"Therapy on Aisle 7: Retailers Are Entering the Mental Health Market"

learn how to start a private practice
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
S

Splenda88

Full Member
5+ Year Member
Joined
Jan 22, 2019
Messages
6,085
Reaction score
6,511
Increased access to mental health care is great, but I'm not sure I trust the likes of CVS and Walmart to deliver care that doesn't cut corners for patients while still compensating quality staff. I'll happily buy shampoo or toilet paper there. Psychotherapy...ehhhh.

I'm concerned this is all part of a race to the bottom in the quality of care. I expect any medication management to be done by the cheapest NP they can hire. I think they want to make psychiatrists superfluous.
 
  • Like
Reactions: 6 users
15 mins med refill for $100--profit
 
  • Like
Reactions: 1 user
Members don't see this ad :)
I hope they start offering ECT, would be so much more convenient for folks.
 
  • Like
  • Haha
Reactions: 13 users
Makes me wonder when these companies will start offering full body CT scans on demand to “optimize disease prevention!” And speaking of Walmart, I don’t know if you all have heard but Walmart is opening a school of medicine in Arkansas too. They would be competing with an increasingly saturated state like AR which already has 3 medical schools, so I am afraid students attending will be left with slim pickings regarding rotations. Sounds like these corporations are just doing everything they can to make a quick buck..
 
  • Like
Reactions: 1 user
EmilKraepelin55 said:
Makes me wonder when these companies will start offering full body CT scans on demand to “optimize disease prevention!” And speaking of Walmart, I don’t know if you all have heard but Walmart is opening a school of medicine in Arkansas too. They would be competing with an increasingly saturated state like AR which already has 3 medical schools, so I am afraid students attending will be left with slim pickings regarding rotations. Sounds like these corporations are just doing everything they can to make a quick buck..
Click to expand...
MD school?
 
  • Like
Reactions: 1 users
EmilKraepelin55 said:
Makes me wonder when these companies will start offering full body CT scans on demand to “optimize disease prevention!” And speaking of Walmart, I don’t know if you all have heard but Walmart is opening a school of medicine in Arkansas too. They would be competing with an increasingly saturated state like AR which already has 3 medical schools, so I am afraid students attending will be left with slim pickings regarding rotations. Sounds like these corporations are just doing everything they can to make a quick buck..
Click to expand...
It's not Walmart opening it, it is one of the members of the founding family. By all accounts, she is quite the philanthropist and it is a genuine nonprofit endeavor
TikiTorches said:
MD school?
Click to expand...
Yes
 
  • Like
Reactions: 4 users
The real issue with this is that it's hard to turn a profit with therapy at baseline. Offering it for even less isn't going to work unless you drive wages down, and there's already a lot of upward price pressure on mental health services due to lack of providers
 
  • Like
Reactions: 2 users
The saturation in the state doesn't matter. It comes down to the residency slots. Maybe WalMart is like kaiser. They start the school to make sure the grads work in their business.
Link please regarding WalMart med school
 
  • Like
Reactions: 1 users
wolfvgang22 said:
Increased access to mental health care is great, but I'm not sure I trust the likes of CVS and Walmart to deliver care that doesn't cut corners for patients while still compensating quality staff. I'll happily buy shampoo or toilet paper there. Psychotherapy...ehhhh.

I'm concerned this is all part of a race to the bottom in the quality of care. I expect any medication management to be done by the cheapest NP they can hire. I think they want to make psychiatrists superfluous.
Click to expand...

Completely agree. I think increasing access to care is great, but the problem is when that is done under the "customer is always right" mindset. I listen to a lot of podcasts, and many of them have been advertising online therapy platforms (e.g., Talkspace, Betterhelp, etc.). Some of the "features" these platforms advertise may perfect sense in terms of what a "customer" would want - immediate access to a therapist, ability to schedule sessions "on demand," etc. - but I'd argue that these are things that may or may not ultimately be helpful over the long run. When you frame therapy as something that you do "only when you need it" and at the drop of a hat, are you really getting something from the experience? I guess you are, but I don't know how the experience could be anything but superficial.

Then again, I've been doing analysis for the last 3 years, so perhaps I'm just rationalizing my own time/money investment...
 
  • Like
Reactions: 4 users
Mad Jack said:
The real issue with this is that it's hard to turn a profit with therapy at baseline. Offering it for even less isn't going to work unless you drive wages down, and there's already a lot of upward price pressure on mental health services due to lack of providers psychiatrists and PA/NP.
Click to expand...
 
  • Like
Reactions: 2 users
NickNaylor said:
Completely agree. I think increasing access to care is great, but the problem is when that is done under the "customer is always right" mindset. I listen to a lot of podcasts, and many of them have been advertising online therapy platforms (e.g., Talkspace, Betterhelp, etc.). Some of the "features" these platforms advertise may perfect sense in terms of what a "customer" would want - immediate access to a therapist, ability to schedule sessions "on demand," etc. - but I'd argue that these are things that may or may not ultimately be helpful over the long run. When you frame therapy as something that you do "only when you need it" and at the drop of a hat, are you really getting something from the experience? I guess you are, but I don't know how the experience could be anything but superficial.

Then again, I've been doing analysis for the last 3 years, so perhaps I'm just rationalizing my own time/money investment...
Click to expand...
Interestingly enough, most of those instant access claims are false advertising. It can be very difficult for patients to schedule appointments and when patients text the therapists, it can take a decent amount of time for a response. Check out the Android reviews on TalkSpace (Talkspace Counseling & Therapy - Apps on Google Play). That type of platform might work for high functioning patients, but once the personality disordered or patients with severe mental illness come on-board, those reviews start to tell a different story.
 
  • Like
Reactions: 3 users
Members don't see this ad :)
  • Like
Reactions: 1 users
LCSWs are a dime a dozen. It's one of the reasons I quit social work myself years ago. These retailers will have no problem churning through fresh social work grads of chequered quality.

They also won't be able to retain any but the most mercenary, low quality, or green MDs and NP/PAs, obviously. I'm most concerned that it will cheapen professional mental health care, not in a financial sense but in a quality sense.

It will result in a two tiered system with mental health for the poor vs. actual treatment for those with resources. They'll argue that is better than no mental health care access. Maybe it is. "Come see a therapist today for our Everyday Low Price at Walmart. Always 😊. " He or she will tell you everything is going to be all right, no change required. It'll be super convenient, too, with the CBD oil head shop that sells Kratom in the strip mall across the parking lot.
 
  • Like
Reactions: 5 users
wolfvgang22 said:
LCSWs are a dime a dozen. It's one of the reasons I quit social work myself years ago. These retailers will have no problem churning through fresh social work grads of chequered quality.

They also won't be able to retain any but the most mercenary, low quality, or green MDs and NP/PAs, obviously. I'm most concerned that it will cheapen professional mental health care, not in a financial sense but in a quality sense.

It will result in a two tiered system with mental health for the poor vs. actual treatment for those with resources. They'll argue that is better than no mental health care access. Maybe it is. "Come see a therapist today for our Everyday Low Price at Walmart. Always 😊. " He or she will tell you everything is going to be all right, no change required. It'll be super convenient, too, with the CBD oil head shop that sells Kratom in the strip mall across the parking lot.
Click to expand...
Yes for only $10.88!
 
  • Like
Reactions: 1 users
  • Like
Reactions: 1 user
TikiTorches said:
Not everything can be solved with money. Look at blue origin.
Click to expand...
I mean, worst case she downgrades to a DO school. With her fortunes she could literally build a teaching hospital and research facility and push out other schools from existing rotation sites
 
  • Like
Reactions: 2 users
wolfvgang22 said:
LCSWs are a dime a dozen. It's one of the reasons I quit social work myself years ago. These retailers will have no problem churning through fresh social work grads of chequered quality.

They also won't be able to retain any but the most mercenary, low quality, or green MDs and NP/PAs, obviously. I'm most concerned that it will cheapen professional mental health care, not in a financial sense but in a quality sense.

It will result in a two tiered system with mental health for the poor vs. actual treatment for those with resources. They'll argue that is better than no mental health care access. Maybe it is. "Come see a therapist today for our Everyday Low Price at Walmart. Always 😊. " He or she will tell you everything is going to be all right, no change required. It'll be super convenient, too, with the CBD oil head shop that sells Kratom in the strip mall across the parking lot.
Click to expand...
This is the direction we are already heading for all of medicine. Full steam ahead, the only question is which part of the Iceberg to we want to ram?
 
  • Like
Reactions: 2 users
wolfvgang22 said:
LCSWs are a dime a dozen. It's one of the reasons I quit social work myself years ago. These retailers will have no problem churning through fresh social work grads of chequered quality.

They also won't be able to retain any but the most mercenary, low quality, or green MDs and NP/PAs, obviously. I'm most concerned that it will cheapen professional mental health care, not in a financial sense but in a quality sense.

It will result in a two tiered system with mental health for the poor vs. actual treatment for those with resources. They'll argue that is better than no mental health care access. Maybe it is. "Come see a therapist today for our Everyday Low Price at Walmart. Always 😊. " He or she will tell you everything is going to be all right, no change required. It'll be super convenient, too, with the CBD oil head shop that sells Kratom in the strip mall across the parking lot.
Click to expand...
I mean, we already have a two-tiered system in manu respects, where the well-off get decent care and the not-so-well-off get minimal to no care
 
  • Like
  • Angry
Reactions: 3 users
Mad Jack said:
I mean, worst case she downgrades to a DO school. With her fortunes she could literally build a teaching hospital and research facility and push out other schools from existing rotation sites
Click to expand...
Downgrades to a DO school? DO schools are a downgrade???
 
Mad Jack said:
From an accreditation difficulty standpoint, absolutely
Click to expand...
I only applied to DO schools. Except my dermatologist, all of my physicians are DOs. I believe in the mind, body, spirit philosophy and OMM , although not used in psychiatry is amazing. I ONLY wanted to be a DO. I thought we were past that. There's one match now. We need to band together as physicians...........................................
 
futuredo32 said:
I only applied to DO schools. Except my dermatologist, all of my physicians are DOs. I believe in the mind, body, spirit philosophy and OMM , although not used in psychiatry is amazing. I ONLY wanted to be a DO. I thought we were past that. There's one match now. We need to band together as physicians...........................................
Click to expand...
I am a DO, dude. I only applied to DO schools. My MCAT was 96th percentile. DOs are fine as doctors. Get the chip off your shoulder, I wasn't talking about DO students or graduates. I'm talking about the COCA's standards for schools, which are much more lax than those of the LCME. They don't require substantial research, they don't require as much with regard to rotation strength (you can literally have all of third year be outpatient by COCA standards), they don't require diversity of funding (MD schools can only have a certain percentage of their funding come from tuition, not so with DO scools), etc. It is significantly easier to get initial accreditation for a DO school than a MD school due to all of this, and she could *absolutely* get a DO school set up but a MD one may be challenging if she can't buy out or create more rotation sites. It is also *much cheaper* to run a DO school, which matters when you have private funding.
 
  • Like
Reactions: 1 user
I am a dudette. The phrase "downgrade" was inappropriate. And good memory about your MCAT score. Good for you.
 
futuredo32 said:
I am a dudette. The phrase "downgrade" was inappropriate. And good memory about your MCAT score. Good for you.
Click to expand...
Again, he said it in the context of accreditation.
 
  • Like
Reactions: 3 users
futuredo32 said:
I am a dudette. The phrase "downgrade" was inappropriate. And good memory about your MCAT score. Good for you.
Click to expand...
I have little respect for the COCA, which is pretty well known on these forums. The COCA is inferior to the LCME and that is a fact, there is no disputing it. As to my memory, it is hard to forget people telling you your MCAT and GPA are average for Harvard (in the year I was admitted), why are you going DO. Your board scores are great for a DO, why are you becoming a psychiatrist. The answer to both is that they were the right choices for me and I'm not unhappy with them in the slightest
 
Last edited:
  • Like
  • Love
Reactions: 4 users
20 minute cbt sessions delivered over 12 manualized once a week visits. Triple the capacity of each counselor. If you’re not better get referred to a “real” counselor. Right after we get the $50x12 = $600 cash only for all that great therapy.
 
  • Like
Reactions: 1 user
nexus73 said:
20 minute cbt sessions delivered over 12 manualized once a week visits. Triple the capacity of each counselor. If you’re not better get referred to a “real” counselor. Right after we get the $50x12 = $600 cash only for all that great therapy.
Click to expand...

Yep exactly. Comes out to a sweet 150/hr for Walmart while paying for the most bottom of the barrel LCSW graduates you can find.

Even for the online therapy platforms right now they really aren’t THAT cheap compared to shopping around in your area. Talkspace for instance costs $316/month for one 30 min actual session a month and “unlimited texting/messaging 5 days per week, therapist responds daily”. You could go to a couple sessions of actual in person therapy for 50 minutes each over that same timeframe for a similar cost.
 
  • Like
Reactions: 3 users
NickNaylor said:
immediate access to a therapist, ability to schedule sessions "on demand," etc. - but I'd argue that these are things that may or may not ultimately be helpful over the long run. When you frame therapy as something that you do "only when you need it" and at the drop of a hat, are you really getting something from the experience?
Click to expand...

I'd argue that immediate access to a therapist would be immensely beneficial for many. Can't count the number of patient's I've encountered who had something happen and would benefit from starting therapy that day who had to wait weeks or months d/t availability. If some of these companies could offer getting started immediately I'd say that's a great thing, though as WiGA pointed out this is rarely the case.

Agree with the rest though. Dropping in for a session here and there with no consistent f/up or constantly messaging a therapist seems to be the opposite of therapeutic aside from the individuals who've done extensive CBT/DBT and just need a quick refresher on coping skills.
 
Stagg737 said:
I'd argue that immediate access to a therapist would be immensely beneficial for many. Can't count the number of patient's I've encountered who had something happen and would benefit from starting therapy that day who had to wait weeks or months d/t availability. If some of these companies could offer getting started immediately I'd say that's a great thing, though as WiGA pointed out this is rarely the case.

Agree with the rest though. Dropping in for a session here and there with no consistent f/up or constantly messaging a therapist seems to be the opposite of therapeutic aside from the individuals who've done extensive CBT/DBT and just need a quick refresher on coping skills.
Click to expand...
I think the implication was immediate access to your established therapist not to establish therapy. Immediate access to your established therapists is problematic because it models a relationship with poor boundaries or unrealistic expectations. There are many with personality disorders or anxiety in which this would be problematic to the therapeutic process.
 
  • Like
Reactions: 3 users
hallowmann said:
I think the implication was immediate access to your established therapist not to establish therapy. Immediate access to your established therapists is problematic because it models a relationship with poor boundaries or unrealistic expectations. There are many with personality disorders or anxiety in which this would be problematic to the therapeutic process.
Click to expand...

Exactly, I'm mostly CBT, but I still adhere pretty closely to "The Frame" within my therapy relationships. We start and stop on time, I am not the ED, the only real questions I field between sessions have to deal with cancellations and reschedules, and I am not a lifelong friend. I suspect that a lot of the midlevels and diploma mill grads who work for places like TalkSpace and other on demand resources, are going to have disproportionately more problems with ethics violations around provider/patient relationship issues.
 
  • Like
Reactions: 2 users
Mad Jack said:
The real issue with this is that it's hard to turn a profit with therapy at baseline. Offering it for even less isn't going to work unless you drive wages down, and there's already a lot of upward price pressure on mental health services due to lack of providers
Click to expand...
The real goal to increase retail foot traffic, which will directly increase retail sales per square foot. Sort of like why Target and Walmart are now in the very low margin grocery business.

This is also the reason why pharmacies are pushing hard into the NP in a box business. They lost a lot of foot traffic and scripts business due to online pharmacy benefit managers, and their response was to buy these online competitiors. But that ironically decreases foot traffic even further.
 
  • Like
Reactions: 3 users
hallowmann said:
I think the implication was immediate access to your established therapist not to establish therapy. Immediate access to your established therapists is problematic because it models a relationship with poor boundaries or unrealistic expectations. There are many with personality disorders or anxiety in which this would be problematic to the therapeutic process.
Click to expand...

Right, and there are obvious problems with boundaries and dependency when patients have instant access to their therapists or even their psychiatrists outside of true emergencies. Was just pointing out a possible bright point with such a organization/system which has failed to come to fruition.


WisNeuro said:
Exactly, I'm mostly CBT, but I still adhere pretty closely to "The Frame" within my therapy relationships. We start and stop on time, I am not the ED, the only real questions I field between sessions have to deal with cancellations and reschedules, and I am not a lifelong friend. I suspect that a lot of the midlevels and diploma mill grads who work for places like TalkSpace and other on demand resources, are going to have disproportionately more problems with ethics violations around provider/patient relationship issues.
Click to expand...

Of course, and when you're doing initial CBT or longer courses I agree that this is important. I do have some patients who have had extensive CBT/DBT in the past where I can review and practice one or two of their coping skills in 15 minutes and they report significant improvements at the next appointment because they'd just been forgetting to use their coping skills. The potential for brief "refresher sessions" for some patients is something I really like about CBT, though it obviously requires a good foundational framework and actually efficacy with implementation on the patient's part.
 
The access to quality therapy is pretty poor in most of the country IMO, even with decent insurance, especially if you’re looking for evidence based therapies other than IPT. This seems like a good thing overall, though the Devil is in the details.
 
CVS takes the lead.

www.nbcphiladelphia.com

CVS Adds Mental Health Services at 11 Philly Area MinuteClinics

CVS Health said Wednesday it has launched mental health counseling and care services at 11 of its Philadelphia and South Jersey MinuteClinics in response to the increased need for such aid since the start of the COVID-19 pandemic, the Philadelphia Business Journal reports.
www.nbcphiladelphia.com www.nbcphiladelphia.com
 
Splenda88 said:
CVS takes the lead.

www.nbcphiladelphia.com

CVS Adds Mental Health Services at 11 Philly Area MinuteClinics

CVS Health said Wednesday it has launched mental health counseling and care services at 11 of its Philadelphia and South Jersey MinuteClinics in response to the increased need for such aid since the start of the COVID-19 pandemic, the Philadelphia Business Journal reports.
www.nbcphiladelphia.com www.nbcphiladelphia.com
Click to expand...

Ugh, this is so cringeworthy. Even the quote and job title are cringeworthy:

“With the addition of these new services, we’re now able to offer the community an innovative, straight-forward approach to mental health care counseling,” said Angela Patterson, chief nurse practitioner officer at MinuteClinic and a CVS Health vice president.
 
  • Haha
  • Like
Reactions: 1 users
What about Brightside and Get Cerebral? Have to wonder if they will be able to deliver on the immediate access, mail order meds as well as what the liability will look like.
 
You must log in or register to reply here.
Next unread thread

Similar threads

Ironspy
Safety in community mental health setting
Replies
2
Views
525
smalltownpsych
smalltownpsych
Sushirolls
  • Poll
Community Mental Health Agency Success
Replies
47
Views
2K
sloh
S
A
Are people getting worse in regards to mental health?
2
Replies
89
Views
5K
whopper
whopper
Coupd'Cat
Where are my community mental health center psychiatrists at?
2
Replies
60
Views
4K
justalittlestar
justalittlestar
P
What to do on 7 off?
Replies
46
Views
3K
nexus73
N
Top