The New York Times on Sunday examined how mental health practitioners “are feeling an economic pinch, partly because of insurance reimbursement schedules that they say have not kept pace with their expenses.” The Times profiles several mental health professionals who maintain that fees negotiated by insurance carriers have forced them to increase their patient loads or look for other sources of income. In addition, social workers say they are facing reduced fees, late payments and “inappropriate assessment of the needs of patients,” the Times reports.

According to Paul Berman, the professional affairs officer for Maryland’s psychological association, many psychologists in private practice say reduced fees have forced them to nearly double their client loads and work many more hours to maintain their incomes. He said that when he went into private practice in 1990, his maximum allowable hourly billing rate as a participant in insurers’ provider networks was $95, compared with today’s rates of about $65 or $75.

According to Richard Frank, a health economist at Harvard University, efforts by insurance companies to reduce costs, as well as the increased use of drugs rather than psychological therapy to treat mental health ailments, have affected the incomes of mental health professionals. He said, “Clearly, the earnings of mental health professionals — medical doctors, psychologists, social workers and counselors — have either been flat or been declining for the past five to eight years.” Frank added, “It’s not so much the number of visits allowed by managed care to mental health professionals has changed. It’s that the fees paid to the mental health professionals have not been rising.”

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

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    Last reviewed: By John M. Grohol, Psy.D. on 29 Mar 2006
    Published on PsychCentral.com. All rights reserved.