Mental Health Startup Resilience Lab therapists vote to unionize

Jtherapists in a mental health start-up On Wednesday, Resilience Lab voted to unionize, one of the first successful organizing efforts at a digital health company.

The move comes after growing concerns among employees after the company laid off 12 therapists, changed how others were paid and introduced third-party software to track patient progress, according to five current and former employees who asked for the anonymity for fear of reprisals. The petition for union elections and layoffs was first reported by Gothamist.

The New York-based startup, founded in 2019 by clinical director Christine Carville and her husband, CEO Marc Goldberg, has claimed the “largest and most diverse collective of New York-based therapists.” As the company grew, employees say it placed more emphasis on technology and software and began hiring ex-WeWork, Uber and Airbnb executives, with a view to a $15 million Series A funding round led by Viewside Capital Partners and Morningside in November.

After post a story on corporate risk financing, Forbes learned that Resilience Lab had, three days prior, laid off 12 of its 200 therapists, giving them a week to transition 271 patients, according to documents reviewed by Forbes. Three administrative employees were also fired, according to current and former employees involved in the union organizing. They also said the majority of the laid-off employees had marginalized identities, including people of color, queer people, trans people and people with disabilities.

Carville and Goldberg did not respond to multiple email and phone calls to the Resilience Lab office for comment for this story.

Resilience Lab employees were elected to be represented by District Council 37 AFSCME, a union that typically represents public sector employees in New York City, by a vote of 79 for, 13 against, according to Kayla Blado, spokeswoman for the National Labor Relations Board, which monitored the election. Blado confirmed that 15 ballots were disputed and were not counted.

In 2022, about 1.2 million health care workers were members of unions, representing 13% of the total health workforce, down half a percent from the previous year, according to the US Bureau of Labor Statistics.

“Now the work begins to secure a contract for our newest members – the first in the nation for a telehealth company,” said Henry Garrido, executive director of District Council 37 in a statement. “All workers deserve the support of a union, whether they conduct their business online or face-to-face.”

youp until four months ago, current and former employees say Resilience Lab offered the prospect of stable, salaried employment in what can be an exploitative training period for early-career therapists. To become a fully licensed therapist, people with a master’s degree in mental health counseling or social work must first undergo thousands of hours of supervised clinical training, which is one of the problems that Carville and Goldberg had previously discussed Forbes they were trying to solve.

Resilience Lab hired supervised therapists under an arrangement where they would receive a percentage of fees for their sessions with patients. If they reached 100 patient sessions for several consecutive months, the company offered the opportunity to achieve what it called “resident” status – a $67,000 salaried job with benefits and bonus potential, according to employees and documents reviewed by Forbes. This was interesting because the median salary for a social worker is $50,390 per year or $24.23 per hour, according to the US Bureau of Labor Statistics.

In June, Resilience Lab announced it was partnering with a Boston-based startup called Mirah to roll out “metrics-based care,” described in a Press release as “the practice of basing clinical care on client data collected throughout treatment”. Patients began receiving weekly assessments to complete outside of their sessions with therapists.

According to a letter signed by more than 60 employees that was sent to Resilience Lab management in July, a group of therapists reacted by saying that the way the company had implemented the software was “unethical “. The group wrote that they were concerned that such frequent assessments and the idea that therapy “progress” was linear could be harmful to patients. The letter also asked for more details about what patient data was being collected and how it would be used.

In August, Resilience Lab announced new hires from other tech startups in an effort to expand its operations. Patrick Morselli, the former head of global expansion at WeWork, has become chief operating officer. John Hamby, former regional head of community engagement at Uber, has been named chief executive, and Alyssa Lin, former director of portfolio strategy at Airbnb Luxe, has become head of growth. Goldberg had already said Forbes the company had “no interest in building Lyft or Uber for therapy.”

In mid-October, the therapists received a new contract. The “resident” position at a salary of $67,000 has been eliminated. In its place, all therapists would receive a base salary of $1,300 per month — $15,600 per year — plus 15% of the patient’s session fee for the first 49 sessions of each month. The percentage share of therapists increased beyond 50 sessions.

When the company announced its Series A funding the following month, the Press release promoted its software products: an online training program for therapists, a “proprietary software infrastructure” for billing, reimbursement and patient outcome tracking, and its client matching software.

Current and former employees say the focus on technology and software has been another blow to the morale of the company’s mental health workers. “They weren’t transparent about it being a mental health technology platform in the hiring process until recently,” said Tanya Tripi-Weiss, one of the therapists. dismissed who is part of the union’s organizing committee. Forbes. “Until recently, we were engaged as if it were a larger private practice in New York.”

Another former employee described it as bait and switch: “I think they used all the clinicians basically as guinea pigs so they could figure out what worked. [with the technology].”

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