Amanda Marlar, founder of My Psych Match, improved access to psychiatric care by connecting people with complex needs to the right provider.
In healthcare, if someone breaks a bone, experiences chest pain, or shows signs of a stroke, they won't be told to come back in a few months. I'll handle it immediately. However, if the crisis is psychiatric – patients are often forced to wait, whether it is an escalation of a panic attack, a severe depression episode, or a disruption from an uncontrolled co-occurrence state such as autism or anxiety.
Nationally, the average waiting time is 48 days between initial appointments when patients first contact a mental health care provider. A variety of factors are active. It is the role of narrow definitions that limit the level of unmet behavioral health needs, a shrinking pool of psychiatric providers, heterogeneous access, and provider scope. As a result, an estimated 21.5 million adults navigate complex diagnosis systems have struggled to connect with the right expertise and ensure proper care.
If a healthcare system leader wants to reduce costs and improve results, I think they must first redesign the intake process to support complexity and then address the shortage of providers. That's inconsistency.
Individual risks of system failure
For individuals navigating severe mental illness, delays in care pose a serious and potentially life-threatening risk. Without timely access to providers equipped to diagnose and manage complex conditions, patients risk missing grades and unemployment, hospitalization, or long-term functional decline. A proper level of care will help prevent patients from cycling through emergency rooms and temporary solutions.
However, in current systems that are often lacking the specialization of the diagnostics needed to treat complex cases and are centered around generalist providers, the ones most needy are the ones who are least likely to get the right support. A study published in General Hospital's Psychiatry found that only 18.5% of US psychiatrists could be used to accommodate new patients with urgent needs. Even private insurance individuals have shown this to be a consistent and systematic issue across all payer types.
Impact on business
The cost of delays in psychiatric care is far beyond individuals. It is also a business problem, an increase in responsibility for the healthcare system, employers, insurance companies and the broader economy. If a patient falls inconsistent with the wrong provider, more testing, referrals and emergency rooms (ERs) should be visited as the condition progresses. Each step adds friction, time delays, resource costs, and results in a system of provider network stuck with inappropriate visits.
This is not good for patients and not good for business. For employers, these inefficiencies can increase absenteeism, presentationalism, reduced productivity and long-term disability claims. According to the World Health Organization, depression and anxiety alone cost the global economy more than $1 trillion in productivity losses per year. Additionally, as employers invest heavily in mental health benefits, poorly matched care will undermine both the outcome and the return on that investment.
The same stress is felt across the healthcare system and insurance companies. The public system absorbs these costs as patients cycle through the crisis. It often ends with costly emergency interventions or long-term disability programs that can be avoided with timely and appropriate care.
The roots of the problem (and the future path)
Several important factors contribute to delayed psychiatric access. It is a fragmented system that separates mental health from labor shortages, low insurance reimbursement rates, and wider health infrastructure. But on a deeper level, I think the problem stems from how psychiatric care is commercialized, rewarding rapid growth and serving the public.
Over the past decade, the rise of telehealth has created new opportunities to remove geography as a barrier to care. In many respects, it was provided based on that promise. The standardized intake processes on some platforms work reasonably well for patients with short-term anxiety or mild depressive symptoms. However, these models may be scarce in patients who need clinical diagnosis, medication management, and long-term psychiatric care.
I believe that the next step in innovation in psychiatric care must come from the redesign of intake systems that identify complexity in advance. This includes deeper diagnostic assessments, provider specialization models beyond algorithm matching, and referral networks built around treatment models. These assessments require identifying co-occurring conditions and route patients to qualified professionals. In reality, this means asking who the patient is being seen, whether the provider is equipped to treat a root problem and getting treatment immediately.
When rethinking this system, we need to consider a larger provider list meaningless if patients are still routed to generalists who are not ready to manage their needs. Instead, networks should focus on clinical specialization and create systems with better care and less expensive crisis interventions. Some new models address this problem differently by developing state-specific matching systems designed to connect patients with providers with expertise in diagnosing and managing overlapping conditions.
Finally, there are no shortcuts to solving psychiatric access. To bridge the care gap, systems must be designed to address availability concerns while matching the required expertise with the patient. This allows you to create a specialized system that serves both patients and businesses. This means redesigning the intake process, expanding the network of specialized providers, and building infrastructure that recognizes the complexities of psychiatric care.
The longer we rely on a generalized model that cannot serve people with complex needs, the longer our patients will fall through the crack. Precision-driven psychiatric care is not a luxury. This is the next necessary evolution of mental health care delivery.
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