Elbows Up for Canadian Mental Healthcare

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Canadians are under stress. Let’s face it. Canadian sovereignty has been a white-hot topic these past four months. Our economy is hurting.

Our best friend and neighbour to the south has turned on us, prompting us to rally together—buying local, keeping our chins up, elbows out, and proudly supporting Canadian businesses.

Yet amid this patriotic wave, one critical area remains overlooked: mental healthcare. While we diligently choose Canadian produce at the grocery store, foreign healthcare platforms aggressively pour millions into advertising their services north of the border, enticing Canadians away from our own practitioners.

Here’s the truth: US venture-backed mental healthcare platforms, notably BetterHelp, threaten Canadian therapists, therapy seekers, and our collective mental health—here’s how.

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Canada’s Healthcare Sovereignty Under Pressure

When comparing ourselves to the United States, the question of healthcare comes up a lot. For many, it’s a defining, important difference between Canada and the United States. And while Canada’s approach to healthcare is not in immediate danger, the United States has been impeding on elements of the Canadian healthcare system in a handful of subtle albeit impactful ways. 

I run a Canadian therapy platform. We’ve helped over 10,000 Canadians choose the right therapist since 2019. First Session partners with over 150 licensed Canadian therapists and help Canadians find, assess, and schedule therapy sessions virtually or in-person.

My company First Session, and all other Canadian mental healthcare companies have been dealing with a very large elephant in Canada's room, hailing from Silicon Valley. You may have heard of them.

BetterHelp. 

I’ve already talked at length about BetterHelp’s long list of issues and practices that warrant the big red label of “problematic” — underpaying and overworking therapists, zero consideration for therapist/fit connection, sharing confidential patient data and information; the list goes on. 

But there’s a “Canadian-specific” issue to seriously consider and add to that above list. Through sheer market penetration, aggressive advertising, and circumventing our own Canadian mental health practitioners, BetterHelp has significantly altered the landscape and discussion around mental health in Canada. And, no surprises here, the consequences are serious. 

Let’s get into it. 

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What is BetterHelp and “convenience-first therapy”? 

If you haven't yet heard of BetterHelp in 2025, consider yourself lucky. 

Founded in 2013, BetterHelp is a US based therapy platform that is heavily advertised on podcasts, television, the internet – literally everywhere.

Emphasizing convenience via no wait times, and 24/7 “text” therapy, BetterHelp is a perfect example of “convenience-first therapy.” 

Users head to the website, answer generic questions, and are algorithmically assigned a therapist.

At first glance, it's an appealing alternative to traditional therapy. No wait times, accessible right from your phone – what's not to like? 

Turns out, a lot. We conducted a survey with former BetterHelp users, and a staggering 70% of respondents reported having a negative experience with BetterHelp.

The reasons for this include everything from constantly changing therapists, no-shows, noticeably withdrawn or burnt out therapists, and issues with billing (again, the full report is worth a read). 

And while they heavily advertise in Canada (and I mean heavily), they do not hire Canadian therapists. Which is a big problem. But more on that later.

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Why Convenience Isn’t Always Better

For me (and many practitioners), the core issue comes down to BetterHelp’s status as the prime example of a “convenience-first therapy” platform – platforms that optimize for speed and convenience above all else.

Why? Because this approach ignores one of the single most impactful and important elements of therapy: the therapeutic alliance.

The therapeutic alliance is the strength of fit between the therapist and the client. It's vital to success in therapy.

BetterHelp claims you can “message your therapist anytime, anywhere,” but this blurs crucial boundaries, fostering dependency rather than genuine therapeutic connection.

But what does any of this have to do with Canada, the United States, and the state of mental health care services? 

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The Polluting Potential of “Big Therapy”

As a Canadian and someone who cares deeply about the mental health of our citizens, American venture capital fueled therapy apps are a threat to our mental health.

BetterHelp is just one example—and the largest at that, of venture funded mental healthcare platforms. I pick on BetterHelp because they clearly disregard our national border, and have no issue pumping ads north of the 49th parallel—more so than any other American company.

BetterHelp’s marketing presence is immense. In just three months in 2023, BetterHelp spent $29M USD on podcast ads alone. As someone with a bit of experience in marketing, I can tell you that number is bonkers.

Naturally, a lot of those ad dollars make their way across the border. More than a handful of “Proudly Canadian” podcasters accept BetterHelp ad dollars to shill the platform (sorry, but I’m going to throw CANADALAND, Sickboy from the CBC, and Canadian True Crime podcasts under the bus here  — they even got to Justin Bieber!). 

By doing so, podcasters are enabling the flow of millions of dollars from a massively funded, US-owned, privately run therapy “alternative” to actively undermine Canadian health services, therapists, and therapy seekers. 

The reasons to feel concerned on this are vast, but here’s a few that concern me (and practitioners across Canada) in particular: 

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How BetterHelp Harms Canadian Therapists

There are, right now, more therapists in Canada than there has ever been. 

COVID inspired a new wave of individuals motivated to become therapists. Supply for therapy is at an all time high, as is demand. So, what’s the issue?

Well, BetterHelp doesn’t hire Canadians, flat out.

One of First Session’s therapists asked BetterHelp’s recruitment team whether they hire Canadians, and BetterHelp’s response was “All of our therapists are based in the US or UK however, we have many therapists on the platform who are permitted to work with internationally-based members.”

So in Canada, we have thousands of Canadians per year studying to become therapists. They are pursuing their Masters’ degree, completing their practicums (for free in most cases), passing their provincial licensing exams, and then spending more time and money to market themselves, pay for supervision, and build up a client base.

But whether they intend on it or not, all Canadian therapists are competing with BetterHelp. Canadians who are newcomers to therapy have no reason to differentiate home grown therapists from the ones advertised behind BetterHelp. And it’s frustrating, because Psychologists, Psychotherapists, and Social Workers are regulated across Canada and held to a very high level of ethics. Canadian therapists are being robbed by the millions of marketing dollars that companies like BetterHelp spend to seduce struggling Canadians to work with international therapists, who are underpaid, overworked, and not held to Canadian standards. 

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Souring Canada’s Therapy Outlook

The more Canadian therapy seekers opt for platforms like BetterHelp, the less likely they are to stick with therapy. And once you have a bad experience with therapy, you may not try again for a long time…or forever.

A couple recent stats from a survey help explain this: 

70% of respondents had a negative experience with BetterHelp.

30% of respondents report that BetterHelp negatively impacted their view of therapy and their likelihood to pursue it in the future.

The main culprit here is the very nature of BetterHelp’s “convenience-first therapy” approach.  

Research demonstrates that a strong connection between therapist and client (aka the therapeutic alliance) is a defining factor in long-term patient growth and progress

But without that connection/alliance? Therapy first-timers abandoning therapy due to frustration is much higher. 

Meanwhile BetterHelp users report therapists who are increasingly “checked out” and noticeably tired or burnt out. At every level and for everyone, this massively VC-funded “alternative” approach to therapy experience disappoints and frustrates. 

The more Canadians who use BetterHelp, the less likely those same Canadians will find the right therapist for long-term growth, the more frustrated they’ll be with therapy, and the higher the likelihood they’ll write off therapy altogether and lose hope.

That represents significant risk to our collective mental health as a country. People talk about the brain drain—smart, well educated Canadians moving to the US for better jobs and earning potential. This is more like like a foreign infiltration of low quality care, robbing Canadians and Canadian practitioners. US "big therapy' have crossed our borders with their deep pockets,  providing low quality services, leaving many Canadians with bad outcomes, disappointed and reluctant to try again.

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Selling Your Data & Trust

The worst part is that none of the above issues capture BetterHelp’s existing history of problematic practices when it comes to patient confidentiality and selling of data. 

They were caught selling over 800,000 users’ “sensitive data” to advertisers in 2023 — a practice, they claim, is “standard for the industry.” Maybe that’s “standard” with the US healthcare system, but it ain’t standard here. 

Meanwhile, frustrated patients report unprofessional or outright “sketchy” therapists during sessions with dubious credentials. 

If that wasn’t enough, consider BetterHelp’s predatory tactic of offering a free month of therapy to folks traumatized by a concert in 2021 (Astroworld) where several audience members were tragically killed. 

The bottomline is that, as a heavily VC-funded and profit-driven enterprise, BetterHelp places value on revenue above all else, at anyone’s expense. 

It’s a toxic and offensive approach to healthcare — and it’s one that we need to actively prevent from infecting our approach and understanding of mental health care in Canada. 

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Choosing Canadian Therapy: You Deserve Better

It’s clear that BetterHelp—and similar US venture-backed platforms—pose real threats to Canadian mental healthcare. But it's not all doom and gloom. Canadians have excellent homegrown options like Inkblot, Layla, Shift Collab, and of course, First Session.

By intentionally choosing Canadian therapists and platforms, you’re not only ensuring better care but actively protecting the quality and integrity of mental health services in Canada.

Let’s keep our elbows up, Canada—our mental health deserves nothing less than the best we have to offer.

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