California Mental Health Commission Director’s London Trip Raises Ethical Questions
This summer, Toby Ewing, the executive director of California’s Mental Health Services Oversight and Accountability Commission, found himself in London, courtesy of Kooth, a London-based digital mental health company. This trip occurred during a critical time when Ewing was actively working to prevent a significant budget cut that threatened Kooth’s contract with the state. The proposed cut, amounting to $360 million, was part of broader budgetary constraints faced by California amid a staggering $45 billion deficit.
The Context of the Trip
Ewing’s involvement with Kooth is not merely coincidental. The company was contracted by the state to develop Soluna, a digital mental health tool aimed at addressing California’s youth mental health crisis. As the state grappled with budget cuts, Ewing took it upon himself to advocate for the retention of Kooth’s funding. His efforts included direct communication with key legislative staffers, emphasizing the importance of maintaining the contract despite the financial challenges.
Emails and calendar entries reviewed by California Healthline reveal that Ewing was deeply engaged in discussions about Kooth’s funding. He reached out to legislative aides, suggesting improvements for Kooth’s youth teletherapy app, demonstrating a proactive approach to ensuring the app’s success and sustainability.
The London Trip: A Closer Look
Ewing, along with three commissioners from the Mental Health Services Oversight and Accountability Commission, traveled to London in June. Initially uncertain about the fate of Kooth’s funding, Ewing received news on the second day of their trip that lawmakers had restored the funding. This development coincided with the trip, raising questions about the appropriateness of the timing and the implications of the trip itself.
Kooth covered the expenses for the trip, which included luxurious accommodations, meals, and international flights. While it is not uncommon for state officials to accept travel expenses from private entities, the optics of such arrangements can be problematic. Critics argue that these practices may create a perception of undue influence, particularly when public officials are seen as advocating for private companies.
Whistleblower Complaints and Ethical Concerns
Ewing’s actions have not gone unnoticed. In September, three employees of the commission filed whistleblower complaints against him, alleging that he prioritized the interests of a private company over his public duties. They expressed concerns that Ewing’s conduct blurred the lines between public service and private interests, a sentiment echoed by government ethics experts.
The commission, which is tasked with overseeing the appropriate use of funds from a millionaires tax for mental health services, operates independently from the Department of Health Care Services, which holds the contract with Kooth. This separation raises further questions about Ewing’s motivations and the appropriateness of his advocacy for a specific vendor.
The Role of Kooth and Its Contract
Kooth’s contract with California, valued at $271 million over four years, aims to provide a free mental health app for users aged 13 to 25. This initiative is part of Governor Gavin Newsom’s broader $4.7 billion youth mental health plan. However, the rollout of the app has faced challenges, with low usage rates reported. In May, Newsom proposed a $140 million budget cut due to these low engagement levels, prompting further scrutiny of the contract and its effectiveness.
Despite the challenges, Ewing remained committed to advocating for Kooth, meeting with legislative staff and discussing strategies to enhance the platform. His emails indicate a willingness to collaborate with Kooth to improve its services, raising ethical questions about the extent of his involvement with a private vendor.
The Aftermath of the Trip
Following the London trip, Ewing was placed on paid administrative leave pending an investigation into his conduct. The commission has refrained from commenting on personnel matters, but the ongoing investigation underscores the seriousness of the allegations against him. The whistleblowers, who spoke on the condition of anonymity, expressed concerns about potential retaliation and the broader implications of Ewing’s actions for the commission’s integrity.
Commission chair Mara Madrigal-Weiss defended the trip, emphasizing the value of virtual mental health resources for youth. She highlighted the importance of collaboration between public and private sectors to enhance mental health services, but the controversy surrounding Ewing’s trip and his relationship with Kooth continues to cast a shadow over these efforts.
Conclusion
As the investigation unfolds, the implications of Ewing’s actions and the relationship between state officials and private vendors remain a focal point of discussion. The balance between advocating for necessary mental health resources and maintaining ethical boundaries in public service is a delicate one, and this case serves as a reminder of the complexities involved in navigating these challenges. The future of Kooth’s contract and the integrity of California’s mental health initiatives hang in the balance as stakeholders await the outcome of the investigation.