The initial call to a psychiatrist or psychologist listed in a commercial insurer’s directory resulted in an appointment just 12% of the time, according to a study published today in JAMA Health Forum.Why It’s Relevant
The barriers that patients face when trying to access mental health care are numerous, including extensive wait times, limited in-network options, and ghost networks—in which insurance directories are padded with clinicians who can’t or don’t actually provide care. This secret-shopper study assessed the accuracy of directories for the largest commercial insurers in Delaware, Montana, New Jersey, Rhode Island, and Virginia between October 2025 and March 2026.
By the Numbers
- Among 5,822 total calls, only 9% of first attempts yielded an appointment with the listed clinician, while 12% of first calls resulted in an appointment with any clinician.
- In total, 61% of the calls were nonevaluable, most commonly because callers reached an answering machine or automated system with no option to speak with a live agent.
- More than half (56%) of the evaluable calls were affected by network directory inaccuracies, the most common of which were contact information errors (31%) and medical specialty errors (22%). Directory error rates ranged from 71% for CareFirst BlueCross BlueShield (BCBS) in Virginia to 45% for Horizon BCBS in New Jersey.
- Psychiatry listings had higher error rates than psychology (58% versus 53%).
- Capacity limitations (such as clinicians not accepting new patients) prevented scheduling in 22% of evaluable calls, with higher rates for psychology (25%) than psychiatry (19%).
What’s More
Among the 437 callers who managed to secure appointments with a specific date, the average wait time was 23 days for psychiatrists and 17 days for psychologists.
The Other Side
Because BCBS affiliates hold the largest commercial market share in each included state, all insurers were BCBS licensees, and the findings may not generalize to smaller insurers or other plan types. Additionally, the high nonevaluable call rate may reflect a structural feature of mental health care delivery, in that solo or small-group practices lack dedicated desk staff and may be harder to reach.
Takeaway Message
“This study makes clear that patients seeking mental health care through commercial insurance networks face formidable barriers,” Jimmy Potash, M.D., M.P.H., the Henry Phipps Professor of Psychiatry and Behavioral Sciences at Johns Hopkins Medicine and chair of APA’s Council on Healthcare Systems and Financing, told Psychiatric News. “The ghost network is the norm; we need to do better. The insurance companies must develop better ways to access their systems, and regulators have to provide more robust means of verifying network adequacy.”
Related Information
Source
Simon Haeder, et al. Mental health ghost networks in commercial insurance plans. JAMA Health Forum. Published October 16, 2026. doi:10.1001/jamahealthforum.2026.3746
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