Why I Left The Network

America is in the midst of a mental health crisis. But finding a therapist who takes insurance can feel impossible. Insurers say that’s because there aren’t enough therapists. That’s not entirely true. ProPublica spoke to more than 500 mental health providers to understand why so many make the agonizing choice to leave insurance networks:

The interviews underscore how the nation’s insurers—quietly, and with minimal pushback from lawmakers and regulators—have assumed an outsize role in mental health care.

It is often the insurers, not the therapists, that determine who can get treatment, what kind they can get and for how long. More than a dozen therapists said insurers urged them to reduce care when their patients were on the brink of harm, including suicide.

All the while, providers struggled to stay in business as insurers withheld reimbursements that sometimes came months late. Some spent hours a week chasing down the meager payments, listening to hold music and sending faxes into the abyss.

Several insurers told ProPublica that they are committed to ensuring access to mental health providers, emphasizing that their plans are in compliance with state and federal laws. Insurers also said they have practices in place to make sure reimbursement rates reflect market value and to support and retain providers, for which they continually recruit.

Therapists have tried to stick it out.

They have forgone denied payments.

They have taken second jobs.

They have sought therapy for their own support.