Boston Study May Have National Implications for Psychiatric Care

A new study conducted by researchers at the Harvard Medical School shows that access to outpatient psychiatric treatment in Boston is insufficient to meet the needs of those in crisis. The researchers believe that their findings parallel national conditions because the federal health bill is modeled after the health system in Massachusetts. Participants in the study called Blue Cross Blue Shield network mental health providers to obtain a psychiatric appointment. They told the providers that they had received emergency room treatment for depression and were advised to get a psychiatric follow-up within two weeks, signifying they were in need of urgent care. Of 64 providers contacted, only 8 offered appointments, and only four had an available appointment within two weeks. Almost one quarter of the phone calls was never even returned and another 23 percent of providers advised the participants to obtain a referral from a primary care doctor first.

“People with mental health problems often can’t advocate for themselves – especially in a crisis,” said Dr. J. Wesley Boyd, an attending psychiatrist at the Harvard-affiliated Cambridge Health Alliance, and lead author. “Health insurers know this and yet, thanks to their restrictive provider networks and their low reimbursement rates for psychiatric services, they’ve created a situation where a patient with a potentially life-threatening disorder, such as the severe depression portrayed in our callers’ scenario, is essentially abandoned at a time of great need.” He added, “How likely is it that a real patient in the grip of severe depression would persevere through so many unsuccessful attempts?”

Dr. Rachel Nardin, chief of neurology at Cambridge Health Alliance and senior author of the study, said: “Lack of adequate access to mental health care strains our entire health care system.” He added that one solution, “would be to remove private insurers from the picture altogether and to establish a single-payer national health insurance program – a program that would cover mental health services as part of its comprehensive benefits package.”

© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • shea


    July 27th, 2011 at 4:28 AM

    But if there is a single payer system, then there are still the same chances that mental health care will not be given the priority that it deserves. I do not see that the private sector insurance plans are helping, but to have the government in charge is not the answer either. It feels like such a catch 22 right now, because there is no easy answer. There sre only a few things that we know for sure, and unfortunately the one thing that continues to stand out is that when there is so much profit to be made off of others ills, then there is going to continue to be corruption and adequate care for a lucky few and sub par care for the rest of us.

  • raymond


    July 27th, 2011 at 8:59 AM

    has been prevalent for a long time is my guess.and we don’t know how many people have suffered irrepairavle damage to their mental health or may have even died due to this shortage of good service.

    it’s people’s lives that were talking about here and there really is no room for laxity and negligence.everything needs to be top notch!



    July 27th, 2011 at 1:07 PM

    People in need to treatment will not be in a position to follow up so much and get their elusive appointment.First we shout about how important it is to seek treatment for mental health and then there is no support for those who do seek help!This is bound to bring down the morale of those affected and will make them feel seeking for help does nothing.This will turn into a general perception and we will have more and more people suffer from totally curable problems.All a result of apathy and insufficient measures.

  • Sarah F.

    Sarah F.

    July 27th, 2011 at 3:31 PM

    Based on my own experience, I have to agree that those who are depressed have difficulty advocating for themselves. I can remember dreading telling one more person my story, even though I knew it would get me closer to finding the help I needed. I don’t think that I would have even fit into the “severely depressed” category and it was still very difficult to reach out and contact the people I needed. It is so sad that those who so desperately need help don’t even get a phone call in return to a request. Hopefully some actions can be taken so no one has to feel forgotten.

  • AnnaGrayson


    July 28th, 2011 at 4:33 AM

    It always is the downtrodden who can’t speak for themselves that will always find themselves being shot down by the system time and again.

  • Shane Browning

    Shane Browning

    July 28th, 2011 at 8:49 AM

    Quote: Almost one quarter of the phone calls was never even returned and another 23 percent of providers advised the participants to obtain a referral from a primary care doctor first.

    If the healthcare providers themselves behave this way then it gives a very bad impression to those seeking treatment and will make them think these people are not bothered to even do their designated job. Hey wait, it won’t make them just THINK that way, it is true! This study is the proof for the same.

  • Searah


    July 30th, 2011 at 2:38 PM

    Not only do you have to battle the doctors and caregivers to get appropriate care, what about the battles that you may then have to face with the insurance companies to get payment for services? Sheesh! It is like all sides try to make it as difficult as possible for anyone who seriously needs help to get it in any way. It really does kind of embarrass me that this is the state of the nation that we live in. Aren’t we supposed to be better than that and willing and able to offer our citizens care that better than that?

  • David C

    David C

    July 31st, 2011 at 6:45 PM

    Mental health care is critical for many individuals survival. Our healthcare system has degenerated to the point that getting treatment for the common cold is impossible.

    My insurance will not pay for my sons therapy. He has been diagnosed with depression, my wife and I have been graced with the ability to pay for the therapy sessions that he requires. How many families can’t pay for this critical service. How many people have to live unfulfilled lives because of crazy insurance rules and regulations? It is sad to me that this could ever occur.

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