Thinking of seeing a psychiatrist online? By understanding the differences between in-person and online psychiatry and medication management, you can decide if telepsychiatry is right for you.
Online psychiatry involves connecting virtually with a medical provider who can evaluate, diagnose, and treat mental health issues, including prescribing medications. Typically, you consult with an online psychiatrist via live video conferencing, although phone calls and messaging may also be options.
You can access online or “telepsychiatry” in a number of different ways. Some psychiatrists offer online consultations through their private practices, while others connect with patients via online directories or third-party platforms. However, many online psychiatry platforms also use psychiatric mental health nurse practitioners (PMHNPs) for psychiatry consultations. While both psychiatrists and PMHNPs can diagnose and prescribe medications, there are distinct differences in their backgrounds, education, and training.
As with in-person providers, an online psychiatrist or psychiatric nurse practitioner will review your medical and mental health history, talk to you about your thoughts, feelings, and behaviors, and use screening tools to assess and diagnose your symptoms. They may also need to order in-person testing, such as blood tests or physical exams, in order to rule out any underlying medical causes of your symptoms.
It’s worth noting that while psychiatrists, online and in-person, are qualified to offer psychotherapy, most of them don’t. In fact, studies show that only about one-in-five psychiatry visits involve therapy. And over half of U.S. psychiatrists no longer practice psychotherapy at all. The major focus for psychiatrists now tends to be on medication. If you’re interested in addressing your mental health issues with talk therapy instead of or in addition to medication, you’ll likely need to also consult a therapist.
Online psychiatry has grown in popularity in recent years, fueled at least in part by increased demand for mental health services, a shortage of psychiatrists, and long wait-times for in-person appointments. Research shows that more than half of US residents live in a mental health professional shortage area (where there is only one psychiatrist per 30,000 or more people) and more than half of all US counties lack a single psychiatrist.
While online psychiatry can help to overcome these barriers to care, it may not be the best option in all cases. Whether it’s right for you can depend on the type of psychiatric issues you’re facing, the complexity and severity of your symptoms, your home environment, your comfort with technology, and the other choices open to you.
Psychiatry is the branch of medicine focused on mental health. A psychiatrist is a medical doctor (MD or DO) who can assess, diagnose, and treat mental health issues using any combination of medication, therapy, and medical procedures. A psychiatrist can also initiate hospitalization.
Psychology is the study of the mind and behavior. A psychologist holds a doctoral degree (PhD or PsyD) in psychology and can assess, diagnose, and provide therapy for mental health conditions. A psychologist cannot perform medical procedures or initiate involuntary hospitalization. While there are “prescribing psychologists” in some states, generally psychologists cannot prescribe medication.
Therapy is a treatment aimed at improving your mental and emotional health. A therapist—such as a Licensed Professional Counselor (LPC) or Licensed Marriage and Family Therapist (LMFT)—holds a master’s degree and uses therapeutic techniques to address mental health issues. A therapist cannot prescribe medication, perform medical procedures, or initiate involuntary hospitalization.
If mental or emotional health issues are adversely impacting your daily life, it’s important to seek help. Overwhelming feelings of stress, anxiety, sadness, or isolation can make it difficult to cope with daily challenges, concentrate at work or school, or even properly care for yourself. Mood swings and behavior changes can further disrupt your life, and encourage you to turn to unhealthy coping mechanisms such as using drugs or alcohol to get through the day. You may even have thoughts about harming yourself.
The sooner you seek help, the sooner you can start to relieve your symptoms and feel better. But should you seek help from a psychiatrist or a therapist? Online or in-person?
Firstly, if you’re experiencing a mental health crisis and have thoughts of self-harming or suicide, you need immediate, in-person support. Please don’t delay. Call 9-1-1 or your country’s emergency services number, visit urgent care or the emergency room, or call a crisis helpline: 9-8-8 in the U.S. or one of these numbers in other countries. An online psychiatrist or other provider may be limited in the response they can offer and few online psychiatry platforms are designed to cope with crisis intervention.
In other situations, deciding between a psychiatrist or a therapist often comes down to the nature and severity of your symptoms.
If you need help coping with challenges in life such as bereavement, relationship issues, employment worries, or other chronic stressors, medication is unlikely to help so talking to a therapist may be a better place to start. Similarly, if you’re dealing with a condition such as anxiety or depression and your symptoms are mild or moderate—coming and going rather than persistent and overwhelming—starting with a therapist may also be a good option. Choosing between in-person and online therapy can depend on your personal preferences and the range of options available to you.
If you’re dealing with substance abuse or a more serious mental health issue—such as bipolar disorder or schizophrenia—you’re more likely to require medication as part of your treatment, so you may want to start by consulting a psychiatrist. If your depression or anxiety symptoms are more severe, or you’re experiencing symptoms such as extreme mood swings, hearing voices, seeing things that aren’t there, or feeling disconnected or a sense of unreality, a psychiatrist may also be the best place to start.
If you’re still not sure whether you should consult a psychiatrist or a therapist, remember that the most important thing is to reach out to someone. A good therapist will recommend you see a psychiatrist if they feel you could also benefit from medication or other medical treatments. And a good psychiatrist or psychiatric nurse practitioner will often suggest therapy as an important part of any treatment program, with or without medication.
When searching for online psychiatry services and medication management, you’re likely to come across two different types of providers:
A psychiatrist is a medical doctor (MD) or doctor of osteopathic medicine (DO) who has completed medical school and a clinical psychiatric residency to specialize in the field of mental health. Becoming a psychiatrist requires about 12 years of education.
Since a psychiatrist is a medical doctor, they are qualified to assess the physical as well as mental aspects of psychological problems. They can diagnose any underlying medical conditions that could be causing your psychiatric symptoms, and monitor the effects of medication on your blood pressure, heart health, or liver and kidney function, for example.
In addition to prescribing medication, a psychiatrist can also prescribe and perform medical procedures to treat more severe psychiatric problems, such as transcranial magnetic stimulation (TMS), deep brain stimulation (DBS), and electroconvulsive therapy (ECT).
A psychiatric mental health nurse practitioner (PMHNP), or simply “psychiatric nurse practitioner,” is an advanced practice registered nurse (APRN) with a master of science in nursing (MSN) degree who specializes in mental health care. Becoming a psychiatric nurse practitioner requires about six to eight years of education.
Like a psychiatrist, a PMHNP can assess and diagnose patients, create treatment plans, and provide therapy. A psychiatric nurse practitioner can also prescribe and manage medications, although, in some states, they are required to work under the supervision of a psychiatrist or other medical doctor to do so. Unlike a psychiatrist, a PMHNP is unable to prescribe or perform medical procedures or initiate involuntary hospitalization.
Whether practicing online or in-person, a psychiatrist must be licensed in the state where you are receiving treatment. You can check they’re licensed in your state by searching on your state’s medical board website. Since a psychiatrist is a medical doctor, you can check they are board certified in the United States by searching here.
A psychiatric mental health nurse practitioner (PMHNP) also has to be licensed in the state where you are receiving treatment. To check the license of a PMHNP:
Checking a provider with a state’s licensing board will also usually tell you if they have a record of disciplinary or ethical violations or license suspensions.
Deciding between in-person or virtual psychiatry can again come down to the type of issues you’re dealing with and the severity of your symptoms, as well as personal preference. Broadly speaking, though, the more severe your issues, the more likely you are to benefit from in-person psychiatry if it’s available.
Other considerations include:
It’s important to remember that psychiatry isn’t just about the mind, but also about brain function and the mind-body connection—how the health of your body can impact how you think, feel, and behave, and vice-versa. One of the key differences between virtual and in-person psychiatry is that online psychiatry doesn’t allow for physical evaluations and treatment.
When deciding between online and in-person psychiatry, another consideration is the quality, experience, and qualifications of the provider. Are you choosing between an in-person psychiatrist and an online PMHNP, for example, or an in-person psychiatric nurse practitioner and an online psychiatrist?
Depending on your needs and situation, one isn’t necessarily a better choice than the other (a good PMHNP may be a better fit than a not-so-good psychiatrist, for example). However, since a psychiatrist is a physician with more extensive training, they are often better equipped to handle more complex or severe cases.
If you have limited mobility or live in a mental health professional shortage area, for example, you may have limited access to in-person psychiatric care, or face a long wait or long travel distance for an in-person appointment. For some people, the choice isn’t so much between tele- or in-person psychiatry, but rather, between getting help online or not getting help at all.
In these situations, even if you suspect that you have a more serious mental health condition, looking for help online can be better than delaying or neglecting care. An online psychiatrist may be able to help you find an in-person psychiatrist if necessary. They can also send you for lab tests at a local facility before making a diagnosis or prescribing medications, or to monitor your health during treatment.
Since widespread online psychiatry is relatively new, some experts argue that there isn’t enough evidence yet to fully determine its long-term effectiveness. However, research suggests that telepsychiatry can be effective in accurately diagnosing common psychiatric disorders and can have a largely positive effect on treatment outcomes. Many patients report being satisfied with online psychiatry, notably those with access to quality equipment and a high-speed internet connection.
The American Psychiatric Association also considers telepsychiatry the equivalent to in-person care in diagnostic accuracy, treatment effectiveness, quality of care, and patient satisfaction.
Still, some clinicians are concerned that the overall effectiveness of online psychiatry may be limited by the lack of legal guidelines available—laws and clinical protocols can vary wildly from one place to the next. There are also ethical concerns about patient and data privacy that could impact its overall effectiveness.
When you feel overwhelmed by a mental health issue, it’s natural to seek out the fastest and most convenient source of relief. But if the idea of navigating a telehealth platform seems too complicated or just adds to your anguish, then online psychiatry may not be the best idea. Similarly, if you’re struggling to find the motivation to even get out of bed, then driving to the next county for a face-to-face appointment may be too much of an obstacle.
Keeping personal preferences in mind, some of the potential advantages of online psychiatry include:
Access. If you live in a rural or underserved area, have mobility issues, or suffer from a condition that makes leaving home a challenge—such as social anxiety or agoraphobia—finding in-person psychiatric care may not be easy. You may be left to rely on a primary care doctor for your mental health needs, or even to avoid treatment altogether. Online psychiatry can help to overcome some of these barriers. It provides access to qualified providers from a much wider geographical area (sometimes from other states). It can also make it easier to find a psychiatrist or psychiatric nurse provider who matches your gender or cultural preferences.
Convenience. Being too busy, not having enough time, or dealing with inconvenient clinical hours are some of the biggest reasons many of us don’t seek care. When you feel overwhelmed by a mental health issue, having to take time off work, arrange child care, and fight the traffic to get to an appointment can seem like a daunting prospect. Seeking psychiatric help online may be more convenient and offer greater flexibility. You can cut down on travel time and expense, and may be more likely to find appointments before or after work.
Savings. The cost of online psychiatry can vary greatly depending on whether you’re covered by insurance, where you’re located, and whether you’re using a private practice psychiatrist or a psychiatric nurse provider on an online platform. Insurance co-pays tend to be the same regardless of the type of psychiatric provider and whether you see them online or in-person. If you’re paying out-of-pocket, though, online care can work out less expensive. Providers who work exclusively online may charge less because they don’t have the expense of an office. And subscription platforms may offer cheaper per-appointment rates. You’ll also save on transport and childcare costs as well.
Comfort. Talking about your mental health and the challenges you’re facing is something that many of us struggle with. If you have a home environment that is quiet, safe, and free of distractions, talking to a psychiatrist online might make it easier to open up and talk honestly. It may also feel less intimidating than a doctor’s office or a medical environment.
Messaging between sessions. Being able to message your provider between sessions can be useful for medication management and monitoring your symptoms. You can let your provider know if you’re having any unpleasant side effects to a medication, for example, if your symptoms have changed, or to check if it’s safe to combine another prescription or over-the-counter medication with your mental health medication. Messaging services tend to be common features on online psychiatry platforms.
Reduced stigma. Despite how many of us seek treatment each year, it’s common to still feel stigmatized about having an issue with your mental health. When you seek in-person psychiatric care, you run the risk of bumping into someone you know in the parking lot or in the psychiatrist’s waiting room. As long as you have a private space to talk, online psychiatry can help you avoid having to share with others that you’re seeking help. Some people also find it easier to try out mental health care for the first time online rather than in-person.
Online psychiatry may not be right for all situations. Some of the potential drawbacks include:
Prescription restrictions. State laws covering the prescription of medications can vary. In many cases, online psychiatrists are unable to prescribe controlled substances, medications that can potentially lead to dependence. Controlled substances include benzodiazepines for the treatment of anxiety, opioids for chronic pain, and stimulant medications often prescribed for attention-deficit hyperactivity disorder (ADHD). In addition to state laws, some online psychiatry platforms also place restrictions on the medications their providers can prescribe. To receive certain medications, you’ll often need to see a prescriber in-person, at least for the initial consultation.
Support when things go wrong. Some platforms or providers will ask for the address where you’re having your psychiatry session, as well as a phone number, in case they need to summon help if you experience a crisis during your consultation. If you experience suicidal thoughts, panic attacks, or a medical emergency outside of a session, though, your online psychiatrist isn’t likely to be a viable source of help—you’ll need immediate in-person support. Most mental health medications have potential side effects, some of them unpleasant, even serious. If you have an adverse reaction, it may take time for an online provider to respond to any message you send, and even then, their means of helping you may be limited.
May not be appropriate for all mental health situations. If you’re dealing with a serious mental health disorder, your symptoms are severe, or you may pose a threat to yourself or others, you’re more likely to benefit from in-person support. If you live in an insecure or abusive environment, struggle with technology, have diminished competence, or a disability that makes online communication challenging, in-person psychiatry may also be a better choice if it’s available to you.
Technical issues. Internet connections fail, apps and software experience glitches, and computers, tablets, and smartphones freeze or break down. Any of these problems can disrupt or abruptly end your consultation with a psychiatrist. If you live in an area without broadband, your internet speed may not be enough to sustain a video call. And if you—or your psychiatrist—aren’t comfortable with technology, you may experience a lot of frustration trying to connect. If you have a disability, some websites or platforms may not be fully accessible.
Barriers to diagnosis. As well as making physical examinations impossible, telepsychiatry can deny providers other useful diagnostic information. Even when connecting over video, some body language signals can be lost. They may miss the tremors in your hand, the tension in your muscles, or your unsteady walk, for example, that they’d almost certainly notice in a face-to-face meeting. When you’re not physically sharing the same space as your psychiatrist, some people also find it harder to develop a rapport and fully open up.
Privacy, confidentiality, and security concerns. As with online therapy, online psychiatry poses issues relating to security and privacy. None of us like the idea of our personal information—especially relating to our mental health—being randomly accessible to others. Worrying about unsecured websites, unencrypted communication tools, compromised data security, and potential breaches of confidentiality may only add to the stress and anxiety you’re already experiencing. While you can take steps to safeguard your personal information online, there are always risks.
Online psychiatry is a rapidly expanding business. That means there will always be companies willing to prioritize profit over your health and well-being. When considering telepsychiatry, it’s important to be aware of the warning signs that you may not be in safe hands.
Providers are unqualified. As with seeking any service online, there’s always the risk of falling prey to an unqualified or disreputable provider. It’s important to check a psychiatrist’s credentials or use a reputable third-party service that screens all the providers available on its platform.
You don’t need a video appointment before getting a prescription. Some services require you to simply fill out a form to receive prescription medication. When you submit the form, you may be told the name of the medical provider who’ll be reviewing your information and prescribing the medication, but you may have no direct communication with them. There’s no one to monitor how well the medication is working, whether the dosage needs to be changed, or what you should do if you experience adverse side effects.
You’re offered controlled substances without the need for a blood test. While you don’t need blood work before being prescribed all medications, reputable providers will often request it, even for medications as common as antidepressants. Blood tests can help a provider:
You’re prescribed medication without a follow-up appointment. A reputable prescriber will want a follow-up consultation to monitor how well a medication is working, assess any side effects, and to decide if the dose or the medication needs to be changed. All some services are interested in is selling you more medication.
To get the most from online psychiatry, the first step is to find the right psychiatrist for you. It’s not just qualifications and experience that are important. A psychiatrist is often your partner in the healing journey, so you want to find someone you’re comfortable with. This is someone you need to be able to talk openly with about difficult subjects, including your intimate thoughts and feelings.
Finding the right online psychiatrist can take some time and effort, so don’t be afraid to ask questions and read reviews.
Compare private psychiatrists, platforms, and directories. All may offer different services or payment structures, but give preference to psychiatrists or PMHNPs who insist on communicating via live video, at least for the initial consultation.
Prepare for your initial appointment. Your time with a provider is limited, so you don’t want to waste that time hunting around for medical or prescription records. Have all your pertinent health information to hand—such as a list of your current medications and their doses, any previous mental health diagnoses or medications you’ve received, what symptoms you’ve been experiencing and when they started, and the name and address of the pharmacy you use. It’s also useful to jot down any questions you have and keep the notepad to hand to keep a record of any important points that arise during the consultation.
Be open and honest. It’s not easy to talk frankly about your thoughts, feelings, and behaviors. But the more open and honest you are, the better your psychiatrist will be able to understand the challenges you’re facing, make an accurate diagnosis, and decide on the best course of treatment.
Consider therapy alongside medication. One treatment can often complement the other. Some mental health medications, for example, can increase the plasticity of the brain, making it more adaptable to the kind of long-term changes that can be produced by therapy. Ask your psychiatry provider what they recommend.
Ensure you have a fast and reliable internet connection. Having a session interrupted technical problems can be one of the major drawbacks of telepsychiatry. If possible, upgrade your internet speed and keep the software or app you use updated.
Limit distractions at home. Talking to a psychiatrist from the comfort of your own home is convenient, but it can easily be disrupted by background noise or other distractions. Find a quiet, private space for your session, turn off your phone, mute any other apps, and ask roommates or family members to keep the noise down.
BetterHelp is an online therapy service that matches you to licensed, accredited therapists who can help with depression, anxiety, relationships, and more. Take the assessment and get matched with a therapist in as little as 48 hours.
Take Assessment HelpGuide is user supported. We earn a commission if you sign up for BetterHelp’s services after clicking through from this site. Learn moreThere’s an array of options when it comes to finding a reputable online therapist.
Online platforms can vary greatly in quality and reliability. Some accept insurance, including Medicare. Some charge per visit, others require a monthly subscription. Many conveniently offer online therapy services as well. To ensure you have the best experience, it’s important to do your homework and read reviews before signing up to a service.
Last updated or reviewed on July 21, 2025Finding and choosing an online therapist or counselor
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