Former Cerebral employees say the company’s practices put patients at risk: “It’s chaotic. It’s confusing. It could be extremely dangerous.”

Former Cerebral employees say the company’s practices put patients at risk: “It’s chaotic. It’s confusing. It could be extremely dangerous.”

Dr. David Mou believes that Cerebral “saves lives.”

The startup treats people with conditions like depression and ADHD, and is the world’s largest online mental health care provider.

But last month, the US Department of Justice launched an investigation into Cerebral’s prescription practices.

Mou, the company’s president and medical director, said that Cerebral is cooperating and that he is “confident” that the Justice Department’s investigation will not find any problems. The company, formed in 2020, exploded during the pandemic, thanks to relaxed prescribing rules and high demand for virtual care. As of the end of 2021, they were valued at $4.8 billion and had hired Olympic gymnast Simone Biles as their director of impact.

Meanwhile, a CBS News investigation found that some users have had problems with Cerebral’s attention quality.

Twenty-eight-year-old Rachael Costar believes Cerebral failed her during her time of need. He developed severe anxiety after the birth of his second child and had seen advertisements on social media for Cerebral offering affordable online mental health services.

“Every night I’d go to bed and say, ‘Tomorrow I’ll do it. I’ll be better tomorrow,'” Costar told CBS News consumer research correspondent Anna Werner.

Costar signed up, met with her prescriber online, and filled a prescription, all in one day. But after that, he said he couldn’t reach his prescriber when he needed instructions from his prescriber on how to safely switch to the new drug they gave him.

“Whenever I needed her help, she was never available,” Costar said.

After six days with no response, Costar said she started taking the medication she was prescribed, but soon broke out in a rash, a possible side effect for which the drug’s manufacturer advises patients to contact their doctors immediately if they experience it. Costar contacted Cerebral for help in trying to contact her prescriber, with no luck.

“I sent them a message to let them know it was spreading and getting worse. And they said they were still trying to get in touch with that doctor,” he recalled.

She eventually went to the emergency room, where doctors treated her with intravenous steroids and told her to stop taking the medication. She then canceled her Cerebral membership.

“They make it look like they want to help. And then they catch you and leave,” Costar said.

She is one of a dozen patients who told CBS News they have had a negative experience with Cerebral’s quality of care.

Mou, who took over as chief executive last month, said his system works.

“If you look at our results, and this is the most important thing, do patients get better? They do. They absolutely do,” Mou said.

Documents obtained by CBS News show that Cerebral’s leadership was briefed on risks facing the company, including patient and clinical safety issues, hires that may not meet Cerebral’s hiring standards, and staff who practice with expired suspended licenses.

Many customers complain that they have experienced similar problems as Costar and were unable to contact their prescribers.

Mou said the average wait time to reach a prescriber is “days,” a metric he says the company is “very proud” of because many patients wait months before they can “get care.”

An internal record obtained by CBS News shows that the company’s own employees flagged nearly 1,200 cases of “non-responsive” prescribers in the past 11 months.

Mou recognizes the dangers of patients not being able to get in touch with their prescribers and seeks to improve this.

“I will say we will definitely take a look at this. And we take continuous improvement here very seriously,” he said.

Aside from patient concerns, some former employees are also concerned about some of Cerebral’s practices. Melissa Butorac worked as a client trainer for Cerebral and compares it to a “fast food restaurant.”

“Get as many people in as fast as you can,” he said.

She is particularly concerned about patients who may be suicidal and believes they are not in good hands with Cerebral.

Butorac said the company handles suicidal customers through Slack, a messaging app.

Mou said the system allows staff to quickly respond to suicidal patients.

“Within minutes, a crisis specialist would help triage this patient to the most appropriate level of care,” Mou said.

But Butorac believes that this messaging system could be dangerous if the messages are not followed up or lost.

“It’s chaotic. It’s confusing. It could be extremely dangerous, right, if someone doesn’t understand the message or follow through,” she said.

A former telephone coordinator for Cerebral, who spoke on condition of anonymity for fear of reprisal, said he handled calls from suicidal patients despite minimal training.

“I’m not trained, I don’t want to say the wrong thing. And I didn’t want that on my conscience, let alone someone die because of something I said wrong,” he said.

Mou said that he would have to review this case but that the company has dedicated a lot of resources to “save lives.”

“We’ve invested a lot of resources, and for the most part, as you can see from our aggregate numbers, we can save lives. You have to take this together. And a lot of our patients are doing very well. If you look at our ratings.” , said.

Mou said Cerebral is dedicated to quality of care.

“Our commitment here is quality of care. And now that I’m CEO, we’re going to double and triple that thesis,” he said.

Cerebral said it has reduced suicidal thoughts in 50% of the patients it studied, and its internal register of prescribing problems shows the “safety checks and balances” it has in place.

Following the CBS News interview with Costar, Cerebral apologized to Costar, saying the doctor who worked with Costar did not follow procedures and no longer works with the company.

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