Telehealth Execs Arrested for Adderall Scheme, What’s Next for the Patients?

The Justice Department has filed its first-ever criminal charges against a digital health company for their prescription practices, and the unfolding story could spell disaster for the mental healthcare of tens of thousands of patients.

On June 13, the Justice Department arrested Done Global Inc. (Done) CEO and Founder Ruthia He and Done Health P.C. Clinical President David Brody for committing healthcare fraud to the tune of $100 million and 40 million pills. But while the charges— defrauding taxpayers and providing ease of access to Adderall and other highly addictive stimulants with no legitimate medical purpose, and to patients who did not meet criteria for ADHD — are severe, the instability that this has caused, and will cause, for mental healthcare patients is a significant additional concern.

After the onset of the pandemic, there was a marked increase in patients seeking mental healthcare services. WHO reported a 25 percent increase in adult anxiety and depression worldwide in just the first two years. With patients struggling, and provider availability lacking, telemedicine “came to the rescue.”

Theoretically, increasing access of mental health services to individuals throughout the US, including regions with severe shortages of psychiatric providers, has its positives. However, big business moving into the mental health space, advertising “short online surveys” and “subscription plans” for treatment, has been a big step backwards for quality mental health treatment. Psychiatric illness is complicated, and formulating both an accurate diagnosis and holistic treatment plan takes time. Providers should spend 60-90 minutes at a minimum at initial visits, collect collateral information from family and significant others when possible, utilize standardized and well-researched tools for patient assessment, and offer not only non-controlled treatment options, but non-pharmacological interventions as well.

As The Medical Director of Philadelphia’s Rittenhouse Psychiatric Associates, an Instructor at Johns Hopkins Hospital and a Supervisor for Jefferson Psychiatric Residents, I know that there is a legitimate need for the treatment of ADHD, and that medications such as Adderall, Vyvanse and other stimulants, do have a purpose for some individuals. But these medications aren’t without risk, and providers need to be thoughtful, thorough and conscientious about their use. Telemedicine is an incredible tool that has helped so many patients get the care that they need. However, it needs to be combined with the quality psychiatric care, that patients deserve. Medications should level the playing field for individuals who have disabilities such as depression, anxiety and ADHD. They should never be used by individuals who do not have these conditions, and should never be used by individuals simply wanting a leg up in performance.

Over the last 10 years, stimulant prescriptions have increased by over 50%, and roughly tripled among 30 to 40-year-olds. Some of these increased prescriptions do in-fact, relate to increased availability of care for appropriate patients- but certainly not all. This increase has coincided with a severe shortage of these medications, for patients who actually do benefit from treatment. Those are the individuals who are now paying the price. The CDC has warned that with Done executives being arrested, there may be 30- 50,000 patients whose care may be disrupted, and who now need to find appropriate treatment with ethical and reputable providers.

I implore the Philadelphia Inquirer, and the community to share this story and to let our community know, that not all psychiatric care is created equally, and that there are dangers associated with seeking treatment from providers whose priority is their bottom line, and not the patients they’re treating. If individuals out there need assistance in finding ethical, thorough and competent treatment, we’re here to help.