California’s Mental Health Commission Faces Controversy Amid Executive Director’s Resignation
On Thursday, California’s Mental Health Services Oversight and Accountability Commission (MHSOAC) announced the resignation of its executive director, Toby Ewing, effective November 22. This decision comes in the wake of significant revelations regarding Ewing’s conduct, particularly his travel to the U.K. funded by a state vendor while he was actively working to secure funding for that vendor’s contract.
The Context of Ewing’s Resignation
Ewing’s departure follows a tumultuous period during which he was placed on paid administrative leave pending an investigation since September. The investigation was triggered by concerns over his actions related to Kooth, a London-based digital mental health company. Kooth has a contract with the state to develop a virtual tool aimed at addressing California’s youth mental health crisis, a pressing issue that has garnered increasing attention in recent years.
Documents obtained by KFF Health News revealed that Ewing had been lobbying to protect state funding for Kooth’s services, particularly in light of proposed budget cuts that threatened to defund the company’s contract. This situation escalated when it became known that Ewing and several MHSOAC commissioners traveled to London, with Kooth covering $15,000 in travel expenses.
The Role of Kooth in California’s Mental Health Strategy
Kooth signed a substantial four-year contract worth $271 million with the Department of Health Care Services (DHCS) to create Soluna, a free mental health app designed for California users aged 13 to 25. This initiative is part of Governor Gavin Newsom’s broader $4.7 billion youth mental health plan, which aims to provide accessible mental health resources to young people and their families.
Despite the ambitious goals of the program, the uptake of the apps has been disappointingly slow. As of May, only about 20,000 of California’s over 12.6 million children and young adults had registered on the apps, leading to just 2,800 coaching sessions. In light of these figures, the Newsom administration proposed a $140 million budget cut to the apps, with both the state Assembly and Senate budget committees suggesting the complete elimination of the program.
The Controversial London Trip
Ewing’s trip to London, which included MHSOAC commissioners Mara Madrigal-Weiss, Bill Brown, and Steve Carnevale, has raised serious ethical questions. While Ewing was in the U.K., he was informed that the state budget had been approved with funding restored for Kooth’s app. Following this news, Ewing communicated with a Kooth executive, sharing ideas to enhance the app and expressing expectations for the company’s involvement in future developments.
Critics have pointed out that this sequence of events creates a troubling appearance of a conflict of interest. Stacie Hiramoto, director of the Racial and Ethnic Mental Health Disparities Coalition, emphasized the importance of public perception, stating, "Maybe there was no wrongdoing, and maybe the company was good. But don’t you understand the appearance of the conflict?"
Advocacy and Public Sentiment
During the commission’s public hearing prior to Ewing’s resignation announcement, mental health advocates voiced their concerns about the commission’s priorities. Susan Gallagher, executive director of Cal Voices, accused the commission of being co-opted by corporate interests, stating, "You’re lobbying behind the scenes for these people to get money. That is not your job. You serve the people."
This sentiment reflects a growing frustration among advocates who feel that the needs of individuals with mental health and substance use issues are being overshadowed by corporate interests. The commission, which is tasked with ensuring that funds from a millionaires tax are used appropriately for mental health services, is now under scrutiny for its alignment with corporate entities rather than the communities it is meant to serve.
Responses from Commission Members
In response to the controversy, Carnevale defended the commission’s actions, asserting that their engagement with the legislature during budget negotiations was requested by the Newsom administration. He claimed that the trip to the U.K. was not directly related to the budget discussions but was instead an opportunity to exchange ideas with mental health policy leaders.
Madrigal-Weiss also defended the mental health apps, highlighting the youth-led design and the positive feedback from users, particularly those from underserved communities. However, the commission’s credibility has been called into question, especially in light of the significant budget cuts proposed for mental health services amidst California’s ongoing fiscal challenges.
The Aftermath of Ewing’s Resignation
Following the publication of KFF Health News’s report on Ewing’s actions, Kooth’s stock price fell by approximately 20%. This decline reflects the market’s reaction to the unfolding scandal and the potential implications for the company’s future in California.
As the MHSOAC navigates this turbulent period, the focus remains on the critical need for effective mental health services for California’s youth. The controversy surrounding Ewing’s resignation serves as a reminder of the complexities and challenges inherent in managing public health initiatives, particularly in a landscape where corporate interests and public welfare often intersect.