When people talk about the broken state of mental healthcare in this country, they usually focus on the shortage of providers, the stigma of seeking help, or the overwhelming demand compared to the supply of clinicians. But one of the biggest—and most silent—forms of corruption sits at the heart of the system: insurance companies.

I learned this the hard way.

Low Reimbursement, High Costs

Mental health professionals spend years in graduate school, accumulate crushing student debt, complete internships, supervision hours, and continuing education. We do all of this because we care about people’s well-being. Yet, when we finally sit down across from a client, the system is stacked against us.

Insurance companies decide how much our work is worth—and their numbers show just how little they value mental healthcare. Reimbursement rates for therapy sessions are notoriously low, often less than half of what we could charge for a private-pay client. Imagine telling your mechanic, plumber, or attorney that you expect them to do high-stakes work for half the going rate, and that they’ll wait months to maybe get paid. That’s the daily reality for therapists who accept insurance.

A Year of Work, No Pay

At one point in my career, I worked with a large insurance company that strung me along for nearly a full year without paying me for sessions I had already completed. Week after week, I continued to provide care to clients who desperately needed it, trusting that the system would honor its obligations. Instead, I was left chasing down phone calls, sitting on hold for hours, resubmitting claims, and being told there were “processing delays.”

Think about that: nearly a year of unpaid labor. If this happened in any other industry, it would be called what it is—corruption.

Who Really Loses?

This isn’t just about therapists being underpaid. When insurance companies drag their feet or set insultingly low reimbursement rates, clients lose too. Therapists burn out, leave the field, or stop accepting insurance altogether. That means fewer providers for those who need them most—the people who can’t afford to pay out-of-pocket.

The end result? A system where access to care is dictated not by need, but by who can pay cash. Insurance companies are padding their profits while patients are left with fewer options and longer waitlists.

Why This Matters

Mental healthcare should be treated with the same urgency and respect as physical healthcare. When someone has a broken bone, we don’t argue with them about whether they deserve treatment or ask them to wait a year for insurance to “process” a payment. Yet for mental health, this type of exploitation is business as usual.

I share my story not just out of frustration, but to shine light on the systemic corruption that keeps therapists underpaid, overworked, and disillusioned—while clients suffer the consequences. Until insurance companies are held accountable, both providers and patients will remain trapped in a system that profits off of our struggle.