Carlin, who has both borderline personality disorder and addiction issues, said she called around to about 10 other providers, but she couldn't find anyone who accepted her insurance and was taking new patients.
"It's such a daunting experience for someone who has trouble maintaining their home and holding a job and friendships," said Carlin. "It makes me feel like no one can help me, and I'm not good enough, and it's not an attainable goal."
In Virginia, the Milliman report found that 26 percent of behavioral health office visits were out-of-network -- more than seven times more than for medical care.
With no alternative, Carlin stuck with her old therapist but must save up between sessions. She has just enough to cover a visit once every few months.
"I make $30,000 a year. I can't afford an out-of-pocket therapist or psychiatrist," said Carlin. "I just can't afford it. I'm choosing groceries over a therapist."
Angela Kimball, director of advocacy and public policy at the National Alliance on Mental Illness, said she worries many patients like Carlin simply forgo treatment entirely.
"One of the most common reasons people give of not getting mental health treatment is the cost. The other is not being able to find care," she said. "It's hurting people in every corner of this nation."
(Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.)
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