Mental Health App Talkspace Raises $50M | Hacker News Reader

Mental Health App Talkspace Raises $50M

bloomberg.com

29 pointshoward94126 comments

Having previous worked in this space (for ginger.io), I’d really recommend against talkspace. The time between replies is so asynchronous that it’s a really poor substitute for actual therapy, and their lack of HIPAA protections is unethical. They need to raise this money because they spend it all on marketing.

I haven’t been at Ginger in a while but they were the best I the biz when I left, and the team really believed in the mission for the greater good.

My experience there sounds different than yours. I saw a cognitive behavioral therapist. At first we chatted a few times a day, then once a day, then a few times a week.

In between those longer breaks you can still write messages — and I did. It’s like having a journal that someone is going to read and help you figure out what you need to be doing.

As for HIPAA violations everyone does this. In the last week I’ve been to a dentist and optometrist and seen patient information displayed inappropriately on screens or on paper work left out at both offices. I’m not saying that HIPAA violations are OK, but Talkspace seems no worse than a brick and mortar office.

Perhaps I’m biased here. TalkSpace helped me get my anxiety under control. For that I recommend them to everyone. But if you have a hard time applying cognitive behavioral techniques like mindfulness on a regular basis I would not recommend them.

There's a difference between doctors violating HIPPA protections on your data by gossiping, vs. you having no HIPPA protections to violate to begin with. Here it wouldn't even be a violation.

Not to mention your doctor's office is not only liable (consequences are no joke) for screwups, they also didn't raise $50M recently in addition to previous funding.

Ginger was HIPAA compliant well before delivering services -- it's unethical to not be, IMHO. It's also not that hard to do the right thing.

Talkspace mentioned they were HIPAA compliant in 2016: https://www.talkspace.com/blog/how-talkspace-keeps-your-data...

Notice how they talk about their technology or platform being compliant. There are various levels — they do not consider themselves a provider:

https://www.forbes.com/sites/toddessig/2016/08/18/talkspace-...

> We try to keep Talkspace.com safe, but you use it at your own risk. We are providing Talkspace.com “As Is” without any express or implied warranties. We do not guarantee that Talkspace.com will be safe or secure.

https://www.talkspace.com/public/privacy-policy

If you plan to use this service understand you get what you pay for. They seem to have no duty of care with your data. I'm not sure how they are able to get away with this without violating HIPAA though.

If they don't take insurance (EDIT: insurance or medicare), they don't need to be HIPAA compliant.

EDIT: This is advice my HealthTech startup received from a very well respected lawfirm. It's not as black and white as this. However, it is a good rule of thumb.

HIPPA isn’t only about insurance. If they collect any personal health information (which, by the very nature of their product, I’m sure they do) they need to be compliant.

No, they don't. Although it's not about insurance either. Here is a list of who is covered: https://www.hhs.gov/hipaa/for-professionals/covered-entities...

Note that a random app that gets "medical data" is not covered unless it counts as a health care provider AND transmits data in certain HHS electronic formats.

That's not true.

They only need to be HIPAA compliant if they're a covered entity and dealing with an HHS related transaction.

https://www.hhs.gov/hipaa/for-professionals/covered-entities...

> A Health Care Provider .... ...but only if they transmit any information in an electronic form in connection with a transaction for which HHS has adopted a standard.

What makes you think that or are you joking?

I have received this advice from several well respected lawyers and read the law myself.

Very interesting. I guess it shows you always have to read stuff yourself before believing anything . Does this mean that if you run a site where people enter their health data you are not really bound by HIPPA? Makes me wonder about something like Apple Health? Are they bound by it when they receive data or only when they pass it somewhere else?

Not looking for legal advice. Just curious. In my company our lawyers tell us what to do anyway.

>Are they bound by it when they receive data or only when they pass it somewhere else?

Neither based on my knowledge. They can do whatever they want with the data and give to whomever they want with no restrictions from HIPAA.

edit: Note that their privacy policy may provide protections and the government may get angry with certain sharing but only if it's politically useful (ie: tinder, hiv status and china).

Not true at all

>I'm not sure how they are able to get away with this without violating HIPAA though.

The same way every health app out there does it. By not having medical professionals involved, not transmitting data in standard electronic medical formats and not getting data already classified under HIPAA. Without those you're no longer a covered entity or business associate under HIPAA so you can do whatever you want.

Contrary to belief, HIPAA is not about medical data as a whole.

> For a fee starting at $49 a week, users can leave text, voice and video messages with counselors who respond five days a week. Customers can pay more for live video chats.

Considering that people with mental health issues often don’t have a lot of money, I’m not sure what market they’re targeting with a price point of $200/month. That’s more than a student loan or cheap car payment!

It's not for everyone, but the hourly cost for a therapist is typically between $90-$200. Also these new services could be covered under some insurance programs (I'm curious for some data points here).

*the 45 minute cost

> Considering that people with mental health issues often don’t have a lot of money, I’m not sure what market they’re targeting with a price point of $200/month. That’s more than a student loan or cheap car payment!

That's not a target market. The target market is a bored housewife with a lot of disposable income. Or someone who believes they need a therapy because a person on a subway sat next to them, etc. The app is to a way to capture the extra money that is left on a table because therapists aren't conveniently located.

That's why the ads show Michael Phelps

cc all mental health professionals. It’s real expensive to go to any therapist; good luck finding someone less than $100 an hour. If you do find one, good luck getting through your deductible to actually cover it.

ycombinator startup 7cupsoftea also offers professional talk therapy from licensed providers. My recommendation is unless you are absolutely terrified of talking to someone in person, don't get e-therapy. So much of therapy isn't from the words but from the transfer of emotion and affect. I think the client will get some level of relief just from typing things out, getting it "off their chest", but it's not the same thing as going to their office, having that exclusive space and time, and seeing and hearing your therapist's affect and reflection of your emotion. Not to mention allowing them to use their expertise in detecting indirect issues. For instance, consider an alcoholic in denial, goes to therapy because of difficulty holding down a job. A well-trained therapist could sniff out the alcoholism even if the client was in denial or never even considered that to be the source. A chat system shortcuts all of that for pure informational content. Emotional problems are seldom solved with Sherlock-esque revelations of information.

what about video e-therapy?

Would one get the same counselor? I have schizoaffective disorder and there is no way I would want to "see" a new counsellor each time. One needs to form a connection and develop trust.

It’s the same counselor. I personally have dealt with depression and anxiety (and am a satisfied yet former Talkspace customer) and I have immediate family with bipolar disorder. I would NOT recommend this service for someone who has complicated mental health needs. If you need “simpler” therapy such as for relationship issues or depression/anxiety than Talkspace is fine, but otherwise I wouldn’t really trust them.

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