The supply and demand imbalance in clinical psychology and psychiatry is why they can choose to be out of network. Demand is not only wanting a good or service but being able to pay for it. Mentally ill people tend to have less or much less money.
The long term trend is not good; why become a psychiatrist when you can earn more as almost any other specialist? (With exception of pediatry). Jails are collectively America's largest mental health service providers. If there was money in psych work you'd see even private equity pump it up like urgent care chains.
Even with single payer or heavily regulated universal insurance schemes there's often a mental health services gap.
The long term trend is not good; why become a psychiatrist when you can earn more as almost any other specialist? (With exception of pediatry). Jails are collectively America's largest mental health service providers. If there was money in psych work you'd see even private equity pump it up like urgent care chains.
Even with single payer or heavily regulated universal insurance schemes there's often a mental health services gap.