Wait for mental health treatment can take months, study says

For those seeking help for mental illness or addiction in Massachusetts, the path can be long and tortuous, often taking several months before treatment begins.

That’s what members of focus groups told researchers commissioned by the Blue Cross Blue Shield of Massachusetts Foundation, as part of a study released Tuesday on barriers to outpatient mental health services in Massachusetts.

The wait is especially long for children, those who need a psychiatrist, adults covered by Medicaid, and people who don’t speak English, the study found.

The report portrays a mental health system that burdens both patients and caregivers. Patients face a frustrating, time-consuming process finding someone who can help. Providers endure low reimbursement rates and administrative hassles.

As a result, according to the study, 10 percent of outpatient mental health clinicians have stopped taking health insurance, further exacerbating the access problem.

These problems are not new and have long been discussed, said Audrey Shelto, foundation president. But the report, she said, “validates the anecdotes and, I hope, provides a call to action.”

The Cambridge-based research firm Abt Associates, working from September 2016 through March 2017, conducted 21 interviews with people in the mental health field, held four focus groups with patients, and received survey responses from 413 licensed clinicians and 85 administrators.

“It’s really capturing the journey of that individual navigating the system,” said Jenna T. Sirkin of Abt, one of the study’s authors. “We had heard a lot of stories from individuals about how challenging it had been.” 

Patients complained that insurers’ provider lists are often outdated, so they spent weeks trying to find a clinician who would accept their insurance, had the expertise to manage their condition, and had openings for new patients.

But once patients locate someone who can help, the mental health providers surveyed said, 80 percent of people can get an appointment within two weeks.

One the biggest challenges is a shortage of psychiatrists, particularly those who take health insurance. Some 14 percent of the psychiatrists surveyed don’t accept any kind of health insurance. As a result, people who can pay out of pocket have the fastest access to treatment.

While adults with Medicaid coverage faced longer delays than those with commercial insurance, children had the opposite experience: youngsters on the state Medicaid program, known as MassHealth, got appointments faster than their peers with commercial insurance and also found a wider array of services.

The study makes several recommendations, including launching incentive programs to encourage people to enter the field and boosting payment methods that recognize the importance of mental health. And at a panel discussion Tuesday, the foundation is showcasing two programs that make it easier for patients to get care.

Four human service agencies in the MetroWest area have teamed up to establish Behavioral Health Partners of MetroWest, a one-stop helpline (844-528-6800) for people seeking behavioral health services. A care coordinator answers the phone, determines what the patient needs and who can provide it, and schedules an appointment. Since July, 20 percent of callers received appointments within a week, 25 percent within two weeks, and 25 percent within three weeks.