Seeking mental health services? Beware of ‘phantom’ providers

Mental health services are in demand. The first year of the COVID-19 pandemic spurred a 25% increase in anxiety and depression, according to the World Health Organization, and psychologists say even more individuals sought treatment last year.

People are admitting that they need help, but finding it may be harder than it looks.

In Oregon, a scourge of so-called phantom providers has left many of those calls for help unanswered, according to a new report. And they could be disrupting access to care in other areas of the country.

Researchers at Oregon Health & Science University found that of the in-network providers listed in Oregon Medicaid directories, almost 6 in 10 are not actually seeing patients. Searching for treatment, patients instead face frustrating barriers to critical mental healthcare.

A “phantom” provider can result from seemingly a simple change—a provider’s retirement, for instance—that could go unchecked. These administrative oversights can then render directories inaccurate, said the report’s lead author, Jane M. Zhu, M.D., assistant professor of medicine in the OHSU School of Medicine. As a result, insurance plans could be boasting an inaccurate number of providers in their network, and states may be unable to properly regulate access to care.

Even more, Zhu said the nationwide surge in mental health needs has overwhelmed healthcare professionals. Providers who do see patients cannot meet the demand. Patients, meanwhile, continue to wait.

Oregon may not be the only place where this is happening. In California, San Diego City Attorney Mara Elliott took legal action against three insurance networks last year, accusing them of “publishing and advertising provider information known to be false and misleading.”

Additionally, this Oregon report cites previous research identifying widespread gaps in care for Medicaid beneficiaries, with half reporting unsatisfied medical needs. Phantom providers could be contributing to these failures.

“If this represents the state of provider directories more broadly, that’s a huge concern for patients,” Zhu said.