A new secret-shopper study found that ghost networks and access barriers to mental health care persist in commercial coverage, not just public insurance programs.

The details: The study assessed network directory adequacy, appointment availability, wait times, and travel burdens for mental health clinicians listed in commercial insurance online plan directories. Over 5,800 secret-shopper calls were made to psychiatrists and psychologists listed in online network directories of the largest commercial carrier in 5 states (Delaware, Montana, New Jersey, Rhode Island, Virginia), October 2025-March 2026.

The findings:

61.3% of the calls were non-evaluable, most commonly because callers reached only an answering machine or automated system.
Among the remaining calls, 23.6% resulted in a scheduled appointment with the listed clinician, increasing to 32.1% when alternate clinicians were included.
Network directory inaccuracies affected 55.6% of evaluable calls, with contact information errors (31%) and specialty errors (22.2%) most prevalent.
Capacity limitations prevented scheduling in 21.6% of evaluable calls.
Mean wait time was 20.5 days, with longer wait times for psychiatry than psychology (22.5 vs. 17.3 days).
Mean travel time was 17.1 minutes overall but 41.8 minutes in Montana and 30.8 minutes for rural residents.

The main point: Across all initial call attempts, only 12.4% resulted in an appointment.

Why it’s important: Patients should be able to find and access needed treatment. But inadequate mental health and substance use disorder provider networks and inaccurate directories are major barriers to care across insurance types, despite longstanding parity laws.