Show HN: Shimmer – ADHD coaching for adults, now on web

There's nothing wrong with stating the objective reality that the cost of Shimmer is HSA/FSA-eligible. HSA/FSA-eligibility is directly relevant to one of Shimmer's key goals, making ADHD coaching accessible to people who can't afford traditional coaching. Using HSA/FSA funds brings down the overall cost significantly, so it's going to be a factor when budgeting. It isn't even close the same thing as snake oil treatments claiming to be "FDA cleared." Consumers may not realize that "FDA cleared" is an absolutely meaningless phrase, but I think we can agree that most adults know the difference between a condom and a licensed medical professional dispensing FDA-approved medication.

"HSA/FSA-eligible" is a legitimate, accurate phrase to describe the services Shimmer provides. Plus, anyone who has a HSA/FSA has most likely received education or literature about it through the company providing it for them (typically their employer). They're not reading this post thinking, "Since I can pay for this with the account that I use to buy sunscreen and band-aids, I will surely see a physician and get drugs." Personally, I thought, "Gee, I wish I had a HSA/FSA so I could use it to pay for this health-related service." All brains are different, especially ADHD brains. It's unhelpful to assume they'll all draw the same false conclusion as you did.

> Overall though, we use PhDs/psychiatrists/master-level coaches to supervise, create protocols, trainings, etc. and use coaches to deliver. (Not AI). Our coaches are either credentialed by ICF (International Coaching Federation) like BetterUp or Ginger or Lyra's coaches, NB-HWC (National Board - Health & Wellness Coaching), or have masters-level psych degree and go through our training.

If the licensed or certified mental health professionals aren't actually hands-on with your clients, it's awfully misleading to say that all of your coaches are licensed or certified mental health professionals or blah blah blah. If you were being honest, you'd skip the nonsense about using mental health professionals as coaches and just say that your coaches go through your training program and are supported by mental health professionals--you know, the actual truth.

1. "I see them all in the same light unfortunately of profiteering in various ways around the incompetent medical system the US has."

You're right, it is unfortunate that you see them all as profiteering off of the failures of the American medical system. As you've noted, the issue here is your choice not to look for nuance or independently evaluate each service.

2. "Is this a better price than a licensed therapist?"

Shimmer has been very clear every step of the way that coaching is not the same thing as — or a substitute for — therapy. For some people, therapy isn't necessary. For others, like me, therapy isn't enough. Coaching fills in the gaps and covers areas that aren't necessarily a great use of time in therapy. In my case, I use therapy to dig into major mental health issues (MDD and PTSD, primarily). I use coaching to help me figure out how to overcome executive functioning barriers and prioritize day-to-day tasks. Both are incredibly helpful in different ways.

3. "It just feels ethically wrong to promote your services to people who are 'undiagnosed' or 'think they have' ADHD."

Have you ever tried to get an ADHD diagnosis in the US? Until recently, testing was virtually impossible for many Americans to access because of scarcity and cost. I was initially quoted $1,700 for an ADHD evaluation from an out-of-network provider, and that was after calling around to numerous places that took insurance, all of which were booked up indefinitely and required referrals (which not everyone's PCP will provide for ADHD testing). I got lucky and found a $500 option, which was then treated as "unofficial" by some prescribers. Finally, I got an "official" diagnosis from an online testing service (unrelated to Shimmer) for $150. I'm incredibly fortunate to have had access to the $650 it cost me to get a diagnosis, along with medical and therapy providers who supported me along the way. Others are less privileged. Do those people not deserve help simply because they can't access a formal diagnosis?

4. "This is exactly what social media is doing today in the sense of trying to convince you you have something because you happen to engage in said content."

Shimmer isn't in the business of telling people they have ADHD or handing out stimulants to any random undiagnosed person who asks. If you take a few moments to look up Shimmer's website and social media, you'll see that they're clearly not aiming to convince people they have ADHD. Each potential client meets with one of the founders (or, I assume, another qualified team member) to discuss their specific situation and needs. If they're a good fit for one of those coaches, they're allowed to sign up and begin coaching. On the off chance that someone did fall through the cracks and begin coaching despite not having ADHD, and their coach didn't notice it right away, then one of two things might happen. Either they'd leave because ADHD coaching isn't suitable for them, or they'd continue because a lot of what happens in ADHD coaching is helpful for all kinds of people with executive dysfunction and trouble focusing.

5. "I mean just look at the eligibility"

"Eligibility" requirements are a bare minimum. One can easily infer from the content Shimmer creates that its services aren't intended (or useful) for all adults with smartphones and internet access.

6. Your link to an article titled "Teens Turn to TikTok in Search of a Mental Health Diagnosis"

Take another look at the eligibility requirements you posted. Shimmer is for adults only. Yes, technically people ages 18 and 19 have ages in the "teens," but they are legally and developmentally considered adults capable of making informed, reasoned decisions about their health. An adult seeking out ADHD one-on-one ADHD coaching from a mental health professional is not the same thing as a teenager scrolling tiktok and diagnosing themselves based on their uninformed interpretation of a video.