Acceptance of New Clients by Mental Health Clinicians in Massachusetts: Findings From a Representative Survey

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The objective was to assess the number of new clients accepted by licensed mental health clinicians in Massachusetts and clinician characteristics associated with new clients accepted. Surveys about client access to outpatient mental health care were sent to a stratified random sample of 2,250 licensed mental health clinicians (psychiatrists, psychologists, licensed certified social workers, licensed independent clinical social workers, licensed mental health counselors, and licensed marriage and family therapists) practicing in Massachusetts. The survey was administered from September 2016 to March 2017 by using a mail survey with a push-to-Web design and telephone follow-up. The final adjusted response rate was 28% (N=413). Results were weighted to reflect the sampling design and for nonresponse and are representative of all licensed mental health clinicians in Massachusetts. On average, clinicians accepted seven new clients per month. Although most clinicians reported accepting one or more new clients per month, half reported accepting four or fewer new clients per month. After adjustment for other factors, the analysis showed that clinicians in practices owned by hospitals or health systems reported accepting eight more new clients per month, on average, than clinicians in solo private practices (p<0.05). Clinicians in private group practices reported accepting two more new clients per month on average than clinicians in solo private practices (p<0.05). Working fewer than 30 hours per week and tenure of more than 1 year in one's current position were negatively associated with acceptance of new clients. New client acceptance varied by practice setting but not by type of clinician. These findings can inform mental health system and workforce planning to improve access to mental health services.