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California Mental Health Agency Director to Step Down Amid Conflict of Interest Claims

California Mental Health Commission Director Resigns Amid Conflict of Interest Allegations

In a significant development for California’s mental health landscape, Toby Ewing, the executive director of the Mental Health Services Oversight and Accountability Commission (MHSOAC), announced his resignation effective November 22. This decision follows revelations of a controversial trip to the United Kingdom funded by a state vendor, coinciding with his efforts to secure funding for a digital mental health service aimed at addressing the youth mental health crisis in California.

The Background of the Controversy

Ewing’s resignation comes after he was placed on paid administrative leave in September, pending an investigation into his actions. Documents obtained by KFF Health News revealed that Ewing had actively sought to protect funding for Kooth, a London-based digital mental health company, during a time when the state was considering budget cuts that would have defunded the company’s contract. Kooth had signed a substantial four-year, $271 million contract with the California Department of Health Care Services to develop Soluna, a free mental health app designed for users aged 13 to 25.

The app was launched in January as part of Governor Gavin Newsom’s ambitious $4.7 billion youth mental health initiative. However, uptake has been slow, with reports indicating that only about 20,000 of California’s 12.6 million children and young adults registered on the app, leading to concerns about its effectiveness and sustainability.

The London Trip and Allegations of Conflict of Interest

The controversy escalated when it was revealed that Ewing, along with several MHSOAC commissioners, traveled to London on a trip funded by Kooth. Public disclosure forms indicated that the company covered $15,000 in travel expenses for Ewing and two other commissioners. This trip occurred shortly after Ewing had lobbied legislative staff to restore funding for Kooth’s app, raising serious questions about potential conflicts of interest.

During a public hearing prior to the announcement of Ewing’s resignation, mental health advocates expressed their concerns about the commission’s priorities. Susan Gallagher, executive director of Cal Voices, criticized the commission for allegedly prioritizing corporate interests over the needs of individuals struggling with mental health and substance use issues. "You are being co-opted by big corporations," Gallagher stated, emphasizing that the commission’s role should be to serve the public.

The Fallout and Future Implications

Ewing’s resignation has sparked a broader conversation about the integrity of mental health funding and the relationships between state agencies and private vendors. Stacie Hiramoto, director of the Racial and Ethnic Mental Health Disparities Coalition, highlighted the importance of public perception, noting that even the appearance of a conflict of interest can undermine trust in the commission’s decisions.

While some commissioners defended the trip as a valuable opportunity for exchanging ideas with mental health policy leaders, the fallout has been significant. Kooth’s stock price plummeted by approximately 20% following the publication of the allegations, reflecting investor concerns about the company’s future in light of the controversy.

The Path Forward

As California grapples with a staggering $45 billion budget deficit, the future of mental health funding remains uncertain. The state Assembly and Senate budget committees had initially proposed eliminating the entire digital mental health program to save costs, but funding for Kooth’s app was ultimately restored. The reasons behind this decision remain unclear, and the commission’s role in advocating for specific vendors is now under scrutiny.

Ewing’s resignation marks a pivotal moment for the MHSOAC and raises critical questions about accountability and transparency in mental health services. As the state continues to navigate its budget challenges, the focus will likely shift to ensuring that mental health resources are allocated effectively and equitably, prioritizing the needs of California’s most vulnerable populations.

In conclusion, the resignation of Toby Ewing serves as a reminder of the complexities and challenges facing mental health services in California. As stakeholders work to rebuild trust and ensure that funding is used appropriately, the lessons learned from this incident will be crucial in shaping the future of mental health care in the state.

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