The Problem
In Pennsylvania, getting into therapy is hard. Staying in therapy is even harder.
If you’re a parent in Pennsylvania trying to get mental health care for your child or teenager, you’ve probably already learned this the hard way: finding a therapist can feel like a second job. Staying with that therapist over time can feel nearly impossible.
Appointments are scarce. Waitlists are long. And even when families finally secure care, it often falls apart because of rules that have nothing to do with clinical need—and everything to do with geography.
This isn’t a failure of families, clinicians, or even insurance.
It’s a system problem.
The rules most people don’t know exist—until they hit a wall
Mental health care is governed by state-based licensing laws that are rarely explained in plain English. Most people—including policymakers—don’t encounter these rules until someone they love is struggling.
Here’s the short version:
Therapists are licensed state by state
A clinician who is fully licensed and qualified in one state is often prohibited from treating a patient in another
These restrictions apply regardless of insurance type—Medicaid, private insurance, or out-of-pocket