Why You Shouldn’t Have to Wait Months for a Psychiatry Appointment

Written By Marium Bibi

Why You Shouldn’t Have to Wait Months for a Psychiatry Appointment

By Shoaib Memon, MD | Psychiatrist & Psychotherapist

Imagine deciding, after months of telling yourself you should, that today is the day you join a gym. You walk in, ready to sign up, and the front desk tells you the next opening is three months away.

Most people would not come back three months later. And the few who did would be starting from a very different place than the person who walked in today.

That is roughly what we ask of people seeking mental health care. Someone finally decides to get help for depression or anxiety, makes the call, and is told the first available psychiatry appointment is weeks or even months away. We tend to treat that wait as an unfortunate but harmless inconvenience. It isn't. A long wait for a first appointment can distort treatment decisions for years, and it quietly loses many of the people who were ready to start.

How long people actually wait

A wait of several weeks for a first psychiatry visit is normal in the US, and months is common in many places. The best evidence comes from "secret shopper" studies, where researchers call practices posing as new patients and record what they are offered.

  • Four large US cities, 2024. A study in JAMA called psychiatric prescribers listed in managed-care directories, asking for the earliest appointment for depression. Median waits were 11 days in Phoenix, 23 in Chicago, 28 in New York and 64 in Los Angeles, with some waits reaching six months.

  • Three US cities, 2015. A simulated-patient study in Psychiatric Services found outpatient psychiatry appointments were hard to get, and those offered were on average about a month away.

  • Canada. At a large Ontario mental health centre, more than half of outpatient clinics had average waits from referral to first appointment longer than three months.

These numbers only count people who got an appointment. They leave out everyone who called, couldn't get through, and gave up.

Problem 1: The wait can make a medication look like it worked

Depression is often episodic. Many episodes ease on their own over weeks to months, even without treatment. That is not a reason to skip care, but it matters a great deal for when care starts.

The research on this comes mostly from people randomized to wait-lists in treatment studies:

  • A 2013 meta-analysis in Psychological Medicine (Whiteford et al., 19 studies) estimated that among adults in primary care with untreated depression, about 23% remit within 3 months, 32% within 6 months and 53% within a year.

  • An earlier meta-analysis (Posternak & Miller, 2001) of 19 wait-list studies found depressive symptoms fell an average of 10–15% over 2–20 weeks with no treatment. The authors noted that many apparent treatment responders are likely experiencing a natural improvement that just happens to coincide with treatment.

  • Estimates vary. A more recent pooled analysis found lower short-term remission (around 1 in 10 within three months), and wait-list samples tend to include milder cases. The point is not the exact number, but that improvement without treatment is real and common.

Now picture the timeline. Someone's episode starts. They struggle for a while before seeking help, then wait three months for an appointment. By the time they are seen, they may be near the point where the episode would have started lifting anyway. They start a medication, feel better a few weeks later, and everyone reasonably concludes that the medication worked.

That conclusion tends to stick. Once a medication "works," stopping it feels risky to both patient and prescriber, and it is easy to stay on it indefinitely. A Cochrane review notes that surveys of long-term antidepressant users suggest 30–50% of long-term prescriptions have no evidence-based indication. Researchers in the UK have also found that reviews of long-term antidepressant use become less frequent the longer someone is on them.

None of this means antidepressants don't work; for many people they are clearly helpful. It means a long wait muddies the evidence for any single person. When someone is seen early, a clinician has more options: measure symptoms over time, start therapy, use watchful waiting for milder cases, or start medication with a clearer picture of what changes are actually due to it.

Problem 2: Readiness has a shelf life

Deciding to get help is hard. For someone with depression, low energy and hopelessness make each step harder. Anxiety can make a phone call feel enormous. When a person finally makes that call, they are at a peak of motivation, and a long wait spends it down.

The data on missed first appointments bear this out:

  • First-appointment no-show rates at outpatient psychiatric clinics have been reported at 26–50%, far higher than in most other specialties.

  • In a study of 400 newly referred patients at an overseas mental health clinic, nearly 40% missed their first appointment, and those who missed it had waited significantly longer.

  • A larger study of 1,475 patients at another clinic also found longer waits among those who didn't show, and recommended shortening wait times as a fix.

  • A randomized trial in a child psychiatry clinic found families who no-showed or cancelled had waited significantly longer than those who came.

Some people who skip that first visit no longer need it. But many simply lost the window: the crisis passed into a grinding, lower-grade struggle, life got in the way, or the effort of starting felt too big a second time. Back to the gym: momentum is part of the treatment. The best time to start is the moment someone is ready.

What getting started should look like

A first appointment doesn't have to mean a prescription. It means someone with expertise sees you while your symptoms and your motivation are both current. From there, good care can include:

  • An evaluation of what's actually going on, including how long symptoms have lasted and how severe they are.

  • Establishing a trusting relationship where symptoms and their improvement can be monitored consistently.

  • Therapy, lifestyle and sleep changes, or watchful waiting for certain individuals.

  • Medication when it's warranted, started with a clear baseline and a plan to review it.

If you're looking for care, it's worth asking practices directly how soon they can see a new patient, checking telehealth options, and asking to be put on a cancellation list. If you're offered a date months out, keep looking.

We would never accept a three-month wait to join a gym. We shouldn't accept it for the moment someone decides to take care of their mental health.

Ready to Start? Ask About the Next Available Appointment

Dr. Shoaib Memon is accepting new patients for psychiatry and psychotherapy in Chicago, with virtual care available to patients across Illinois. If you are ready to begin, schedule a free initial consultation to discuss your needs and ask about the earliest available appointment. Actual appointment timing depends on availability, so ask rather than assuming you must wait months.

Disclaimer: This post is for educational purposes only and does not constitute medical advice. It is not a substitute for professional diagnosis or treatment. Talk with a qualified healthcare provider about your own situation, and don't start, stop or change any medication without their guidance.

References

Wait times

Untreated depression and spontaneous remission

Long-term antidepressant use

First-appointment no-shows

Marium Bibi
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