Psychologists are encountering significant challenges due to insurance-related issues, which limit their ability to meet the rising demand for mental health services. The American Psychological Association’s 2024 Practitioner Pulse Survey highlights administrative and financial barriers that prevent many psychologists from participating in insurance networks, thus impacting patient access to care.

The survey conducted among 853 psychologists in September 2024 by the APA and APA Services, Inc., reveals that approximately one-third (34%) of psychologists do not accept any form of health insurance. Of these, nearly half (48%) had previously participated in insurance networks. Only a small fraction (18%) reported never having engaged with insurance during their careers.

A primary obstacle cited by over 80% of those who have left or never joined insurance networks is insufficient reimbursement rates. Additionally, 62% identified administrative challenges such as pre-authorization requirements and audits as deterrents. More than half (52%) expressed concerns about payment reliability, including delays and refund demands.

APA Chief Executive Officer Arthur C. Evans Jr., PhD, stated: “We’ve heard from individual psychologists who have been pressured by insurance companies to cut off care to patients, including those with serious mental illness or at risk for suicide.” He added that the hurdles created by insurance companies harm both psychologists and patients needing care.

The survey also indicates an increase in demand for mental health treatment. Over half (53%) of psychologists reported having no openings for new patients, while a similar percentage (51%) noted an increase in symptom severity among existing patients. More than four out of ten psychologists (44%) observed a need for extended treatment durations.

Lynn Bufka PhD, APA’s head of practice, commented: “Psychologists want to work with insurance providers to provide access to patients who must rely on their insurance for their mental health needs." She emphasized that fair compensation and reduced administrative burdens could enhance access to mental health services.

This annual survey has been part of the APA Practitioner Pulse Survey series since 2020. Initially focused on tracking changes during the COVID-19 pandemic, it now monitors workforce shifts post-pandemic as of May 2023. Conducted online with invitations sent to a sample of 35,000 individuals on September 4, 2024, the survey achieved a completion rate of 3.1%.