The online mental health delivery system is sorely lagging in development. Service delivery models suggested by many dot.com mental health websites put both the practitioner and consumer at risk. Many such websites are developed with more of an eye toward making a profit than delivering services that would benefit the involved parties.For example:
- Some web-based businesses require that a practitioner sign a service agreement that not only holds the practitioner responsible for any and all malpractice liability, but explicitly indemnifies the dot.com.
- Some web-based businesses encourage practitioners to work with anonymous patients, and therefore cannot act on the legal mandate imposed on clinicians to report suspected child, elder and in some cases, spousal abuse; suicide or homicide.
- Some web-based businesses encourage practitioners to refer suicidal patients to them, so they can “handle” the patient by alerting the authorities, who will be asked to intervene and take the patient off the clinician’s hands.
- Some web-based businesses offer consent agreements and disclaimers, but the effectiveness of such agreements on web pages is questionable.
- Some web-based businesses verify the practitioner’s credentials and state of licensure, but they do not verify the consumer’s state of residence. The practitioner, then, does not have evidence of a consumer’s location when delivering services. Yet, the professional may be responsible for practicing out of state, even if consumers misrepresent themselves.
- Some web-based businesses fail to inform consumers that their clinicians must be licensed in the state of residence of each and every consumer, as well as be familiar with local emergency services.
- Some web-based businesses offer “psychological testing” to consumers but don’t use valid and reliable psychological tests that have been normed on the population being tested, and where test administration is not standardized, and that test results are not given in anything but a written report that the consumer is left on their own to interpret.
While some companies are beginning to offer creative services to both mental health practitioners and consumers, they are few and far between.
These are some of my thoughts. What are yours?