bad day, but that didn't mean I had a bad life. The anxious feelings would pass. Somehow, it worked.

I contacted the American Psychological Association (APA) to get their take on online mental health services. I fully expected them to be negative about them, but they were actually positive. For one thing, "Online platforms remove some of the barriers that exist in other spaces," Vaile Wright, APA's senior director of health care innovation, told me. "You can access the service anywhere, and you aren't reliant on finding someone in your immediate area." That's helpful, since there is a severe shortage of mental health professionals in the United States, and particularly in rural areas.

In addition, numerous studies have shown that teletherapy conducted with a video or audio component, and even just emailing or texting back and forth (known as "asynchronous messaging") can be as effective as in-person therapy for conditions such as anxiety, depression, eating disorders and obsessive-compulsive disorder. "As long as the platforms use proven methods for therapy, we know that teletherapy works," she says.

BetterHelp is the largest digital mental health service, with over 4 million clients, but it's not the only one. Others include TalkSpace, GrowTherapy and Online-Therapy, which offer counseling with licensed therapists that may be covered by your health insurance policy.

GrowTherapy and TalkSpace also have psychiatrists who can prescribe medication if needed. There are also niche services such as Faithful Counseling, which taps into the BetterHelp network of therapists and offers Christian-based therapy. ReGain is an online service for individuals and couples who are looking to improve their relationships with other people, and Pride Counseling is a specialized service for LGBTQ+ individuals who are looking for mental health therapists.

LeClair says that online therapy, at least with BetterHelp, tends to be oriented to finding solutions to immediate problems rather than for long-term therapy. Typically, therapists use cognitive behavioral therapy techniques (CBT) to help people change habits, beliefs and behaviors that are causing them trouble. That said, some people living in rural areas where they can't see therapists in person might use the service long-term.

Online platforms also aren't ideal for people with serious mental health conditions, such as schizophrenia and bipolar disorder, who typically need medication in addition to specialized counseling and close monitoring.

Online therapy platforms like BetterHelp have been criticized because they are for-profit entities that were developed by technology companies rather than health care organizations. Reimbursement to therapists is often poor and the therapists may have high quotas to meet, placing pressure on them to see many patients as quickly as they can. There have also been instances of alleged privacy and data breaches. For example, BetterHelp was fined $7.8 million by the Federal Trade Commission in 2023 for selling clients' personal data to social media companies to generate revenue.

"The majority of the cons lie in the tension between privately held companies needing to make a return on their investment and their unrealistic expectations on how to commercialize and monetize mental health treatment," Wright explains.

She advises users to read the terms of service before signing up for a mental health platform and making sure they are OK with how the service plans to protect data and identity. "Data breaches could have big implications for consumers," she says. For instance, "you might not want your employer to know that you are getting help for substance abuse. There is also the risk of identity theft."

Ultimately, you need to make your own calculation for how tolerant you are for the risk involved, she says.

For me, while I recognize the downsides to online therapy platforms, months later, I'm still grateful that I was able to get help when I needed it at a reasonable cost. I especially liked joining the group therapy session — just being in the company of other people from all over the world made me feel less abnormal and out of control. Now if I could just stop moving, one of my major anxiety triggers, I'd be golden!