Reno offers free therapy

Digital mental health counseling available to residents 13 and older

IMAGE/FRANK X. MULLEN: The Talkspace app is a text-based system with one video chat per month included under the city's contract with the company.

Since Dec. 21, about 500 people have signed up for Talkspace, a digital mental health therapy system provided by the City of Reno. That leaves about 200,000 residents also eligible for the free service.

City officials predict the number of users will greatly expand this week when Talkspace begins a $200,000  advertising and marketing effort.

“December was a soft launch, similar to opening a restaurant; make sure everything is going to work and work well before you go out and do your big grand opening, your advertising and push to get people in the doors,” said Rebecca Venis, Reno city communications director. “The campaign… is a very comprehensive plan that will launch including some digital media, PR, social media and other advertising driven to get folks into the system and get them to understand the program.”

Text-based therapy

Residents who want to sign up for the service may do so at talkspace.com/Reno, rather than the firm’s main website. After answering a few questions, users will get a code within two days to be able to choose a therapist and start conversations. The service allows users to send unlimited text, voice, and video messages from their phones or any device, according to Reno officials. The city’s announcement explained that: “Your dedicated therapist will engage daily, five days per week. Monthly video appointments and self-help exercises are also available… You may encounter a waitlist for therapist services if demand exceeds network capacity. If this occurs, Talkspace will follow up with more information.”

The Reno City Council unanimously voted Dec. 2 to approve the program to provide 12 months of digital mental health care therapy sessions available to all Reno residents 13 and older. The service cost the city $1.3 million, provided by the CARES Act (COIVID-19 relief). Some local mental health professionals objected to spending money on the New York-based company instead of involving local therapists in the effort.

Dylan Shaver

Dylan Shaver, chief of staff at the Reno City manager’s office, said directly using local professionals would have been a great solution to providing mental health care to residents during the pandemic. But he said constraints on how the CARES Act money could be spent and a tight deadline for the federal funds to be allocated before they were set to evaporate at the end of the year made Talkspace the best option. CARES Act funding, at the time, had to be used before the end of 2020. Federal officials  extended that deadline after the city made the agreement with Talkspace.

Enough therapists available?

Talkspace is required to use therapists and counselors licensed in Nevada, a state that ranks at the bottom of nearly all lists for the availability of mental health resources.

“(The ability to meet the need) was an important part of our initial conversations with Talkspace,” Shaver said. “With something like 202,000 people over age 13 in Reno, what if they signed up tomorrow? That would create a tremendous bottleneck.”

“It was super easy to sign up. I was approved the next day. I filled out a “symptoms” page and then it recommended 3 different therapists. I got to read their profiles and choose one. She has been great so far. I get one video call a month and messaging. The hour video calls go by really fast so I don’t feel like I get to cover a lot of topics but I can message her any time I want and she usually gets back to me in a few hours Mon-Fri. I don’t think it would be good for someone who had major things to talk through because it feels pretty removed… but she’s been helpful with giving tools to boost my self esteem and post partum anxiety.

— A Reno mother describes her experience with TalkSpace, via reddit.

Job listings for Reno service

Talkspace, Shaver said, is recruiting therapists who are licensed in Nevada and he noted that professionals licensed in other states are able to obtain Nevada licenses. “We would prefer local providers, but it’s possible to get folks licensed in other states in front of the Nevada (licensing) board. There’s no automatic reciprocity, but it can be a relatively fast process.”

Job listings for Talkspace that list Reno as the location of available positions.

Talkspace also advertises for therapists and other mental health professionals on several online job sites, including ZapRecruiter and Glassdoor, as seen in the image, above. The company is paid $1.3 million whether 500 or 50,000 residents take advantage of the service. That raised questions among local therapists about the firm’s incentive for building a large client base.

A test market

“They do have an economic inceptive not to fall on their face here,” Shaver said. “They contracted to provide service to anybody who wants and needs it in the city of Reno. Basically, this is a demonstration model and they are determined to do it and do it well here. It’s a way to provide their services that hasn’t been done before.”

The firm has been at the center of several controversies over the years. Critics have raised questions about the security of information provided by users, whether or not “text therapy” is really therapy, the honesty of online reviews and other issues. The Reno News & Review sent a list of questions to the firm’s spokesperson on Jan. 21. On Jan. 22, the spokesperson said those queries wouldn’t be answered until the week of Jan. 25, after the story’s deadline.

Talkspace’s founders have denied allegations made in an Aug. 7 New York Times article  and in previous media articles critical of the company. The Reno City Council was aware of the critical coverage when it voted to contract for the firm’s services.

Ironing out glitches

Shaver said there were some technical concerns with the Talkspace app, but “we’re working through that.” He said some of the problems with the application may have occurred because users didn’t restart their devices after installing the application. “We’re serious about making sure that this is as accessible a product as it can be,” he said.

“I am using (Talkspace), my first ‘therapist’ was pretty much a joke, telling me my anxiety ‘will pass, just hold on’….  but I switched and my new person is a little better, maybe. I don’t see how someone with serious struggles could make any headway with the service, the texting works by sending a message and then waiting 2 hours for a reply so it’s really like email therapy more than anything. The therapists truly do not seem to have much experience, so many recommended to me have been practicing less than 1 year.

– A Reno resident, Jan. 23, via reditt.

First-responders sign up

Many city employees, including police officers and other first responders, Shaver said, are using the service.

“We’ve had tremendously positive feedback from our own personnel,” he said. “They’ve been burning the candle at both ends just like everybody else, responding to an emergency for the last 10 months.”

Some of the employees told him they wanted some help processing their reactions to the crisis, but didn’t have time to shop (for therapists) or called therapy offices that weren’t accepting new patients. “We’re eliminating those barriers for those people. Most people don’t have the ability to disappear for two hours in the course of a day (to see a therapist).” The testing system, he said, is a digital version of a therapist making house calls.

WORDCLOUD/MARY PAHLKE: The pandemic takes its toll on mental health.

Feedback from users

A city employee interviewed for this story, who did not want to be identified, said she is pleased with the service. “I don’t know if it (qualifies as) the type of therapy you would get in-person or not,” she said. “But it just felt good to talk to someone who is a trained counselor about the pressures I’m going through.”

The Reno News & Review posted requests on several social media sites asking Reno residents who have used the service to comment on their experiences. Their feedback was generally positive, and several of those comments are reproduced in this story. Some users commented about their therapists. A few wrote that they also had trouble navigating the Talkspace app, but others said the system is easy to use.

“I was surprised how easy it was to sign up… I didn’t need to provide insurance info or any real personal info at all. I was given the choice of three therapists with varying experience (two practicing less than 1 year and the third in the business for over eight years… The app is easy to use although the city only pays for one video chat a month which my therapist said he wishes they covered more. Its unlimited text though,  which is actually nice. As a millennial I’m used to texting out my feelings and it makes mood tracking very efficient. Its only been like a week so IDK if it’s been helpful yet but so far I like the service and it’s been easy to use.”

– A Reno resident, Jan. 22, via reddit.

When to reach out

Shaver said the service is a preventative as well as a therapy service for people who are experiencing symptoms of depression or other mental concerns. “When do you seek help when the effects of the pandemic are universal?” he asked. “If this were a physical malady, a stomach ache or something, how long do you wait before going to the doctor?  If, like many people, you are experiencing general malaise or grief, don’t just sit on it; you don’t have to.”

The criteria for using the service is, he said, “you just have to feel that it’s the right time for you… There isn’t any standard for that outside of your own personal experience.

“If you feel you might need it, try it out, it’s free,” Shaver said. “We’ve made it as easily as possible. And if it’s not for you, it’s not for you. It feels better to have even started the conversation.”

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