WASHINGTON — Soldiers returning from war are finding it more difficult to get mental health treatment because military insurance is cutting payments to therapists — on top of already low reimbursement rates and a tangle of red tape.

Wait lists now extend for months to see a military doctor, and it can takes weeks to find a private therapist willing to take on military people. The challenge appears great in rural areas, where many National Guard and Reserve troops live.

To avoid the hassles of Tricare, the military health insurance program, one frustrated therapist opted to provide an hour of therapy time a week to Iraq and Afghanistan veterans for free. Barbara Romberg, a clinical psychologist in the Washington, D.C., area, has started a group that encourages other therapists to do the same.

"They're not going to pay me much in terms of my regular rate anyway," Romberg said. "So I'm actually feeling positive that I've given, rather than feeling frustrated for what I'm going through to get payment."

Joyce Lindsey, 46, of Troutdale, Ore., sought grief counseling after her husband died in Afghanistan last September. The therapist recommended by her physician would not take Tricare. Lindsey eventually found one on a provider list, but the process took two months.

"It was kind of frustrating," Lindsey said. "I thought, 'Am I ever going to find someone to take this?' "

Roughly one-third of returning soldiers seek out mental health counseling in their first year home. They are among the 9.1 million people covered by Tricare, a number that grew by more than 1 million since 2001.

Tricare's psychological health benefit is "hindered by fragmented rules and policies, inadequate oversight and insufficient reimbursement," the Defense Department's mental health task force said last month after reviewing the military's psychological care system.

Lois Krysa, quality manager of the Tricare office that serves Fort Campbell, Ky., and Fort Bragg, N.C. — Army posts with heavy war deployments — said, "Unfortunately, in some of our communities ... we are maxed out on the available providers." She added, "In other areas, the providers just are not willing to sign up to take Tricare assignment, and that is a problem."

Tricare's reimbursement rate is tied to Medicare's, which pays less than civilian employer insurance. The rate for mental healthcare services fell by 6.4 percent this year as part of an adjustment in reimbursements to certain specialties.

Since 2004, Tricare has speeded up payments to encourage more doctors to participate, said Austin Camacho, a Tricare spokesman. In some locations, the Defense Department has also raised rates to attract physicians, he said.

"We are working hard to overcome those challenges," Camacho said.

According to data from Tricare's Medical Benefits and Reimbursement System office, the program pays mental health providers as much or more than a corporate plan would pay for treating a patient — although in some cases, it is lower.

Psychologists who treat active-duty troops are paid 66 percent of what Tricare views as the customary rate. So a psychologist eligible for a customary $120 per hour would be paid $79.20 for the hour by Tricare, even if the psychologist's standard rate is $150 per hour.

Active-duty troops use Tricare Prime, a managed-care option maintained by private contractors. Their mental healthcare is free. Guard and Reserve troops and their families frequently use Tricare Standard, a fee-for-service plan. They pay an annual deductible and 20 percent of the amount Tricare pays the therapist.