• We spent more than 10,000 hours researching over 70 online therapy platforms, and our testers signed up for the 20 most popular platforms-including 15 offering psychiatry-to bring you our top picks.
  • Our testers test each platform for at least four weeks, focusing on the sign-up process, therapist selection, therapy session quality, and customer service interactions.
  • We surveyed over 2,000 online therapy users, held focus group interviews with both users and therapists, and consulted over 60 mental health experts.
  • We score each platform according to affordability, data privacy, availability, and inclusivity.
  • Our pages are updated regularly to update pricing and service information and to reflect our ongoing testing of new online therapy platforms.

Taking the time out of your schedule to prioritize mental health can be challenging. Finding the best online psychiatrist platforms, also known as telepsychiatry, is one way to access mental health care from home. Much like online therapy services, virtual psychiatry allows you to connect with a clinician without the commute, which can help those with busy schedules or limited mobility. 

Psychiatry providers are board-certified, licensed physicians or psychiatric nurse practitioners who offer mental health care that is distinctly different from that provided by therapists. Psychiatrists can prescribe psychiatric medications in addition to psychotherapy, also known as talk therapy, though not all psychiatrists provide therapy. Even the best online therapy services cannot prescribe medications without a psychiatry provider’s guidance. 

In our research, we looked for online mental health platforms that offered psychiatric care, specialized psychiatric care, and extra features to support mental wellness. We prioritized platforms that offer transparency in cost and appointment availability. We also researched which medications each platform can prescribe, which ones they can’t, and how you can fill a prescription if it is part of your treatment plan. Additionally, we highlighted which states the platforms currently operate in, where there are specific laws or regulations around online prescriptions, and when in-person psychiatry may be a better option. Here are our Handbook Team’s findings for the top five online psychiatry platforms and a few others worth considering. 

Our picks for the best online psychiatrist platforms

In a mental health emergency

Online psychiatrists may not be the most appropriate resource to help in a mental health crisis. If you or someone you know is a danger to themselves or others around them, it is an emergency, and cannot wait for an online therapist’s response.

Don’t wait. You can find help immediately by:

All the above options will connect you with trained professionals who can provide crisis support. You can find even more resources, including international options, on our helpline directory page.

What medications can online psychiatry providers prescribe?

Online psychiatry platforms are not able to prescribe all types of medication. While most of them can prescribe certain common medications for anxiety and depression, like selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), they may not be able to prescribe controlled substances, like benzodiazepines for anxiety or stimulants for attention-deficit/hyperactivity disorder (ADHD). The types of medications that can be prescribed online are determined by regulations within each state. Some states, for example, require an in-person consultation before you can be prescribed medication. It’s important to ask about the requirements and restrictions in your state before pursuing treatment.

Compare the best online psychiatry platforms of 2024

Cost* $95–$349 per month $299 for initial evaluation; $175 for follow-up visits Varies by provider Varies by provider $284 for initial evaluation; $108 for follow-up visits
Insurance Yes Yes No Yes Yes
Option for medication delivery? No No Yes No No

* Out-of-pocket cost without insurance.

The best online psychiatry platform reviews

Best overall: Brightside 

Best overall
9.3 Excellent
Brightside
Offers additional helpful features and learning resources.
Integrates therapy and psychiatry.

Key features

  • Monthly plans with therapy, psychiatry, or both.
  • Message your providers anytime.
  • Self-paced lessons.
  • Anxiety and depression symptom tracker.
  • Accepts insurance, including Medicare and certain Medicaid plans.

Brightside Pricing Without Insurance

Psychiatry: $95 per month.

Therapy: $299 per month.

Psychiatry + therapy: $349 per month.

Our final verdict

Brightside Health (Brightside) is a comprehensive mental health care platform offering monthly subscription plans for online psychiatry and therapy sessions. It has an easy-to-use app with valuable features such as self-paced lessons, a symptom tracker, and a messaging system to keep in touch with your provider.

Additional information

Brightside clinicians can prescribe certain common antidepressant and anxiety medications, including selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). Brightside lists all of the medications its clinicians can prescribe on their website.

Providers on Brightside cannot prescribe controlled substances, including benzodiazepines for anxiety, like Xanax, Klonopin, and Ativan, or stimulants for ADHD, like Adderall or Ritalin. If it is determined that these types of medications should be part of your treatment, it may be best to see a psychiatrist in person for an evaluation, especially because some of these drugs require lab work and ongoing monitoring.

Brightside provides care for people 18 and older in all 50 states. The platform states that it’s not a good fit for people who struggle with:

  • Ongoing, high-risk self-harm.
  • Schizophrenia or symptoms of psychosis.
  • Bipolar disorder I or acute mania.
  • Severe substance abuse.
  • Medically unstable eating disorders.
  • Kidney or liver disease, seizures, or cardiac arrhythmias.

Again, Brightside clinicians do not prescribe controlled substances.

Insights from our tester

Most psychiatry platforms simply connect you with a provider for virtual sessions. Brightside stands out as one of the few platforms offering additional helpful features and learning resources. Brightside users have access to self-guided mental health resources called Self-Care Lessons based on the Unified Protocol, an approach that has been shown in studies to be effective for a wide range of mental health concerns, including agoraphobia, generalized anxiety disorder, and obsessive-compulsive disorder (OCD). Additionally, Brightside shares helpful data and research around its methodology and results.

Our tester had good things to say about the Brightside app, which made it easy to manage their appointments and see their progress. Brightside’s symptom tracker assesses users’ anxiety and depression symptoms every two weeks, a helpful tool to keep track of long-term progress.

We liked that the platform integrates therapy and psychiatry in approaching mental health care. Brightside’s Psychiatry + Therapy plan gives you four monthly sessions with a licensed therapist in addition to your initial psychiatric video evaluation and ongoing care. You can message your psychiatry clinician at any time or schedule follow-up visits as-needed to discuss your prescription. Our tester found that the messaging feature between users and providers made switching between providers seamless, which can be a plus in coordinating your care between a psychiatrist and a therapist.

After spending hours comparing it to other online psychiatry platforms, we found Brightside to be the best. Not only does Brightside offer both therapy and psychiatry, but it also includes valuable services and features. A Brightside subscription for psychiatry is relatively affordable, starting at $95 monthly. Finally, we liked that Brightside accepts insurance (including Medicare Part B, some Medicare Advantage plans, and certain Medicaid plans), one of the biggest factors that can help make psychiatric care more affordable.

To learn more, read our Brightside review.

Our top pick

Best for using insurance: Talkspace

Best for using insurance
9.0 Very Good
Talkspace
In-network providers can make psychiatric care more affordable.
Ability to personalize appointment frequency.
Key features
  • Pay-per-session online psychiatry sessions.
  • Keep track of your short-term and long-term goals.
  • Check coverage before signing up.
  • Accepts insurance.

Talkspace Pricing Without Insurance

  • Initial evaluation: $299.
  • Follow-up visits: $175 per session.
  • Initial evaluation and one follow-up visit bundle: $435.
  • Initial evaluation and three follow-up visits bundle: $725.
  • Three follow-up visits bundle: $475 ($158.33 per session).
  • Six follow-up visits bundle: $890 ($148.33 per session).
  • Nine follow-up visits bundle: $1,260 ($140 per session).
Our final verdict

Talkspace’s pay-per-session online psychiatry sessions and in-network providers can make psychiatric care more affordable. Talkspace accepts major insurance plans, and users can easily check their coverage before signing up.

Additional information

Talkspace provides online psychiatry for people 18 and older in all 50 states. The platform states that it supports individuals with common mental health conditions such as depression, anxiety, bipolar disorder, OCD, post-traumatic stress disorder (PTSD), ADHD, insomnia, and panic disorder. It does not provide a list of conditions that its providers don’t support.

Talkspace clinicians can prescribe common SSRI and SNRI medications, as well as drugs like Wellbutrin, Buspar, Trazodone, Abilify, Strattera, and “any medication that is not a controlled substance and is deemed medically appropriate by your Talkspace provider,” according to their website.

While Talkspace states that it can support individuals with ADHD, Talkspace psychiatry providers do not prescribe controlled substances, such as stimulant medications (e.g. Adderall, Ritalin, Concerta, Vyvanse) and sedatives (e.g. Xanax, Valium, Klonopin). Stimulant medications are often the first-line treatment for ADHD, so know that Talkspace psychiatry may not be able to offer you all the treatment options for your condition.

Insights from our tester

Similar to Brightside, Talkspace also offers online therapy and psychiatry. One key difference we liked about Talkspace is that online psychiatry sessions can be booked as needed rather than bundled into a monthly subscription. We found the ability to personalize appointment frequency was important since the timing of follow-up appointments can vary by individual.

“There are a lot of things that go into the decision about how often a provider and a patient should meet. [Provider] comfort with the safety of the treatment, [provider] comfort with the progress the patient is making, the stability of the symptoms and of the stressors in a patient’s life, and more. There is no one-size-fits-all.”

Lyle Forehand, psychiatrist and medical director at Magellan Health.

Talkspace providers are in-network with major insurance plans such as Cigna, Optum, and Aetna, and the platform allows you to check your coverage without signing up for an account.

We recommend checking your coverage for online psychiatry on Talkspace separately, even if you already use your insurance for its online therapy, as these are sometimes covered differently by insurance plans.

If you’re not using insurance to pay for psychiatry on Talkspace, you can pay for sessions in a bundle, which can reduce the cost of each session from $175 to $140 per session.

On the Talkspace platform, you can expect to have a separate chat room with your psychiatry provider. Unlike Brightside, your chat with your psychiatry provider cannot be shared with your therapist.

Best for same-day appointments: Sesame

Best for same-day appointments
9.0 Very Good
Sesame
Simple provider search that shows providers’ earliest availability.
Easily browse and compare provider profiles.
Key features
  • Pay-per-session online psychiatry sessions.
  • Same-day appointments available.
  • Easy sign-up process.
  • Medication delivery available.

Sesame Pricing Without Insurance

  • Session rates vary by provider and location.
Our final verdict

Sesame Care (Sesame) has an easy-to-use platform for booking psychiatry sessions. You can easily browse provider profiles, see their availability, and compare visit fees. Provider availability varies by location, but some have same-day and next-day appointments. Sesame doesn’t take insurance, but it does offer the option for medication delivery, and many common psychiatric medications are on its “$5 meds” list.

Additional information

Sesame provider availability can vary by state, and the scope of practice for each online psychiatry provider on Sesame varies as well. Users browsing Sesame provider profiles can check for any patient age restrictions under the Service Details section. According to the platform’s customer service, if your condition or concern is outside the scope of a Sesame provider, the provider will decline your appointment request, and the platform will refund your visit fee.

Online psychiatry providers on Sesame do not prescribe controlled substances or narcotic medications.

Insights from our tester

Researchers have found the median wait time for an online psychiatry appointment was 43 days (and for in-person appointments, the wait time was even longer—67 days). Sesame has a simple provider search that shows providers’ earliest availability, and when we tested the platform, it had same-day appointments with psychiatry providers in our state.

In January of 2024, we searched for online psychiatry appointments in Texas, the state with the worst access to mental health care, according to Mental Health America. We were happy to find that out of 38 Sesame providers in Texas, more than half (53 percent) had same-day availability. We also found the cost per session can vary by provider and location. Appointment costs ranged from $42–$385. The upfront information on Sesame’s platform can help you get online psychiatric care quickly and you will know exactly what you will pay without going through insurance verification or committing to a monthly subscription.

Although getting started with Sesame is easy, you may not have a lot of choices in providers, depending on the state you live in. We only found one psychiatry provider available in Alabama, a state with the second-poorest access to mental health care. The provider did have an appointment within 48 hours of our search, but we would have liked to see more choices.

We liked that Sesame was an option for affordable medication management as well. Sesame providers have the option to send your prescription through SesameRx, which is the platform’s medication delivery service. We learned that SesameRx offers certain generic medications for $5 per 30-day supply, plus a $5.99 shipping and processing fee. Users may find their medication more affordable through Sesame than some prescription medication co-pays.

Best provider search tool: Zocdoc

Best provider search tool
9.0 Very Good
Zocdoc
Provider directory with features to help you find a provider to suit your unique needs.
Best for finding providers that meet specific criteria.
Key features
  • Pay-per-session online psychiatry sessions.
  • See provider appointment availability, insurance coverage, and patient reviews.
  • Same-day appointments available.
  • Search for providers using 13 category filters.

Zocdoc Pricing Without Insurance

  • Session rates vary by provider and location.
Our final verdict

Zocdoc is a provider directory with features to help you find a provider to suit your unique needs. You can filter virtual psychiatry providers by insurance plan, patient age, and therapist identity. Unlike platforms that do the matching, you can choose your provider on Zocdoc based on the information from their profiles. There, you can see provider biographies, training, and availability.

Additional information

The medications available from prescribers on Zocdoc vary by each individual provider, based on their location and practice. Users can check their online psychiatry provider’s profiles to understand the population (“Clientele seen” section) and conditions (“Focus areas” section) they treat.

Users can also search for providers on Zocdoc offering in-person psychiatry visits.

Insight from our tester

Of all the sites we reviewed for psychiatry online, Zocdoc is the best for finding providers that meet specific criteria. You can refine your search for an online psychiatry consultation by 13 different filters, including availability, provider identity, languages spoken, and different treatment approaches.

Like Sesame, we also found some providers on Zocdoc offering same-day virtual psychiatric appointments. Unlike Sesame, however, we found there were typically more providers available on Zocdoc. For example, compared to the 38 psychiatry providers in Texas on Sesame, Zocdoc lists 513 providers, most of whom also take insurance.

Additionally, you can filter providers by their treatment approaches. For example, we could find those who specialize in cognitive behavioral therapy (CBT), a treatment approach that encourages change in unhelpful thinking or behavior patterns.

Finally, the provider profiles on Zocdoc make it easy for users to see patient reviews, which is helpful if you want to know how the provider delivers care. Ratings are divided into overall rating, wait time, and bedside manner, and patients can include comments about their experience.

Best for adolescents: MDLive

Best for adolescents
8.8 Very Good
MDLive
No-frills telehealth platform that offers online care for urgent care, primary care, dermatology, and mental health.
Ability to provide care for a wide variety of conditions.
Key features
  • Pay-per-session online psychiatry sessions.
  • Treats individuals 10 and older.
  • Accepts insurance.
  • Does not prescribe medications for ADHD.
  • Cannot provide care for more complex conditions like autism spectrum disorder or substance use disorder.

MDLive Pricing Without Insurance

  • Initial evaluation: $284.
  • Follow-up visits: $108 per session.
Our final verdict

MDLive is a no-frills telehealth platform that offers online care for urgent care, primary care, dermatology, and mental health. Parents can book online psychiatry appointments for adolescents 10 and older. Child and adolescent psychiatrists (CAP) are available on the platform, and we even found providers with same-day availability.

Additional information

MDLive provides online psychiatry for people 10 and older and in all 50 states. It states that its mental health providers can provide care for conditions such as:

  • Addictions.
  • Aging and caregiver support.
  • Anxiety.
  • Bipolar disorder.
  • Depression.
  • Grief and loss.
  • LGBTQ+ support.
  • Life changes.
  • OCD.
  • Panic disorders.
  • Parenting support.
  • Phobias.
  • Relationship issues.
  • Stress management
  • Trauma and PTSD.

In addition to people with ASD, who experience psychosis, or who are struggling with substance use, MDLive does not provide care for:

  • Emergency or crisis situations (suicidal or homicidal thinking, self-harm, or risk of harm to others).
  • Any condition or combination of mental health conditions that prohibit the ability to perform normal day-to-day activities.

MDLive online psychiatry providers do not prescribe:

  • Stimulants to treat people with ADHD.
  • Other controlled substances such as benzodiazepines, used to treat anxiety, and phentermine, used for weight loss.
  • Lifestyle medications such as sildenafil (Viagra) for erectile dysfunction.
  • Medications intended for intramuscular injections.
  • Sleep medications.
  • Medications that require regular lab work and monitoring when lab work is not present for review during the appointments.
  • Medications that have the potential for abuse, such as pseudoephedrine and some muscle relaxants.
  • Medical marijuana.
  • Antiviral molnupiravir and other medications used to treat COVID-19, except for Paxlovid.
Insights from our tester

Our tester found booking an online psychiatry visit on MDLive was easy. We found providers available after hours, ready to meet the same day. Although out-of-pocket costs per online psychiatry session can be higher than average on MDLive, your visit can be more affordable if you use insurance coverage. You’ll need to sign up for an account and input your insurance information to determine if your MDLive psychiatry visits will be covered by insurance.

MDLive also stands out because it offers treatment for children 10 and older. Parents looking for mental health care for their adolescent or teen (10–17 years old) can create a profile on the platform and book an appointment with a child and adolescent psychiatry (CAP) specialist. According to the American Academy of Child and Adolescent Psychiatry, CAPs specialize in diagnosing and treating disorders affecting children, adolescents, and their families.

CAPs can diagnose and treat attention-deficit hyperactivity disorder (ADHD), but MDLive providers do not prescribe stimulant medications for the treatment of ADHD. MDLive also states that it does not provide care for adolescents with moderate to severe autism spectrum disorder (ASD), who have active psychosis, or who are struggling with substance use.

MDLive is a telehealth platform and isn’t specialized to support only mental health. Although we found the platform easy to navigate and sign up for, it didn’t have extra features or resources supporting mental wellness.

Other brands to consider

Talkiatry

Talkiatry is a network of online psychiatry and therapy providers. It only accepts patients with in-network insurance plans, but you can easily check if Talkiatry takes your insurance by using its insurance checker tool. While Talkiatry doesn’t charge membership fees, it also has no extra features like those available through the platforms mentioned above.

Talkiatry only operates in 43 states and is currently unavailable to people in Alaska, Delaware, Hawaii, Idaho, New Mexico, North Dakota, South Dakota, and Wyoming. Talkiatry also doesn’t provide care for people diagnosed with schizophrenia or eating disorders. 

While comparing online psychiatry platforms, we found Talkiatry to be similar to Talkspace psychiatry, but because it doesn’t operate in all states, it didn’t make our list of top picks. But if you live in one of the 43 states it operates in and have one of the insurance plans it accepts, Talkiatry may be a good option.

We talked to one Talkiatry user who told us that she liked the platform because she was able to make her initial appointment for the next day after signing up. She also told us that refilling her prescriptions was easy through Talkiatry, with her medications often available the same day she requested a refill.

To learn more about this platform, read our Talkiatry review.

Little Otter

Little Otter is an online children’s mental health platform supporting children, parents, and the whole family. Unlike MDLive, Little Otter supports children zero to 14 years old. It offers online therapy, parent training, couples therapy, and child psychiatry. Its app has sections for family assessments and custom reports, a messaging portal with your care team, and a resource section containing toolkits and educational articles for parents. 

The platform is only available in a handful of states and is in-network with a few insurance plans: Independence Blue Cross (in Pennsylvania and Delaware), AmeriHealth, and Sana. It currently has providers licensed in California, Colorado, Florida, Georgia, Illinois, Maryland, New York, New Jersey, North Carolina, Pennsylvania, Texas, Utah, Virginia, and Washington, DC. 

Little Otter’s out-of-pocket online psychiatry costs were the highest among the online psychiatry platforms we researched. An initial evaluation costs $500, and follow-up sessions cost $250 each. It may be worth your consideration if you’re in-network with its providers, live in one of the states it operates in, and are looking for online mental health support for you and your child. 

What is online psychiatry?

Psychiatrists are health care professionals providing mental health care. Because they are either medical doctors or nurse practitioners, they are equipped to evaluate, diagnose, and treat mental health conditions. Psychiatry treats a wide variety of mental health conditions, according to the American Psychiatric Association, including depression, bipolar disorder, anxiety, obsessive-compulsive disorder, substance abuse disorders, eating disorders, borderline personality disorders, and schizophrenia.

Medication management is unique to psychiatry since psychiatrists can prescribe medications as part of the treatment of mental health conditions, while therapists and psychologists cannot. Psychiatrists typically do not provide psychotherapy but may refer patients to a therapist as part of a holistic treatment plan.

Online psychiatry is very similar to in-person psychiatry. Telehealth psychiatrists use an online platform to evaluate, diagnose, and treat mental health conditions. However, because of laws concerning controlled substances, there are some medications an online psychiatrist may not be able to prescribe.

How much does online psychiatry cost?

When comparing the best online psychiatry platforms, we found the cost varied greatly between platforms. Among the platforms we tested, the average cost of an initial session was $305.63, with the lowest cost being $180 and the highest priced at $500. Follow-up sessions typically cost a fraction of the cost of the initial session, and the average cost of a follow-up session with the online psychiatry providers we reviewed was $151.57.

Subscription-based platforms do offer lower-cost visits as a monthly subscription. These visits are with a prescriber who can manage medication, and they start at $29 per month.

Do Medicare and Medicaid cover online psychiatry?

Yes. Medicare covers online psychiatry sessions with in-network providers under “outpatient mental health services.” Medicaid coverage for online psychiatry can vary by state. A study by KFF found that all the states surveyed covered psychiatric evaluations in their Medicaid plans.

Our online psychiatry testing experience

of research
10,000+   hours
of research
researched
70   platforms
researched
tested
20   platforms
tested
surveyed
2,000   people
surveyed
interviewed
30   people
interviewed
consulted
60+   experts
consulted

The Handbook Team continually works to research online therapy and mental health platforms. So far, we’ve put in over 7,500 hours of research, testing, and evaluation to review different online therapy and psychiatry platforms, down to the fine print. We wrote this review to guide you in finding a provider who can best fit your mental health care needs. Here’s what we did with each:

Our Online Psychiatry Testing Process
1
Fill out the intake assessment. Fill out the intake assessment.
2
Subscribe as a new user. Subscribe as a new user.
3
Review provider match options. Review provider match options.
4
Evaluate appointment availability. Evaluate appointment availability.
5
Research the types of medications the platform can prescribe. Research the types of medications the platform can prescribe.
6
Contact customer support with questions. Contact customer support with questions.
7
Explore platform features such as journals, worksheets, and symptom trackers. Explore platform features such as journals, worksheets, and symptom trackers.
8
Cancel subscription. Cancel subscription.

Testers explore the platforms and fill out the intake assessments to learn what questions the platforms ask, how many questions they ask, and how quickly they are matched with psychiatry providers. Testers then review the list of providers available to see how many choices they have and what information they can see about the providers. We also ask testers to evaluate the available appointment times to see how quickly they could be seen and how many choices they have. For each platform, we document which medications they can prescribe and how users can fill their prescriptions. Testers also reach out to customer service with specific questions to gauge how quickly and thoroughly they respond to requests and evaluate any additional features the platforms offer, like journals and worksheets. Testers logged their experience in a diary and came together to share their findings when testing concluded.

Our Handbook Team constantly works with more than 60 mental health experts for their guidance and input. For online psychiatry specifically, we interview psychiatrists who offer virtual psychiatry to learn more about their experience. Note: these providers offer telehealth sessions through their private practice, not clinicians on online platforms.

We ask for details on when online psychiatry can be beneficial and when online mental health care is not appropriate. For example, we learned that in the case of someone suffering from agoraphobia, experts told us that in-person sessions are more meaningful to the individual’s progress compared to avoiding exposure therapy by exclusively attending online appointments. We also learned that, for certain conditions, a prescription for a controlled substance is considered a first-line treatment, . A first-line treatment or medication is the initial treatment option given by a provider because it is proven effective for a specific condition. , and can be an important part of care. For example, stimulants like Adderall or Ritalin are often prescribed to help manage ADHD and are often considered the most effective treatment. However, these are controlled substances, and not all online psychiatry platforms can prescribe them. 

We looked for online psychiatry platforms that accept insurance, offer transparent pricing, and offer valuable features such as symptom trackers and worksheets.

Medication management can be difficult to add to a daily routine for someone starting a new medication without proper support. That’s why we looked for platforms that offered patients continued access to prescribers who can answer questions about their care and medication. For example, platforms may have messaging portals where patients can message their clinicians to ask follow-up questions.

Learn more in our online therapy methodology.

Our final verdict

We researched and found five of the best online mental health care platforms that offer psychiatry to consider. Brightside was our top pick because it comes with supportive resources and features to help you keep in close contact with your psychiatry provider. Talkspace, Sesame, Zocdoc, and MDLive are also top platform choices, each with its own unique pros and cons.

Ryan Sultán, psychiatrist and assistant professor at Columbia University, adds that online psychiatry also breaks down some of the stigma of attending traditional in-person appointments. “This mode of delivery can encourage more people to seek the help they need,” Sultán says.

Though the experts we’ve interviewed reaffirm that there can be benefits from online psychiatry, online psychiatry platforms may not be appropriate for all cases. For example, they may not treat all conditions or offer all treatment options. In cases of mental health emergencies, severe mental health symptoms, complex diagnoses, or if it’s your first time seeking psychiatric care, we recommend consulting with providers in person to receive more comprehensive care and medical advice before engaging in telepsychiatry. 

Before you try online psychiatry

We asked psychiatrists what patients should know before they try online psychiatry sessions. Here’s what we think you should consider when deciding between online psychiatry or in-person psychiatry:

  • Is this an emergency? 
  • Are you nervous about communicating over audio or video online?
  • Do you have a quiet space where you feel safe and comfortable sharing the details of your health history and mental health?
  • Are you looking for medication therapy or starting a new medication? 

If you answered yes to any of the above, an in-person appointment may benefit you more. Richard Miller, psychiatrist at Landmark Medical Center in Woonsocket, Rhode Island, explains that in-person appointments can better assess signs and symptoms of certain conditions, like substance use disorder, bipolar disorder, or schizophrenia, that may not be obvious in an online session. “[There are] lots of [signs] one can miss if they’re simply making a phone call or doing a Zoom session,” he says. In his practice, Miller shares that he prefers in-person first evaluations because they can be better suited to building a strong and comfortable rapport between the provider and patient.

The psychiatrists we interviewed mentioned a few symptoms and conditions where in-person treatment can be more beneficial than online psychiatry alone. These included:

  • Psychosis.
  • Paranoia.
  • Agoraphobia.
  • Bipolar disorder.
  • Schizophrenia.
  • Substance use disorder.
  • ADHD. 
  • Severe depression and anxiety, with suicidal ideation.

Online psychiatry providers may have some requirements to meet before they’re able to prescribe certain medications remotely. Depending on individual state regulations and provider practice scope, controlled substances like stimulant medications for ADHD may require an in-person evaluation before prescribing. 

There are many non-controlled psychiatric medications that require regular blood tests to monitor the safety and effectiveness of your medication therapy, which can be more challenging with online psychiatry. For example, lithium, the first-line treatment for bipolar disorder, isn’t a controlled substance but still requires frequent monitoring of blood concentrations to determine the safest and most effective dose for an individual. 

However, some psychiatry providers can still deliver comprehensive psychiatric care virtually. Online providers in private practice may be able to prescribe medications like controlled substances that online therapy platforms can’t. They can also offer the option for in-person evaluation and follow-ups. 

The experts we spoke to stressed that whether online psychiatry is right for you or not is very individualized. An individual struggling with their mental illness could benefit from accessing care online, whether it’s through a private practice provider or an online platform—it all depends on the case. Ultimately, getting mental health care is better than not getting any care at all. We recommend talking to your primary care provider about whether online psychiatry is a good option for you. 

Frequently asked questions

Psychiatrists and psychiatric nurse practitioners can prescribe medications remotely after assessing your medical history. However, providers on online psychiatry platforms like Brightside and Talkspace may not be able to prescribe all types of medications, specifically controlled substances. Individual providers who offer telemedicine visits may be able to prescribe these types of drugs, but, depending on your location, may require an in-person consultation first.

A psychiatrist is a licensed physician who completed residency after medical school and specializes in supporting mental health and prescribing psychiatric medications. A therapist is a non-prescribing provider who provides psychotherapy, talk therapy, or other non-medication-based mental health support. A psychologist is someone trained in psychology who can provide therapy. We use the term “psychiatry provider” throughout this article to indicate both a psychiatrist and a psychiatric nurse practitioner, both of whom can prescribe psychiatric medications.

Online psychiatry providers can support certain mental health conditions, including anxiety, depression, OCD, insomnia, and PTSD. Online platforms may not be able to treat more complex issues, such as bipolar disorder or treatment-resistant depression, and providers on these platforms cannot prescribe all types of medications. Specifically, online psychiatry platforms may not prescribe controlled substances, such as stimulant medications for ADHD or benzodiazepines for anxiety. Depending on your state of residence, individual psychiatrists who offer virtual visits may be able to prescribe these types of medications after an initial in-person consultation.

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