Uncared For — Episode Summary
Podcast: Uncared For (Lemonada Media)
Host: SuChin Pak
Guest: Kendra F. Dunlap, trauma-focused therapist
Episode: Why Is It So Hard To Find a Therapist?
Date: August 27, 2025

Main Theme & Purpose

This episode investigates the struggles Americans face when trying to access mental health care, particularly the daunting process of finding a therapist who both suits their needs and takes insurance. Host SuChin Pak unpacks systemic roadblocks through a candid conversation with Kendra F. Dunlap, a therapist who left insurance networks after experiencing overwhelming administrative burdens. Together, they explore why so many people can’t secure therapy, highlight the damaging impact on marginalized communities, and discuss both the personal and systemic changes needed for improvement.

Key Discussion Points & Insights

The Challenge of Finding a Therapist

• Lengthy Wait Times & Provider Shortage
  • Kendra shares a personal experience: “I called, it was like in September and they told me that I wouldn't be able to be matched with anyone until December and that was just not okay.” (01:49)
  • SuChin references a survey: 40% of people seeking mental health care make four or more calls to find a provider—versus 14% for physical health care. (02:46)
  • Many therapists simply aren't taking new patients, don’t accept the right insurance, or have capacity.

Therapist Background: Kendra F. Dunlap

• Kendra specializes in trauma-informed, relational, and liberation-focused therapy, mainly serving BIPOC women, caregivers, and high-achieving individuals plagued by perfectionism and systemic pressures. (04:50, 05:14)
• She emphasizes an openness and curiosity rooted in her identity as a Black woman. (06:10)

Insurance: From Manageable to Overwhelming

• When Kendra began her practice (2016), insurance billing was straightforward. (07:14, 09:58)
• The pandemic (2020–2021) brought a surge in demand and administrative headaches: “Every week, for every client ... I had to call to correct the claim. [...] I was spending two hours a week being rerouted, having calls hung up, getting different kinds of messages about what I needed to do.” (09:58)
• Claims were frequently denied due to outdated systems and telehealth coding confusion.

Unsustainable Economics for Therapists

• Insurance reimbursed 50–60% less than what Bay Area therapists could charge in the private market. (11:58)
• Administrative burdens meant losing money: “I could have taken more clients on, but then that would have meant spending even more time trying to get paid. And it was having to call to fix the mistake that wasn't mine.” (11:58)
• The combination of low pay and time-wasting bureaucracy made the practice unsustainable.

Emotional & Ethical Toll

• Kendra: “I wanted to be able to be the most present with my clients and offer the best care ... Spending so much time having to do this during the pandemic ... started to take a toll on my physical and mental health.” (13:25)
• Despite high demand (“six to 10 inquiries a week”), she was unable to refer clients elsewhere because most colleagues were also overburdened and opting out of insurance networks. (14:55)

Industry-Wide Burnout & Clawbacks

• Therapists feared ‘clawbacks,’ where insurance demands repayment—even years after services are rendered. (17:27)
  • “For folks that don't know [clawbacks] is when insurance companies ask for money back that they've already paid ... that can be so detrimental to a sole practitioner or even a group.” (17:27)
• Loss of autonomy: Venture-capital-backed therapy networks and insurance companies dictate care models, reimbursement, and even data practices—sometimes leading to privacy breaches. (19:23)
• Burnout in the profession is at an all-time high. (19:23)

Breaking Points and Leaving Insurance

• Insurance companies pressured Kendra on how long she could spend with clients—discouraging the use of codes with higher reimbursements, even when clinically necessary. (20:55)
  • “I would get letters ... counseling letters about my use of this code was more than the average clinician ... it was trying to discourage me from using that code because it's the higher reimbursable rate.” (20:55)
• She left insurance panels in 2022: “...the next part was, how am I going to tell my clients who some of them had been searching for a therapist for months or years. And so that's probably what kept me in it a little bit longer than probably was feasible, both mentally and physically.” (23:18)

Impact on Patients: Ghost Networks

• Kendra guided clients toward insurance “networks” that often resulted in dead ends. These ‘ghost networks’ list providers who are not actually available: “After calling nearly 400 mental health providers listed ... 86% were ghosts.” (24:30)
• For clients who stayed, she offered sliding scale rates to maintain accessibility—but this was only possible for about 20–30% of them. (25:21)

Additional Barriers: Diagnosis & Stigma

• Insurance requires a formal mental-health diagnosis for coverage—creating added stigma for patients, disproportionately impacting communities of color. (28:14)
  • “For a lot of individuals the stigma of a diagnosis ... especially for marginalized and BIPOC communities ... there's a heavier weight for those communities.” (28:14)
• People of color face higher rates of underdiagnosis and undertreatment, exacerbated by systemic inequities and provider shortages. (29:02)

Generational & Community-Wide Impact

• Lack of mental health access creates cycles of trauma and poor health. (30:36)
  • “If a mom is not getting the help that she needs ... how does that child internalize what that means and then how they choose to see the world and the impacts that it has to their own mental health?” (30:36)
  • Unaddressed childhood trauma is linked to increased risk of chronic physical diseases (e.g., heart disease, diabetes) in communities of color. (30:36)

Practical Solutions & Resources

• Sliding Scale and Subsidy Programs:
  • Open Path Collective: online directory for affordable therapy (32:30)
  • Love Lounge Foundation: for Black women and girls (32:30)
• Community Resources:
  • Local mental health departments, Mental Health America, and crisis/support groups (33:05)
  • Workplace Employee Assistance Programs (EAPs) offer short-term free therapy (33:05)
• These are stopgaps, not comprehensive solutions.

Hope Amidst Crisis

• Despite adversity, Kendra stays inspired by her clients’ resilience and progress:
  • “What gives me hope is my clients, the resilience that my clients have, ... seeing them when they thrive after going through periods of really, you know, difficult situations and points. That's what keeps me in the work ... and keeps me wanting to continue to do the work.” (34:08)

Notable Quotes & Memorable Moments

• On systemic access:
  “You finally get the courage to reach out, just to be kicked to the side and just not feel seen.”
  — Kendra F. Dunlap (02:36)

• On the therapist’s dilemma:
  “Dealing with insurance was like having a second job she never applied for.”
  — SuChin Pak (20:29)

• On ripple effects:
  “If a mom is not getting the help that she needs ... how does that child internalize what that means and then how they choose to see the world.”
  — Kendra F. Dunlap (30:36)

• On burnout:
  “Never—and I have been doing this for 20 years—I’d have to say in the last five years, the level of burnout has never been higher.”
  — Kendra F. Dunlap (19:23)

• On hope:
  “What gives me hope is my clients ... that’s what keeps me in the work and keeps me engaged.”
  — Kendra F. Dunlap (34:08)

Timestamps for Key Segments

• 01:49 – Kendra’s personal struggle finding a therapist
• 04:50 – Kendra’s approach & client demographic
• 07:14 – Early experience with insurance
• 09:58 – How insurance headaches escalated during the pandemic
• 11:58 – Financial tradeoffs with insurance reimbursements
• 14:11 – The emotional toll of leaving insurance networks
• 17:27 – Explanation of “clawbacks” and risk for therapists
• 19:23 – Burnout and loss of autonomy for providers
• 20:55 – Breaking point: insurance interference with clinical decisions
• 23:18 – Telling clients she was leaving insurance
• 24:30 – Ghost networks and the realities for patients
• 28:14 – Stigma of diagnosis as a barrier to care
• 30:36 – Generational impact in communities of color
• 32:30 – Alternative resources for affordable therapy
• 34:08 – What keeps Kendra hopeful

Conclusion

The episode exposes how America’s insurance-based mental health system leaves both patients and providers exhausted, frustrated, and underserved—especially in marginalized communities. Administrative hurdles, low reimbursements, and barriers like “ghost networks” compound structural inequities. SuChin Pak and Kendra Dunlap call for systemic changes that allow therapists to focus on care and ensure real access for all, while offering listeners practical advice and a sense of cautious hope grounded in human resilience.