Objective <p>Over the past 20 years, Puerto Rico has experienced a reduction in medical professionals and an erosion of the healthcare system. In this study, we assess the degree to which psychiatrists in Puerto Rico are answering phone calls and accepting new patients, accepting the public health insurance or cash payments, and the length of time between the call and the appointment offered.</p> Methods <p>A “<i>secret shopper</i>” analysis was performed, in which a research team attempted to contact 183 psychiatric service providers or organizations listed in the 2023 directory of one of the major private health insurance companies in Puerto Rico.</p> Results <p>Approximately 47% of the calls were answered and 46% of those resulted in members of the research team being offered an appointment. In about 40% of the answered calls, the service provider was not accepting new patients, and in approximately 11%, the caller was asked to send more information to be able to secure an appointment. Wait time for appointments ranged from 1 to 2 days to up to nine months. Additional factors, such as healthcare coverage, being able to afford treatment out-of-pocket, and the ability to provide additional required information also complicated the process of securing an appointment with a psychiatrist in Puerto Rico.</p> Conclusions <p>Access to psychiatric healthcare in Puerto Rico was found to be a challenging endeavor with a lack of response, providers not being able to accept new patients, and long wait times constituting barriers to these services in Puerto Rico.</p>