By Melissa Morales, FNP-C, ENP-C, PMHNP candidate. Medically reviewed by Thomas Winter, MD.
If you have never seen a psychiatric provider by video, the whole idea can feel a little strange. Can someone really evaluate you through a screen? What happens during the appointment? Can they prescribe medication? After twenty years in emergency medicine and psychiatric practice, I can tell you the honest answer: for most adults, yes — and the research backs that up. Here is what actually happens, start to finish.
Before your visit
Once you schedule, you’ll complete intake paperwork online — your history, current medications, and a few screening questionnaires. This isn’t busywork. It lets your appointment time go toward talking about you, not filling out forms. Before the visit, gather three things: a list of every medication and supplement you take, the name of your preferred pharmacy, and any records from past mental health treatment if you have them. None of these are required, but they make the first visit far more productive.
You’ll also get a secure video link. You don’t need special software or technical skill — if you can join a video call with family, you can do this. A phone, tablet, or computer with a camera works. Find a private spot where you can speak freely. Your car counts. Plenty of our patients take appointments from a parked truck, and it works just fine.
What the first appointment looks like
Plan on about an hour. A real psychiatric evaluation is a structured conversation covering what brought you in, how long it has been going on, your sleep, your energy, your medical history, past medications and what they did or didn’t do, family history, and how symptoms are affecting your work and relationships. If it feels thorough, that’s the point. A ten-minute visit that ends with a prescription is not an evaluation, and you should be wary of any service that offers one.
By the end of that first visit, we talk through what I think is going on, in plain language, and what the options are — medication, therapy, both, or sometimes neither yet. You leave with a plan you understand and had a say in.
Does video care actually work?
This is the question underneath all the others, and it has been studied for more than two decades. Reviews of the research consistently find that psychiatric care delivered by video produces diagnostic accuracy and treatment outcomes comparable to in-person care for most adult conditions, with high patient satisfaction [1,2]. Psychiatry translates to telehealth better than almost any other specialty, because the exam is the conversation. I don’t need to listen to your lungs to evaluate depression — I need to see your face, hear your story, and have time to ask the right questions.
What about prescriptions?
Most psychiatric medications — antidepressants, anti-anxiety medications, mood stabilizers, sleep aids — can be prescribed through telehealth and sent electronically to your local pharmacy the same day. Certain controlled medications carry additional federal and state rules that continue to evolve, and we’ll discuss what applies to your situation honestly during your visit rather than making promises up front. If a medication requires something telehealth can’t provide, we tell you that and help arrange it.
What telepsychiatry is not
Telepsychiatry is not for emergencies. If you are in crisis or having thoughts of harming yourself, call or text 988 or go to your nearest emergency department — and having spent two decades working in emergency departments, I can tell you they take these visits seriously. A small number of complex situations are also better served in person, and when that’s the case, we say so and help you find the right care rather than pretending video is always the answer.
The bottom line
For most adults dealing with depression, anxiety, ADHD, PTSD, or bipolar disorder, telepsychiatry means getting evaluated by an experienced, board-certified provider within days instead of months — without the drive, the waiting room, or the time off work. If you live in Alaska, Arizona, Montana, Wyoming, Idaho, or California, we’re currently accepting new patients. The first step is a scheduling request on our website; the second step is a conversation.
References
- Hubley S, Lynch SB, Schneck C, Thomas M, Shore J. Review of key telepsychiatry outcomes. World Journal of Psychiatry. 2016;6(2):269-282.
- Hilty DM, Ferrer DC, Parish MB, Johnston B, Callahan EJ, Yellowlees PM. The effectiveness of telemental health: a 2013 review. Telemedicine and e-Health. 2013;19(6):444-454.
This article is for education and is not medical advice or a substitute for evaluation by a qualified clinician. If you are in crisis or thinking about harming yourself, call or text 988 to reach the Suicide & Crisis Lifeline, available 24/7.