That's kind of how HMOs like Kaiser work. They are really good at dealing with issues that could get severe. But things that are not going to turn into something that will cost them money they don't really do a good job at, such as mental health care. Diagnosing you with anxiety or ADHD and prescribing you drugs for it just costs them money, so if they can make it super hard for you to get the diagnosis then they don't have to spend it. It's not really something that will eventually land you in an expensive hospital stay or long term PT.