A fair number of patients ask me, before their first appointment, whether a video visit can really replace sitting across from a psychiatrist in person. It’s a reasonable question. The honest answer is that for most psychiatric care, it can — and for some patients, it works better.
I want to walk through what a telehealth psychiatric visit actually involves, who it tends to suit well, and where its limits are.
What telehealth visits cover
I use HIPAA-compliant video for both initial evaluations and ongoing medication management. All you need on your end is a smartphone, tablet, or computer with audio and video. There’s no special software to install or hardware to buy — the appointment works the same way a video call with anyone else would.
- Initial psychiatric evaluations, including full history-taking
- Ongoing medication management and follow-up visits
- Same physician every visit — continuity of care, not a rotating roster of providers
- Available to patients whose primary residence is in New Hampshire or Massachusetts
What it doesn’t cover
Spravato® (esketamine) sessions are the one significant exception. Because the medication requires in-person monitoring under FDA-mandated REMS guidelines, those sessions have to happen at our Portsmouth office. Everything else — the evaluations, the medication adjustments, the ongoing conversations that make up most of psychiatric care — can be done by video.
Who telehealth tends to suit well
In my experience, telehealth works particularly well for patients managing a long commute, parents balancing childcare around appointments, people in rural parts of NH or MA without easy access to a psychiatrist, and patients who simply find a clinical office setting adds friction or anxiety they’d rather avoid. It’s also been valuable for patients who travel for work but want to maintain continuity with the same physician rather than restarting care elsewhere.
That said, it’s not the right fit for everyone. Some patients do better with the structure and presence of an in-person visit, particularly early in treatment or during a more acute period. Part of an initial evaluation is figuring out, together, what setting actually works for you — not assuming one format fits every situation.
Getting started
If you’re considering telehealth, the first step is the same as an in-person evaluation — a thorough review of your history, current concerns, and what you’re hoping treatment will accomplish. From there, we figure out together whether ongoing care by video makes sense, or whether an in-person visit is the better starting point.