Mental Health Agency Director Resigns

Her departure has raised discussions around transparency and the use of public funds.

The recent resignation of Toby Ewing, the executive director of California’s Mental Health Services Oversight and Accountability Commission, has raised discussions around transparency and the use of public funds. The agency director resigned following scrutiny over his interactions with Kooth, a U.K.-based digital mental health company contracted by the state to address California’s youth mental health crisis through its virtual mental health tool, Soluna. The tool is part of a larger youth mental health initiative led by Governor Gavin Newsom, aimed at making professional telehealth services more accessible to California residents ages 13 to 25.

The controversy centers around Ewing’s trip to the U.K. earlier this year, paid for by Kooth, while he was simultaneously advocating against proposed budget cuts that would have defunded Soluna’s contract. In response, Ewing has been on paid administrative leave since September as part of an investigation into possible conflicts of interest. The situation has prompted colorful debates within the California mental health community, with some accusing the commission of prioritizing corporate relationships over the public’s mental health needs.

The California Mental Health Services Oversight and Accountability Commission operates as an independent entity tasked with ensuring funds from a special mental health tax on high-income earners are allocated responsibly by counties. During the commission’s recent meeting, mental health advocates voiced concerns over perceived corporate favoritism. Susan Gallagher, a prominent advocate with Cal Voices, spoke out, asserting that the commission was neglecting its duty to serve the public by allegedly lobbying on behalf of Kooth and similar corporations. Such allegations come at a time when California faces a staggering $45 billion budget deficit, putting pressure on public programs to justify their costs.

The contract in question, valued at $271 million over four years, was initially awarded to Kooth in 2023. Soluna, the app created under this contract, launched in January but has reportedly struggled with low engagement rates. By May, only around 20,000 users, from a potential pool of over 12 million eligible youth and young adults, had registered, leading to discussions in the state legislature about cutting $140 million from the program. Instead, funding for Kooth’s contract was ultimately preserved after Ewing’s intervention with legislative staff. Notably, he participated in a U.K. trip in June alongside other commissioners, funded by Kooth. Official records show Kooth covered $15,000 in travel expenses for Ewing and two commissioners, although it is unclear if similar coverage was provided to the third commissioner.

Stacie Hiramoto, director of the Racial and Ethnic Mental Health Disparities Coalition, voiced her concerns, suggesting the optics of the trip alone were problematic, even if no wrongdoing had occurred. She stated that public perception is critical, particularly in cases involving public trust and large financial stakes. However, Commissioner Steve Carnevale defended the trip as an opportunity to gain valuable insights from U.K. mental health leaders, maintaining that the timing of the trip was unrelated to California’s budget decisions.

Data presented to lawmakers in May showed limited engagement with Soluna, a factor that seemed to play a role in the initial proposal to scale back its funding. Yet, the Newsom administration ultimately decided to retain the contract, which raised questions among legislators and advocates alike. Kooth’s continued payment, as outlined in the contract, is reportedly tied to user engagement targets, with increased compensation contingent on reaching a user base of 366,000. The decision to preserve Kooth’s funding despite low participation rates has fueled concerns about whether the program’s effectiveness is being measured rigorously enough. Now, Ewing’s resignation adds a layer of uncertainty to the commission’s leadership, which may now face further scrutiny as it works to address California’s pressing youth mental health needs amid broader financial constraints.

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California mental health agency director to resign following conflict of interest allegations

California Mental Health Agency Director To Resign Following Conflict of Interest Allegations