Consumers say they like what they see on the online psychotherapy sites, such as their colorful graphics, cute-kid faces and upbeat styles.
"In person, I am very reserved and 'unemotional' - all business," Lifescape patron "Tickin'" said. "In chat, I have found a voice I haven't had before."
"Deb" wrote, "As a gambling counselor, I have many clients who work the night shift at casinos. The information on the toll for marriages was helpful."
The E-health market is vast and growing. A 1999 Harris poll found that 60 million people searched the Web for health information, and four of the top 10 most searched health topics were mental health-related. Such sites as Medscape.com, Webmd.com and DrKoop.com dominate. In fact, Lifescape began as the mental health provider for DrKoop.com.
"Everyone faces psychological issues, whether it is dealing with stages of life - aging, parenting, the inevitable stages of development - stress at work or home, dealing with grief," said Lifescape CEO Elliot Gerson. "We can all benefit from help, and the Internet affords a way to bring millions of people better services."
If you think you have a drinking problem, for example, it may be easier to find out about alcohol-abuse treatment - and even seek it - at your private computer screen. Someday, Alcoholics Anonymous meetings may be routinely conducted online.
The cause of mental health sites was boosted in December when the first Surgeon General's report on mental health concluded that one in five Americans experiences a mental health problem every year, with half having such problems at least once in their lives. It said that while 22 percent of the population currently has a diagnosable mental disorder, nearly two-thirds of these people never get help because of social stigma, cost or lack of available resources.
"[According to] the surgeon general's report, the majority of people who could benefit do not seek those services for a number of reasons, with stigma perhaps the leading reason," said Gerson. "That, in itself, is tragic. There are effective treatments for virtually all mental health conditions." Lifescape, he says, can be a leader in using what he sees as an "ideal medium" - the Internet - to offer an array of mental-health care information and services.
People, have, in fact, been reaching out to each other online since the early 1980s within closed networks run by entities like CompuServe, the Source and the Well.
"This is not something new," says John Grohol, an Austin-based psychologist and expert in online psychology who wrote The Insider's Guide to Mental Health Resources Online (Guilford, 1999). "People will try anything on the Internet. ost of the time, even when dealing with issues like this, it doesn't hurt to try reaching out.
"What's new is that professionals are getting into this area, looking to provide some services."
Grohol is a past director of Mentalhelp.net - a consumer site sponsored by CMHC, an information technology company for healthcare and human services. It's a site that offers similar services to Lifescape, with similarly sophisticated graphics, but it has been around longer - and it is non-profit.
The profit-making nature of some dot-com companies, particularly in the healthcare arena, bothers Grohol, who left as one of DrKoop.com's featured mental health professionals over ethical concerns and is launching his own Web site, Lifehelper.com.
In September, DrKoop.com came under fire from medical ethicists, consumer advocates and others who alleged the Web site blurred the line between its objective content and its advertising. The launch of Lifescape was delayed while Dr. C. Everett Koop, the former surgeon general, addressed the criticism and changed some of his practices in regard to the Web site.
Grohol is critical of Lifescape's $11 million, four-year sponsorship of DrKoop.com while it provides the majority of the mental health content for the site. Lifescape's leading investor is FHC Health Systems, one of the nation's largest managed behavioral healthcare providers, founded by psychiatrist Ronald Dozoretz.
"Sponsorships are advertising," said Grohol. "To me, that's the equivalent of Nicorette providing the content for the stop-smoking area" of a Web site.
Mental health professionals point out that making money is usually part of any patient-professional agreement. Gerson noted that the basic service on Lifescape is free and denies any conflict of interest.
"All of our content is peer-reviewed. We have the absolute best-credentialed list of universities and organizations contributing to our content, which is proprietary to us.
"There is a strict separation of church and state with respect to our content. There is no connection between our investors and what we do," he insisted. "If anything, there is a stronger argument that we provide information that would be contrary to the interests" of a managed care provider.
Laurie Flynn, director of the National Alliance for the Mentally Ill, who is on the Lifescape medical advisory board, has peer-reviewed articles for Lifescape.
"They are making a strong effort to assure people that what they offer is science-based information and up to date," she said. "This is yet another way to combat stigma. There is an awareness of ethical issues. That's important because there are sites on the Web that are somewhat flaky. It's such a wild, wild West kind of mentality on the World Wide Web."
There are about 200 Web sites devoted to mental health issues but few have the breadth or epth of a Lifescape, which is poised to transport as much as possible of the $80 billion spent in the mental health market to its portal on the World Wide Web.
Being all things to all people in mental health has fostered other critics of Lifescape as well. Martha Ainsworth, founder of Metanoia.org, a respected mental health Web site, said Lifescape's content is so general it can be found in any number of places on the Web.
Social worker David Grotke, who offers counseling on the Web and has written about online ethics, said he tired of the "cookies" - advertising and tracking devices - used on Lifescape as he attempted to utilize the site's information. "I read their 'privacy statement' and it's clear this is a site that's in it for the money."
In addition to its consumer site, Lifescape has a corporate site, Lifescape Advantage, which offers other services to corporations for employee assistance, and school districts and universities on a paid basis.
Gerson said Lifescape has plans for major expansion, including internationally. In the near future it will offer a new employee portal called At Work Cafe that will provide news, stock quotes, weather and sports for corporate clients, and perhaps most importantly for those seeking mental health services, it will begin offering direct referrals to psychologists, psychiatrists and social workers who meet strict credentialing requirements.
"No other site does that," said Gerson.
"There is greater recognition of the importance of mental health to everyone," he added. "We really are covering all aspects of mental health using the Internet as our fundamental platform."
By Danna Walker
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