New York opens new front in campaign to cut wait times for mental health treatment

By HPN Staff

Patients in New York will get faster access to mental health services as part of a national push to cut wait times — although it’s unclear whether there will be enough psychiatrists and other providers to meet the new mandates.

Under the new “network adequacy” requirements, private health plans and the state’s Medicaid program must ensure that patients can get an initial appointment with a mental health professional within 10 days of making a request or within seven days of being discharged from a hospital.

“Network adequacy is about making sure third-party payers have enough health care providers to meet their patients’ needs,” New York State Health Commissioner Dr. James McDonald said. 

“These regulations will help New Yorkers who too often wait weeks or even months for an initial appointment for mental health or substance use disorder treatment.”

Why it matters

State and federal health agencies are grappling with surging demand for mental health services since the COVID-19 pandemic and a shortage of mental health professionals, resulting in long wait times for patients.

A recent Columbia Business School study found that 35 percent of Americans do not have access to a psychiatrist or a psychologist in the county where they live. Therefore, “increasing the capacity of the US mental health system is the key to effectively reducing the socioeconomic cost of mental illness,” the authors of the study concluded.

According to the Centers for Disease Control and Prevention (CDC), more than 12 percent of U.S. adults regularly experience feelings of worry, nervousness or anxiety. A further 5 percent regularly experience depression and almost 50,000 suicides are recorded each year by the CDC.

This makes suicide a leading cause of death in the U.S. — the eleventh highest overall. However, among children and young adults, suicide is much more prevalent, according to the National Institute of Mental Health (NIMH).

“Suicide was the second leading cause of death among individuals between the ages of 10-14 and 25-34, the third leading cause of death among individuals between the ages of 15-24, and the fourth leading cause of death among individuals between the ages of 35 and 44,” the NIMH reports.

Additionally, the study by the Columbia Business School has estimated the economic cost of mental health disorders at roughly $280 billion per year.

Additional context

The American Psychiatric Association (APA) has supported the national push to reduce wait times for mental health services. But the APA has also warned that setting maximum wait times without increasing the number of mental health professionals won’t solve the problem.

“There remains a well-documented and growing behavioral health workforce shortage,” the APA warned federal health regulators during a 2023 rulemaking on wait times. “There simply are not enough mental health clinicians to care for patients regardless of insurance status.” 

According to a 2024 federal study, a total of 17 states have added maximum wait times for mental health appointments in their network adequacy regulations for private insurance plans. 

In a related development, federal health regulators recently set a 10-day maximum waiting time for Medicaid, for the Children’s Health Insurance Plan and for private insurance plans that are offered through Affordable Care Act exchanges.