22 Comments
Jul 6, 2022Liked by Owen Scott Muir, M.D

This is a good piece — writer is a good and sharp thinker and he is good at criticizing the system while neither exonerating nor alienating himself from it, which is a trick few people can pull off. The shrinkage world needs a lot more like him.

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Jul 6, 2022Liked by Owen Scott Muir, M.D

thank you - great piece

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Jul 6, 2022Liked by Owen Scott Muir, M.D

Solid

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Jul 20, 2022Liked by Owen Scott Muir, M.D

I work at Cerebral. A lot of these are common talking points made by leadership. Unfortunately, it misses the actual issue: At an *individual level*, does Cerebral produce high quality care AND client satisfaction? My belief is that it does not. Leadership outright rejects employee complaints of clearly unethical practices. Incomplete data (as you mentioned with the suicidal improvement metric) is wielded in inappropriate and misleading ways. Clinicians are encouraged to continue treatment beyond expected duration/outcomes in order to maintain subscriptions. Clients wait for days to hear from customer support, if at all. The turnover at Cerebral due to employee burnout and ruthless caseloads is unmatched. The list goes on and on. I'd be interested to see if other people who work at Cerebral or have left due to unfair/unethical practices would place the same weight on these 7 points.

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Jul 11, 2022Liked by Owen Scott Muir, M.D

WELL SAID! TY

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Jul 7, 2022Liked by Owen Scott Muir, M.D

Thanks for providing some base rates and diffusing some of the misconceptions in (mental) health care! Really enjoyed your piece.

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This is an absolutely absurd attempt at defending a company that exploited the mentally ill for financial gain.

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I appreciated the real, true facts, Sir. Life is all about context!

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This is an absolutely absurd attempt at defending a company that exploited the mentally ill for financial gain.

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This is an absolutely absurd attempt at defending a company that exploited the mentally ill for financial gain.

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I see your points about 1) stimulants being safe and effective and 2) the real problem is total lack of access to care and 3) cerebral wasn't perfect, but played a potentially meaningful role with potentially limited failures (e.g. their incident reports rate being low)

However, isn't the real issue the supposed prescribing of stimulants to individuals that don't need them for reasons based on marketing CAC? The latest WSJ reports suggested that Cerebral moved from prescribing anxiety meds to stimulants due to LTV/CAC. They then leaned on prescribers to move the needle, and found patient experience matched this shift in behavior. They paired this with misleading marketing on addictive platforms to vulnerable populations (TikToks aimed at young women).

What do you think about this? Genuinely curious, thanks for a thought-provoking read.

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I really enjoyed reading this article! Appreciate the writer's candor about the state of (or lack there of) mental health care in this country. I do take issue with the writer's assertation that "mid-level providers" including Psychiatric Mental Health Nurse Practitioners (PMHNP's) provide insufficient care, or lack sufficient training to provide care to those with Bipolar disorder and other more serious mental conditions. While PMHNP's do not receive equal training to our psychiatrist (MD) counterpart, we do provided safe, essential, evidence-based care and have proven outcomes.

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