Despite the soaring demand for mental health treatment, insurance-related obstacles are preventing many psychologists from participating in insurance networks, according to the American Psychological Association’s (APA) 2024 Practitioner Pulse Survey. These challenges are exacerbating the mental health crisis by making it harder for patients to access timely care.
The survey, conducted in September 2024, involved 853 psychologists and revealed that approximately 34% of them were not accepting any form of health insurance. Of those, nearly half (48%) had previously participated in insurance networks but had since stopped. Only 18% of respondents had never worked with insurance throughout their careers.
Among the psychologists who opted out of insurance networks or never participated, the survey found that more than 80% (82%) cited low reimbursement rates as a primary barrier. Administrative hurdles, including pre-authorization requirements and audits, were also a significant issue for 62% of respondents. Additionally, over half (52%) identified concerns about payment reliability—such as delays and refund demands—as key factors in their decision to disengage from insurance participation.
“We’ve heard from individual psychologists who have been pressured by insurance companies to cut off care for patients, including those with severe mental health conditions or at risk for suicide,” said APA CEO Arthur C. Evans Jr., PhD. “Psychologists spend countless hours tracking down missed payments and lose thousands of dollars due to audits that occur months or even years after services are provided. These hurdles aren’t just harming psychologists—they’re also hurting the patients who need care the most.”
The survey’s findings also coincide with a continuing surge in demand for mental health services. More than half (53%) of psychologists reported having no openings for new patients, while 51% noted an increase in the severity of patient symptoms. Additionally, 44% of psychologists observed a need for longer treatment durations among their patients.
“Psychologists are eager to collaborate with insurance providers to ensure that patients who rely on insurance for mental health services can access the care they need,” said Lynn Bufka, PhD, head of practice at the APA. “However, when reimbursement rates are too low and administrative burdens are too high, many psychologists are forced to make difficult decisions about whether to work with certain insurers. Insurance companies can help address this issue by paying psychologists fairly and eliminating unnecessary administrative obstacles that hinder care delivery.”
Survey Methodology
The APA Practitioner Pulse Survey has been conducted annually since 2020, originally tracking the impact of the COVID-19 pandemic on psychological practice. The survey now aims to monitor trends in the workforce following the end of the emergency in May 2023.
The 2024 survey was conducted online, with invitations sent to a random sample of 35,000 psychologists in September. A total of 853 responses were received, yielding a completion rate of 3.1%.
The APA, headquartered in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States, with over 157,000 members. Through its divisions and affiliations, the APA works to advance psychological knowledge to benefit society and improve lives.
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