Study finds low appointment rates for mental health calls

A recent study, published in JAMA Health Forum on October 16, reveals that a significant majority of calls to mental health professionals listed in commercial insurance directories do not result in scheduled appointments. Between October 2025 and March 2026, researchers placed 5,822 calls to psychiatrists and psychologists in Delaware, Montana, New Jersey, Rhode Island, and Virginia, finding that only about one in eight calls led to an appointment.

Challenges in accessing mental health care

The study’s findings indicate that a mere 12.4% of calls resulted in an appointment with a clinician. Among the 2,252 calls with clear outcomes, 55.6% were hindered by errors in the directory, 23.6% successfully connected callers with the listed clinician, and 21.6% were thwarted by capacity constraints. Furthermore, the average wait time for appointments with a specified date was approximately 20.5 days.

The study’s authors noted that the process of connecting patients with care through network directories is often “broken,” with systemic and pervasive barriers. All the insurance carriers surveyed were affiliated with Blue Cross Blue Shield. Notably, 61.3% of calls, totaling 3,570, were considered “nonevaluable” due to the caller only reaching an automated system or answering machine without the option to speak with staff.

Consequences for patients and insurers

Accurate directory information is key, as it carries financial implications under the U.S. Centers for Medicare & Medicaid Services guidance on the No Surprises Act. Insurers are required to verify and update directory information at least every 90 days and make changes to their databases within two business days of receiving updates from providers. If a patient receives out-of-network care due to inaccurate directory information, the insurer cannot charge more than the in-network rate.

State and federal regulatory actions

Directory accuracy is also a matter of legal concern. In February, New York State Attorney General Letitia James announced that EmblemHealth would pay $2.5 million in penalties and fees, provide restitution to members, and undergo independent monitoring following an investigation into mental health access. The settlement revealed that over 80% of surveyed behavioral health providers listed as accepting new patients were effectively unavailable.

The settlement requires EmblemHealth to conduct regular secret shopper surveys, publicly report the results, track complaints, and implement a provider recruitment and retention plan. It also mandates an out-of-network option at in-network rates when a member cannot secure a timely in-network appointment.

Federal scrutiny of directory accuracy is expanding, particularly in Medicare Advantage. On October 16, the Centers for Medicare & Medicaid Services proposed requiring plans to verify directory information every 90 days and publicly display accuracy scores for contract year 2028. The agency also proposed protecting members from out-of-network cost sharing when relying on incorrect listings. The study was funded by Inseparable, a national mental health advocacy non-profit organization, and highlights the need for improved directory accuracy to ensure timely access to mental health care.