Mental health clinicians face contracts that charge patients for staying with them

Sarah Cady, a psychiatric nurse practitioner near New York City, discovered a clause in an employment contract that would require her to pay $7,500 for each patient who chose to continue treatment with her after she left the practice.

The clause reflects a broader trend in private mental health practices where patients are treated as proprietary assets. Contracts often include non‑solicitation provisions that prevent clinicians from informing patients of their departure or from encouraging them to follow the clinician to a new setting.

Patients are typically unaware of these hidden provisions, which can limit their ability to make informed choices about their care. When clinicians are forced to leave abruptly, the lack of transparent handoffs can disrupt ongoing treatment.

Cady argues that such practices undermine patient autonomy and raise serious ethical concerns about the commodification of mental health care.