NEW YORK, Dec. 11 (UPI) -- U.S. researchers suggest unless those needing help for mental illness have deep pockets, they may have a hard time finding a psychiatrist to accept insurance.
Dr. Tara F. Bishop, an assistant professor in the Department of Public Health and Medicine at Weill Cornell Medical College in New York, and colleagues said the number of psychiatrists is quickly dwindling -- a drop of 14 percent from 2000-08 -- because psychiatrists are retiring and medical students are not choosing to go into psychiatry.
The researchers found psychiatrists increasingly refuse to accept Medicare and Medicaid, or even private insurance, as payment. In the five years between 2005-10, investigators found the percentage of psychiatrists who accepted private insurance dropped by 17 percent, to 55 percent, and those who took Medicare declined by almost 20 percent, also to about 55 percent. Their acceptance of Medicaid was 43 percent.
"More than physicians in other specialties, psychiatrists accept lower rates of insurance, and those who don't take insurance are likely charging cash for their services," Bishop said in a statement.
"I must say we were surprised by the findings."
The low insurance rates for psychiatry might "impact recent calls for increased access to mental health services -- via the Affordable Care Act -- and if the trend of declining acceptance rates continues then the impact may be even more significant," the researchers said.
"For example, not only are there fewer physicians who can help people with moderate to severe symptoms of mental illness, those patients must then try to find a doctor who will take their insurance," Bishop said. "This is not a formula for success."
Weill Cornell investigators and colleagues at Columbia University and the University of California, San Francisco, used data from the National Ambulatory Medical Care Survey, which represents about 90 percent of the ambulatory care delivered by private physician offices or group practices. This database does not include psychiatric outpatient clinics linked to hospitals or large medical centers.
"Some patients with some of the most severe mental illnesses, such as schizophrenia or bipolar disease, may be cared for in those clinics, and this database does not capture that population," Bishop said.
The researchers don't know why psychiatrists are increasingly rejecting insurance payment; but part of the reason might be that it takes considerable time -- typically, an hour or so -- to provide counseling and therapy, and therefore, psychiatrists might not be able to see as many patients in a day as physicians of other specialties, Bishop said.
The findings were published in the JAMA Psychiatry.
