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Americans with commercial insurance are generally told they have access to a strong network of mental health providers. But when researchers called providers listed in those networks, securing an appointment was usually difficult or impossible, according to a new study.

Researchers, posing as "secret shoppers" looking for appointments for issues including anxiety and grief, called 5,822 psychiatrists and psychologists on commercial provider lists in five states—Delaware, Montana, New Jersey, Rhode Island and Virginia.

Their aim was to test whether the provider information in insurance directories actually connected patients with available, in-network mental health professionals.

A successful call (meaning someone picked up the phone) resulted in an appointment with the health care provider only 24% of the time. If the caller was willing to see another clinician, an appointment could be made 31% of the time.

The research, led by Simon Haeder and Wendy Xu of The Ohio State University College of Public Health, appears today in JAMA Health Forum.

"Access to mental health care in the U.S. is a well-documented struggle. This shows that even those with private insurance, who are told they have many providers to choose from, can have a hard time getting the care they need," Haeder said.

The researchers couldn't analyze more than six in 10 calls because they reached an automated system or answering machine and could not speak with a person.

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