Amanda Marlar, founder of My Psych Match, improving psychiatric care access by connecting people with complex needs to the right providers.
In healthcare, when someone breaks a bone, experiences chest pain or shows signs of a stroke, we don’t tell them to come back in a few months. We treat them immediately. But when the crisis is psychiatric—whether it be escalating panic attacks, a severe depressive episode or a behavioral collapse from unmanaged co-occurring conditions such as autism and anxiety—patients are often being forced to wait.
Across the United States, the average wait time is 48 days between when a patient initially contacts a provider for mental healthcare and their first appointment. A variety of factors are at play: rising levels of unmet behavioral health needs, a shrinking pool of psychiatric providers, uneven access and narrowly defined roles that limit a provider’s scope. The result is a system where an estimated 21.5 million adults navigating complex diagnoses struggle to connect with the right expertise and secure proper care.
If leaders in the healthcare system want to decrease costs and improve outcomes, I believe we must first redesign intake processes to support complexity, then address provider shortages, because, as I see it, the biggest cost driver isn’t access. It’s misalignment.
The Individual Risks Of System Failure
For individuals navigating severe psychiatric conditions, delays in care pose significant, potentially life-threatening risks. Without timely access to a provider equipped to diagnose and manage complex conditions, patients risk missed school years, job loss, hospitalization or long-term functional decline. The right level of care can help prevent patients from cycling through emergency rooms and temporary solutions.
However, with the current system structured around generalized access and generalist providers who often lack the diagnostic specialization needed to treat complex cases, those most in need are the ones least likely to get proper support. A study published in General Hospital Psychiatry found that only 18.5% of psychiatrists in the U.S. were available to accept new patients with non-urgent needs. Even individuals with private insurance didn’t fare better, showing that this is a systemic issue consistent across all payer types.
The Business Implications Of Inaction
The cost of psychiatric care delays extends far beyond the individual. It’s also a business problem and a growing liability for healthcare systems, employers, insurers and the broader economy. When patients are mismatched with the wrong provider, they end up needing more tests, referrals and emergency room (ER) visits as their condition progresses. Each step adds friction, time delays and resource costs, resulting in a system of provider networks clogged with inappropriate visits.
This isn’t good for patients, and it isn’t good for business. For employers, these inefficiencies can increase absenteeism, presenteeism, decreased productivity and long-term disability claims. According to the World Health Organization, depression and anxiety alone cost the global economy over $1 trillion annually in lost productivity. And as employers invest heavily in mental health benefits, poorly matched care undermines both outcomes and the return on that investment.
The same stress is felt across healthcare systems and insurers. Public systems absorb these costs as patients cycle through crises, often ending up in costly emergency interventions or long-term disability programs that could have been avoided with timely, appropriate care.
The Roots Of The Problem (And A Way Forward)
Several key factors contribute to psychiatric access delays: workforce shortages, low insurance reimbursement rates and fragmented systems that isolate mental health from the broader healthcare infrastructure. But at a deeper level, I believe the problem stems from how psychiatric care has been commercialized, rewarding rapid growth and serving the general population.
Over the past decade, the rise of telehealth has created new opportunities to remove geography as a barrier to care. In many ways, it delivered on that promise. Some platforms’ standardized intake processes work reasonably well for patients with short-term anxiety or mild depressive symptoms. But these models can fall short for patients who require clinical diagnosis, medication management and long-term psychiatric care.
I believe that the next phase of psychiatric care innovation must come from redesigning intake systems that identify complexity up front. That includes deeper diagnostic assessments, referral networks built around provider specialization and treatment models that go beyond algorithmic matching. These assessments should identify co-occurring conditions and route patients to qualified specialists. In practice, this means asking who the patient is being seen by and whether that provider is equipped to treat the root issue, then quickly getting them into treatment.
As we rethink this system, we must also consider that bigger provider lists mean nothing if patients are still being routed to generalists unprepared to manage their needs. Instead, networks should be centered around clinical specialization to create a system with better care and fewer costly crisis interventions that strain the broader healthcare system. Some newer models are addressing this problem differently by developing condition-specific matching systems designed to connect patients with providers who have expertise in diagnosing and managing overlapping conditions.
In closing, there is no shortcut to solving psychiatric access. To close the care gap, we must design a system that addresses availability concerns while simultaneously matching patients with the expertise they need. This, in turn, can create a specialized system that serves both patients and businesses. That means redesigning intake processes, expanding networks of specialized providers and building infrastructure that recognizes the complexity of psychiatric care.
The longer we rely on generalized models that fail to serve those with complex needs, the longer we allow patients to fall through the cracks. Precision-driven psychiatric care isn’t a luxury—it’s the next necessary evolution of mental health care delivery.
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