As a clinical social worker, I believe access to mental health care matters.

I also believe people deserve to know who is providing that care, who has access to their information, and who profits from it.

Those two beliefs have become increasingly important as mental health care has become an attractive market for corporations and investors.

If you've searched online for a therapist recently, there's a good chance you've encountered a large therapy platform before you've ever encountered the independent therapists practicing in your own community.

That's not necessarily because those platforms offer better care.

They have something your neighborhood therapist probably doesn't have: enormous scale, sophisticated technology, substantial marketing budgets, and, in some cases, millions of dollars in outside investment.

Some of these companies have also made therapy easier to access. They've simplified insurance billing, expanded telehealth options, and helped connect clients with therapists when finding care locally can be frustrating.

So this isn't an argument that corporate therapy is inherently bad or that independent therapists are inherently better.

It's an argument for informed consent.

Because therapy is an unusually intimate service.

You may tell your therapist about trauma, relationships, sexuality, grief, substance use, fears, family conflict, medical concerns, or experiences you've never told another person.

Before entering that information into a website or beginning care through a platform, I think you deserve answers to some basic questions:

Who owns this company?

How does it make money?

Who has access to my information?

How is my therapist compensated?

And when the interests of clients, clinicians, insurers, corporations, and investors don't perfectly align, whose interests come first?

Those aren't anti-business questions.

They're informed-consumer questions.

And when the product involves your mental health, they're worth asking.

Mental health care has become big business

There is an important distinction to make here.

Private equity, venture capital, and publicly traded corporations aren't the same thing. When we talk about the “corporatization” of mental health care, we're actually talking about several different business models.

But they have something in common: outside investors increasingly see behavioral health care as an opportunity for growth.

A 2024 study examining acquisitions of behavioral health treatment facilities between 2010 and 2021 identified 2,806 facilities involved in acquisitions. Private equity-backed acquisitions accounted for approximately 60% of that activity.

A separate study examining private equity investment through 2022 found that PE acquisitions in behavioral health grew from one acquisition involving 38 locations in 2010 to 176 acquisitions spanning more than 5,000 locations in 2022. More than half of the acquisitions identified in that study occurred in 2020 or later.

And this trend extends beyond traditional behavioral health facilities.

Online therapy and therapist-network companies have attracted enormous investments as well.

Grow Therapy, for example, announced a $150 million Series D investment in 2026, following previous rounds of outside investment.

These companies aren't necessarily owned by private equity firms. Some are backed by venture capital or other institutional investors. Others are part of publicly traded healthcare corporations.

The distinction matters.

But so does the larger trend.

There is a tremendous amount of money interested in your mental health care.

And whenever healthcare becomes an investment opportunity, consumers should ask questions.

Who actually profits from your therapy session?

When you see an independent therapist, the financial relationship is often relatively easy to understand.

You or your insurance company pays the practice. That revenue pays the therapist and covers the costs of running the practice: office space, electronic health records, malpractice insurance, continuing education, billing, technology, taxes, administrative expenses, and everything else required to provide care.

Large platforms can introduce additional layers.

Depending on the company, a platform may negotiate reimbursement with insurers, retain part of the revenue associated with services, charge employers or health plans, operate through subscriptions, or use some combination of these models.

Those companies also have employees, technology costs, advertising budgets, executives, and investors.

None of that automatically makes the service unethical.

But it creates an important question:

When decisions are made about mental health care, whose interests are represented at the table?

The client?

The therapist?

The insurance company?

The platform?

The investor?

Sometimes those interests align.

Sometimes they may not.

Your therapy data deserves special consideration

This may be one of the most important pieces of this conversation.

Mental health information is extraordinarily personal.

And one major case involving an online therapy company demonstrates why consumers should pay attention to what happens to information they enter online.

In 2023, the Federal Trade Commission finalized an order involving BetterHelp after alleging that the company had disclosed consumers' email addresses, IP addresses, and information from health questionnaires to third parties including Facebook and Snapchat for advertising purposes despite making promises about how personal health information would be used.

BetterHelp agreed to pay $7.8 million to resolve the FTC's charges. The final order also prohibited the company from sharing health information for advertising and imposed additional privacy requirements.

That history does not mean every therapy platform handles information the same way.

It also doesn't mean current practices at a company are necessarily identical to past practices.

It does demonstrate why these questions matter.

Before entering sensitive mental health information into any website or app, consider asking:

Who receives this information?

Where is it stored?

What information is collected before I even become a therapy client?

Is my information used for analytics, marketing, or advertising?

Can third parties receive it?

What happens to my information if I stop using the service?

A professional-looking website or polished app shouldn't replace basic questions about privacy.

HIPAA isn't a universal privacy shield

People sometimes assume that anything connected to healthcare automatically falls under HIPAA.

It isn't always that simple.

Privacy protections can depend on what type of organization is collecting information, why it is collecting it, and its relationship to healthcare providers and insurers.

There can also be a difference between information you provide directly to your therapist as part of treatment and information you enter into a website while searching, completing a quiz, browsing services, or creating an account.

This doesn't mean you should be afraid to use technology to find a therapist.

It means it's worth understanding what you're agreeing to before sharing deeply personal information.

Does corporate ownership affect the quality of therapy?

This is where nuance matters.

A therapist working through a national platform may be an exceptional clinician.

An independent therapist may not be.

Ownership structure alone tells you very little about the individual sitting across from you.

There are also legitimate ways technology and larger organizations can improve access. They may make insurance easier to use, reduce administrative work for clinicians, offer telehealth infrastructure, or help clients locate therapists more quickly.

The concern is what can happen when mental health care is designed for scale.

Therapy is inherently individualized.

Good care may require consultation, specialized training, coordination with other providers, thoughtful documentation, flexibility, or recognizing that another clinician is better qualified to help a particular client.

Researchers studying investment and consolidation in behavioral health have repeatedly pointed out that we still need more evidence about how these changes affect quality, access, spending, staffing, and patient outcomes.

That uncertainty is worth paying attention to.

How do I know whether my therapist is actually qualified?

Start with something simple:

Verify their license yourself.

Don't rely exclusively on a platform profile, social media bio, advertisement, or the letters listed after someone's name.

Mental health professionals are licensed by the state in which they practice, and state licensing boards generally provide ways for consumers to verify licenses.

Look up the therapist's name.

Confirm that their license is active.

Then ask questions.

You might ask:

What experience do you have working with the issue I'm seeking help for?

What specialized training have you completed?

What therapeutic approaches do you use, and why do you think they may fit what I'm experiencing?

How will we evaluate whether therapy is helping?

What happens if this approach isn't working for me?

Where are my records stored?

Who besides you has access to my information?

You are allowed to interview your therapist.

A therapist should be able to explain how they work without making guarantees about your outcome.

What if I can't afford traditional private-practice therapy?

This part of the conversation matters enormously.

It's easy to criticize corporate mental health care while ignoring one of the reasons these companies became attractive in the first place:

Therapy can be expensive.

Insurance networks can be difficult to navigate.

Deductibles can make supposedly “covered” therapy unaffordable.

Waitlists can be long.

And rural communities may have very few clinicians nearby.

Telling someone to “just find a private-practice therapist” isn't particularly helpful if they can't afford one.

Fortunately, a large for-profit therapy platform isn't the only alternative.

Consider asking independent therapists whether they maintain reduced-fee or sliding-scale appointments.

Look at nonprofit community mental health organizations in your area.

University and graduate training clinics may offer therapy provided by clinicians-in-training under supervision at significantly reduced rates.

If you have health insurance, contact your insurer and ask for current in-network therapists. Because directories aren't always current, contact the therapist directly to confirm that they're accepting both new clients and your specific plan.

And don't underestimate the value of simply asking a local therapist:

“I can't afford your rate. Is there someone in the community you would recommend?”

Therapists often know other therapists.

Many of us would rather help you find appropriate care somewhere else than have cost prevent you from receiving care at all.

Resources for Finding Qualified, Lower-Cost Therapy

Verify your therapist's license

Search the official licensing board for the state where you live rather than relying solely on a directory or platform profile.

Nevada residents can verify clinical social workers through the Nevada Board of Examiners for Social Workers, marriage and family therapists and clinical professional counselors through the Nevada Board of Examiners for Marriage and Family Therapists & Clinical Professional Counselors, and psychologists through the Nevada Board of Psychological Examiners.

Open Path Psychotherapy Collective

Open Path is a nonprofit organization that connects financially eligible people with participating therapists offering reduced-fee therapy.

At the time of publication, individual sessions through Open Path are generally $40–$70 per session, with a limited number of $30 sessions available through student interns working under supervision. Open Path charges a one-time membership fee.

Unlike some corporate therapy platforms, Open Path functions as a directory and referral service. Participating therapists remain in their own independent or group practices and manage their own intake, records, payment systems, and therapy relationships.

Eligibility requirements apply, so check current requirements directly with Open Path.

Nevada 211

Nevada residents can use Nevada 211 to search for free and lower-cost mental health resources, including counseling services, child and adolescent counseling, grief support, crisis resources, and other community-based services.

University and graduate training clinics

Universities with counseling, psychology, marriage and family therapy, or social work training programs may operate community clinics where graduate clinicians provide therapy under supervision.

Ask who supervises the clinician, what credentials the supervisor holds, and how supervision works.

Independent therapists with sliding-scale openings

Some private-practice therapists reserve a small number of reduced-fee appointments. These may not always be prominently advertised, so it's reasonable to ask.

Your health insurance

If you have mental health coverage, call the number on your insurance card and ask specifically about outpatient mental health benefits, your deductible, copay or coinsurance, and how to locate currently active in-network therapists.

Then verify availability directly with the therapist.

Mental health care should still be human

I am not opposed to technology in mental health care.

I use technology in my own practice.

Telehealth has expanded access tremendously, particularly for people living in rural communities. Insurance can make therapy financially possible for people who otherwise couldn't afford it. Large platforms may help some people find care who might not have found it otherwise.

Access matters.

But access shouldn't require us to stop asking questions about privacy, quality, transparency, or who benefits financially from our care.

And affordability shouldn't mean people have only two choices: pay full private-practice fees or hand their most personal information to a national corporation.

Community mental health centers, nonprofit organizations, university training clinics, sliding-scale private practices, supervised interns, nonprofit therapist networks, and independent clinicians who accept insurance all remain important parts of our mental health system.

As a social worker, I want people to have more choices, not fewer.

So wherever you receive therapy, ask questions.

Verify your therapist's license.

Ask about their experience with the issue you're seeking help for.

Understand how your records are stored.

Read the privacy policy before entering deeply personal information into an app or website.

Ask whether your therapist works independently or through another company.

And if cost is preventing you from getting help, ask about reduced-fee options and community resources before assuming a national platform is your only affordable choice.

You don't need to understand private equity, venture capital, healthcare economics, or HIPAA regulations to advocate for yourself.

You are allowed to ask a very simple question:

Who benefits from the way my mental health care is being delivered?

The answer should always include you.