(Bloomberg) -- The therapist’s page on the CareDash website looked official: It had a profile photo, an office address and phone number, and a button to “check availability” and book an appointment.

But for potential patients who clicked on that button, it didn’t take them to set up time with the therapist, who had never signed up for CareDash. Instead, the patients were prompted to try therapy from BetterHelp or Talkspace Inc., one of the many startups launched in recent years to offer therapy online.

CareDash, an online health company founded six years ago, said in a statement Friday that it was changing many of its practices, including how it steers patients to advertisers. BetterHelp, which is owned by Teladoc Health Inc., said on social media Thursday that it had cut its advertising arrangement with the company. Talkspace also said it was stopping advertising with CareDash.

The blowback was sparked by an online protest by independent therapists who say CareDash used publicly available information to create shadow profiles that steered business away from them and toward the startups.  

On the short video app TikTok, a post from a therapist named Alicia Murray called out the practice. Murray’s post has received over 400,000 views in two days, and resulted in dozens of replies from people saying they are therapists who found similar shadow profiles on CareDash. 

Online mental health startups work to meet a real need in the US: There are too few therapists, insufficient insurance coverage, and a growing number of patients seeking counseling or care for everything from temporary mental health needs to more serious, complex conditions. That’s led to a flood of investment in startups seeking to help those patients. Venture capitalists put $6.9 billion into mental health and behavioral health companies last year, close to three times the 2019 total, according to data compiled by Pitchbook. Competition for patients and growth has followed.

Bryan Harnsberger is a licensed psychologist and the cofounder of Wellesley Counseling and Wellness LLC in Massachusetts, and says that he also found a CareDash profile made without his consent, and that it directed potential patients to the online startups.

“I feel like someone else is catfishing me,” said Harnsberger, using a slang term for online impersonation. “I’ve spent hundreds of thousands of dollars in training and hours in the community working to build my reputation and my persona. And now they’re going to potentially use that to gather their own leads.”

Website Changes

On Friday, CareDash emailed a statement saying it would make changes: “Over the last few days, CareDash has listened to the concerns of many in the therapist community and we recognize the opportunity to improve the profile pages we display.”

Harnsberger and other therapists contacted by Bloomberg provided recent photos of CareDash’s site before the changes were made. Under the old design, once the “check availability” button was clicked, it would scroll down the page and say the provider hadn’t provided a way to schedule online through CareDash and that “you could get connected with an online therapist” right above ads for BetterHelp and Talkspace. Those features no longer appear on several profiles reviewed by Bloomberg.

In the statement sent Friday, CareDash said it had removed the website features that therapists said directed potential patients elsewhere, including a “Book An Appointment” feature for profiles where the therapist hadn’t signed up for CareDash, as well as steps to “reduce potential confusion about provider availability.”

In a separate, earlier statement, the company had said that it creates profiles for licensed health professionals without their permission or knowledge and that profiles are not taken down, even if asked for by the therapist. In its follow-up statement, the CareDash did not say it would change that policy, but would make it clear from where it obtains data.

Caredash was founded in 2016 and is headquartered in the Boston area. It raised $2.8 million from venture capital firm Link Ventures during two funding rounds in 2014 and 2017, according to PitchBook.  BetterHelp, a 2013 telehealth start-up bought by Teladoc in 2015 for $3.5 million in cash and other considerations, said Aug. 4 that it was pulling its advertising from the site.

“CareDash is an entirely separate company and we do not control their business practices,” BetterHelp said in a statement on its social media accounts. “We had a service agreement with CareDash so that users who were looking for a therapist could get help from one of the therapists in our network. Since we’ve learned of some concerns raised about CareDash, we’ve stopped promoting BetterHelp on their website and ended the arrangement. These changes will take effect shortly.”

Reached for comment by Bloomberg, BetterHelp reiterated the statement it had posted online earlier. In an emailed statement, Talkspace said its ads had been placed through an agency. “Once we were made aware of any issues regarding this site, Talkspace immediately discontinued our nominal advertising relationship. We are committed to transparency around our business practices,” the company said.

Benjamin Caldwell, a marriage and family therapist in Los Angeles, found an unauthorized profile of himself on CareDash.

“I haven’t seen anybody be as sort of egregiously misleading about what a consumer can do on that site as what CareDash has been doing,” Caldwell said. CareDash suggested that “if you as a consumer came to my profile on CareDash, that you could use that button or link to check my availability or to schedule with me. And this is despite the fact that of course I have no affiliation with CareDash.”

Blowback

The company’s practice led to blowback from groups representing mental health professionals. The American Psychological Association, the Clinical Social Work Association and the National Association of Social Workers sent alerts to members about the situation and encouraged them to file complaints with the US Federal Trade Commission and state attorneys general.

CareDash’s site allows health providers to “claim” their pages and update information. The American Psychological Association, or APA, sent a cease-and-desist request Aug. 4 asking CareDash to deactivate and remove all psychologist profiles that have not already been “claimed” by the provider and discontinue advertising that “suggests that psychologist providers have endorsed or approved the CareDash platform.”

The APA alleged that CareDash has generated and displayed thousands of “unauthorized medical provider ‘profiles.’” Bloomberg reviewed a copy of the letter.

Profiles that haven’t been “claimed” by a provider say that mental health providers’ data was collected from the NPPES NPI Registry, a publicly available database of all registered health professionals managed by the US government. CareDash’s website tells providers to “please claim your profile in order to update your information and provide the best way for patients to reach you.”

Some providers discovered their CareDash profile includes their private home address from their National Provider Identifier records. The NPI registry does not allow providers to register with a post office box, and some don’t work out of a physical office location.

Other clinicians have found their profiles to list inaccurate licensing, affiliations and other information.

Susan Bush, a licensed clinical psychologist and owner of Birchwood Clinic in Chicago, said her page was unauthorized and had “multiple inaccuracies,” including her business location, the company where she works, and the company with which she is affiliated.

“Whatever information is public will be available on CareDash by default,” CareDash said in its first statement to Bloomberg. The company said that if information on a profile was wrong, it could be updated at the request of the health professional. 

Other provider directories like ZocDoc and Psychology Today require clinicians to sign up, create their own profile, pay for it, and choose the information they want to display, Bush said.

Harnsberger, for example, said he uses Psychology Today, but he created his profile and has “clear understanding and clear control” over it.

In addition to the business considerations for therapists, the stakes for patients can be serious, said Caldwell, the Los Angeles therapist.

“It’s really hard even if you have coverage to actually obtain mental health care,” Caldwell said. To have a website like CareDash “suggest to consumers that you can actually find these providers and schedule with these providers through our site, only for then the consumer to be redirected away from the therapist that they had searched for to an online platform instead” isn’t right, he said.

“That is deeply problematic,” he said. “It seems like a kind of bait-and-switch operation.”

©2022 Bloomberg L.P.