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Looking for a Psychiatrist? Try One of These 9 Best Online Psychiatry Services

Out of 82 tested companies, these are our top choices for online psychiatry

Finding a psychiatrist when you need one can feel like an impossible task. Approximately half of all U.S. counties don’t have any psychiatrists, and a study of more than 500 Affordable Care Act Marketplace networks found that only about 43% of psychiatrists were in-network with insurance plans. What’s more, a May 2023 study found that only 19% of psychiatrists were accepting new patients and among those, the median wait time for an appointment was 67 days.  Online psychiatry companies are stepping up to fill this huge gap in care. These services offer access to a large network of pre-vetted, highly qualified psychiatrists, many of whom accept insurance.

To help identify the best online psychiatry services out there, we tasked testers, experts, and our research team to put these companies to the test. We surveyed over 8,000 users at 82 online mental health companies and directories, had testers sign up for the services for at least a month, had three licensed therapists help us evaluate each company, and sent out questionnaires to each company. Given the variety of features and options on our list of top picks, we hope to take the sting out of finding high-quality, timely psychiatry.

9 Best Online Psychiatry Services of 2024

Why Trust Us
82
Companies reviewed
8,400
Total users surveyed
350
Data points analyzed
We surveyed 100 users from 55 online therapy companies and 27 therapist directories to understand their experiences with these services. Then, we tested the services ourselves across multiple states, conducted comprehensive data collection research, and evaluated our results with the help of a licensed therapist.

When choosing an online therapy provider, we recommend that you read the company’s privacy guidelines before you sign up to better understand whether it is HIPAA-compliant and whether it shares any private information with third parties. There have been some online therapy concerns raised by the Federal Trade Commission (FTC) and several government officials about what user health information online therapy providers collect and what they do with any information they collect.

Our Online Therapy Methodology

Curious about the extensive work we did to research and evaluate online therapy companies? Take a look at our online therapy methodology.

Looking for a Psychiatrist? Try One of These 9 Best Online Psychiatry Services
Looking for a Psychiatrist? Try One of These 9 Best Online Psychiatry Services

Best for Availability : Teladoc Health


  • Price: Up to $119 per therapy session, $299 for initial psychiatry appointment and $129 per follow-up
  • Is Insurance Accepted?: Yes
  • Type Of Therapy: Couples Therapy, Individual Therapy, Medication Management, Psychiatry
Why We Chose It

Teladoc Health is the total package: It is highly accessible and easy to use, accepts insurance, and offers a broad network of well-qualified mental health providers. Among the 82 online mental health services we assessed, Teladoc stood out for its nationwide availability, flexible scheduling, acceptance of a high number of insurance plans, and incredibly high user approval ratings in our survey. With qualified therapists and psychiatrists available in all 50 states, appointments available seven days a week from 7 a.m. to 9 p.m. Eastern Time, and mental health services available for ages 13 and up, Teladoc couldn’t be more available.

Pros & Cons
Pros
  • Easy-to-use platform

  • Appointments available 7 a.m. to 9 p.m. ET seven days a week

  • Available in all 50 states

  • Live video talk therapy also available

  • Excellent provider network with good availability

  • Providers rated highly for caring, respectful attitudes

  • Can participate in video appointments via app or website

Cons
  • Psychiatry sessions can be costly without insurance coverage

  • Same-day appointments may not be available

  • Cannot see insurance plans accepted until sign-up

Our Testing

We had five people sign up for and test mental health services at Teladoc from Missouri, New York, Ohio, and Texas. One thing we especially appreciated was Teladoc’s simple online scheduling system. It was much more user-friendly than the ones at other online providers we looked at. Access to both licensed psychotherapists and board-certified psychiatrists is available seven days a week, from 7 a.m. to 9 p.m. ET—which is a much wider range of times than most other online mental health companies offer. Every provider had many open appointment slots when we tested them, and we could schedule months in advance if needed.

We had great experiences overall: All of the mental healthcare providers we interacted with at Teladoc were highly qualified, compassionate, and professional. They were good listeners who offered thoughtful insight and actionable advice. However, in one case, the provider we selected kept the camera off for video sessions, which we found disappointing. Despite this, the conversation was comfortable, and there were good observations that were helpful.

"Scheduling was simple and I was surprised at how quickly I was able to book something once registered. Sign-up was extremely easy and straightforward. They asked basic questions about my mental health and medical history, and before each session, you filled out a questionnaire about your mental state."

—Teladoc tester, who sought treatment for anxiety

A downside is that the wide availability of appointment times did not translate into being able to find appointments within a day or two. Plus, evening and weekend appointments were much more limited than options during standard business hours. But in general, we were able to schedule a visit with our providers of choice within a week. Also, Teladoc does not treat psychosis, substance use, or eating disorders. Like most online prescribers, Teladoc’s psychiatrists can’t prescribe controlled substances, such as Xanax and Valium for anxiety disorders or Adderall for attention-deficit/hyperactivity disorder (ADHD), so it is not ideal for people requiring those types of medications.

Plans & Pricing
  • Insurance Accepted: Accepts many insurance plans, including major providers like Aetna, UnitedHealthcare, and some Medicare and Medicaid plans
  • Subscription Required: No, pay-per-session service
  • Out-of-Pocket Costs: Varies by insurance; If you’re paying out of pocket, the pricing is up up to $299 for the initial psychiatry consultation and up to $129 per session for follow-ups; therapy appointments are up to $119 per session
What Users Say

We surveyed 100 users of Teladoc:

  • 94% rated Teladoc as very good or excellent overall
  • 89% rated their therapist’s qualifications as very good or excellent
  • 94% said that most or all of their needs were met at Teladoc
  • 98% are likely or very likely to recommend Teladoc to a friend or someone like them
  • 30% said they were using Teladoc for psychiatry or medication management services

Best for Alcohol Use Disorder : Monument


  • Price: Starts at $15+ per month
  • Is Insurance Accepted?: Yes
  • Type Of Therapy: Group Therapy, Individual Therapy, Medication Management, Peer Support
Why We Chose It

Alcohol use disorder (AUD) is one of the most common psychiatric disorders in America—it’s estimated that approximately 28.1 million U.S. adults have AUD. Unfortunately, due to treatment barriers and stigma, fewer than 1 in 10 people with AUD seek treatment. Because of its effectiveness in treating the condition, medication is considered a first-line treatment for AUD. But again, few people access these treatments: only 2% of people with AUD were prescribed medications known to be effective in treating the disorder. This is why Monument’s service is so important. By offering specialized treatment of AUD that combines online psychotherapy and medication management, and by accepting insurance, Monument makes effective treatment accessible to more people.

Pros & Cons
Pros
  • Specialized focus on alcohol use disorder

  • All providers have experience treating substance use disorders

  • Accepts many insurance plans

  • Well-coordinated therapy and medication services

  • Access to therapist-moderated support groups

  • Can prescribe medications shown to be effective in treating alcohol dependence

Cons
  • No built-in referral network to inpatient rehab

  • Must pay $15 community membership fee, not covered by insurance

  • Services not available in all states

Our Testing

Monument treats alcohol use disorder with medication and therapy, and while we could not assign someone to test out its medication services (we did not find it ethical to do so), we did test out the sign-up process and other aspects of the service, surveyed 100 users, extensively researched the company, and sought expert insight on it. Overall, we were impressed with Monument’s offerings and service model for AUD.

We love how unique Monument is as a specialized telehealth platform for people with alcohol use disorder. The platform encourages a multidisciplinary team approach by assigning each client both a therapist and a physician for medication management.

First of all, simply offering high-quality treatment online is a boon to patients with AUD. For those concerned with the stigma, it may prove easier to seek care online. Plus, online treatment reduces other barriers to care, such as transportation and childcare, and ensures that people in areas without in-person care options can still receive treatment. The $15 per month community membership also buys you access to therapist-moderated support groups and a 24/7 online community forum. There are support groups aimed at specific ages or identities, such as women, men, BIPOC people, LBGTQIA+ people, parents, or relatives, as well as topic-based groups such as mindfulness, codependency, and self-compassion

Although Monument’s therapists can help with some co-existing disorders, such as anxiety or depression, which are common in people with substance use disorders, its providers cannot prescribe medications to treat those conditions. They also cannot treat any co-occurring use of other substances. We were dismayed that Monument’s website did not mention referrals to more intensive levels of service, such as residential or inpatient treatment. Monument is also not available nationwide. Currently, it is available to residents of Arizona, California, Colorado, Connecticut, Florida, Georgia, Iowa, Kentucky, Maryland, Mississippi, Michigan, New Jersey, New York, North Carolina, Ohio, Oregon, Pennsylvania, South Carolina, Texas, Virginia, Washington state, and Washington, D.C. Still, for those interested in seeking medication, therapy, and group support for AUD, we recommend Monument as a solid care option.

Plans & Pricing
  • Insurance Accepted: Monument is in-network with the following insurance companies (specific plan coverage varies by state): Aetna, Cigna, Oxford Health Plans, and Oscar; accepts Medicare; accepts FSA/HSA payments
  • Subscription Required: Yes
  • Out-of-Pocket Costs: Community membership is $15 per month (not covered by insurance); treatment costs vary by insurance; if paying out-of-pocket, these services cost $100 each for physician appointments, $149 per month for therapy every other week, and $249 per month for weekly therapy appointments.
What Users Say

We surveyed 100 users of Monument:

  • 84% rated Monument as very good or excellent overall
  • 94% rated their therapist’s qualifications as very good or excellent
  • 98% said that most or all of their needs were met at Monument
  • 95% are likely or very likely to recommend Monument to a friend or someone like them
  • 23% said they were using Monument for medication management services

Best for Anxiety and Depression : Brightside


  • Price: $95-$349 per month
  • Is Insurance Accepted?: Yes
  • Type Of Therapy: Individual Therapy, Medication Management, Psychiatry
Why We Chose It 

Anxiety disorders are among the most common mental health conditions in America, affecting approximately 30% of adults at some point in their lives. As for depression, nearly 17% of U.S. adults will experience depression during their lifetime. Brightside Health specializes in treating anxiety and depression and provides streamlined, coordinated treatment plans in all 50 states. Brightside stood out among the competition for its focus on tracking patient progress to ensure improvement. It has patients regularly fill out surveys to track their symptoms, allowing provider teams to see whether treatment is working or not and then make adjustments to medications or therapy approaches accordingly.

Pros & Cons
Pros
  • Coordinated platform for therapy and psychiatry/medication management

  • Primary focus on depression and anxiety

  • Available in all 50 states

  • Access video appointments on website or app

  • Uses evidence-based approaches of cognitive behavioral therapy (CBT) and medication

  • Says it covers 130 million Americans via health insurance

Cons
  • Adults only (18 and over)

  • Provider is selected for you

  • Short sessions

Our Testing

We had four people test out Brightside Health’s mental health services from North Carolina, California, and New York, three different-sized markets in different areas of the country. One thing we liked about Brightside’s care model was that it offers coordinated psychiatry and psychotherapy services. What’s more, you can sign up for either service individually or purchase a bundle of both services at a discount. Treatment is targeted toward modalities and medications that address anxiety and depression, including cognitive behavioral therapy (CBT), app-based exercises to use on your own, and symptom progress trackers. 

We were consistently impressed by the high quality of care we received at Brightside. Not only did we find highly qualified providers, but they were also personable and warm. And while Brightside accepts most major insurance plans, we really love that even without insurance, its services are on the low end of the average cost of therapy and much lower than the national average for psychiatric care. Brightside’s medication-only plan is $95 a month, and you receive one 15-minute psychiatric appointment and ongoing provider support, including medication adjustments. Since the high costs of treatment can compound any pre-existing anxiety, Brightside’s relative affordability makes us feel particularly good about recommending it.

"I live with anxiety and this year it was at its peak. After having panic attacks for the first time, I finally decided to try therapy. I like how convenient [Brightside] is in terms of scheduling, and being able to do it remotely allowed me (a busy working mom) to easily make time for this. So far, therapy has been helpful and I'm glad I gave it a shot."

—Brightside Health tester, who sought treatment for anxiety

One of Brightside’s biggest weaknesses, though, is the short session length. After the initial psychiatric evaluation, follow-up psychiatry sessions are only 15 minutes long (although this is pretty common in online services). Therapy sessions tend to run 30 to 45 minutes (instead of 45 minutes to one hour at other services). In addition, controlled substances (such as Xanax or other benzodiazepines) are not prescribed, so for more severe or specific diagnoses that require them, Brightside may not be ideal.

Plans & Pricing
  • Insurance Accepted: Cigna (all states except Minnesota), Aetna, Allegiance, UnitedHealthcare, Ambetter (all states, except Connecticut, Hawaii, Maine, Massachusetts, Rhode Island, Vermont, Wisconsin), Anthem CA, Blue Shield of CA, Blue Cross Blue Shield (of Montana, Illinois, Texas only), PEHP (Utah only), Florida Blue, Meritain; accepts Medicare and Medicaid in some states; accepts HSA/FSA payments
  • Subscription Required: Yes
  • Out-of-Pocket Costs: Varies by insurance; medication-only plan is $95 per month plus your pharmacy co-pay; therapy-only plan is $299 per month, which includes one session per week; additional therapy sessions can be purchased for $59 each; medication and therapy plan is $349 per month
What Users Say


We surveyed 100 users of Brightside:

  • 88% rated Brightside as very good or excellent overall
  • 94% rated their therapist’s qualifications as very good or excellent
  • 93% said that most or all of their needs were met at Brightside
  • 99% are likely or very likely to recommend Brightside to a friend or someone like them
  • 21% said they were using Brightside for psychiatry or medication management services

Best for Medication Management : Talkiatry


  • Price: Depends on your insurance
  • Is Insurance Accepted?: Yes. BCBS, Optum, Cigna, UnitedHealthcare, Aetna, Medicare, and others
  • Type Of Therapy: Individual Therapy, Medication Management, Psychiatry
Why We Chose It

Talkiatry not only specializes in psychiatry, but it’s also one of the few services that specifically emphasizes psychiatric care delivered by board-certified psychiatrists. At many other companies, psychiatric nurse practitioners, general practitioners, or physician’s assistants primarily provide medication management, but psychiatrists are the most highly trained in mental health care. Among the 82 companies we assessed, Talkiatry stood out for its ability to prescribe controlled substances. This means Talkiatry can treat a much wider array of mental health diagnoses, such as bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and substance use disorder.

Pros & Cons
Pros
  • Therapy and medication management offered

  • Longer session times than most other services

  • Broad variety of diagnoses treated

  • Treats ages 5 and up

  • Network of more than 300 psychiatrists

  • Can prescribe controlled substances

  • Accepts insurance

Cons
  • Only accepts patients via insurance

  • Doesn’t accept Medicaid

  • Not available in Alaska, Delaware, Hawaii, Idaho, New Mexico, North Dakota, South Dakota, or Wyoming

Our Testing

We had two people test Talkiatry from New York and both had good experiences using the company’s adult psychiatry services. Talkiatry also treats children as young as age 5, a rarity among online psychiatry providers. Child psychiatry is another crucial care shortage area for mental health treatment. Because the need for care far exceeds its availability, child mental health was declared a national emergency by the American Academy of Pediatrics in 2021. We believe the high level of care provided by Talkiatry, coupled with its wide range of ages treated and its ability to treat a wider variety of conditions, make it a great psychiatric medication management provider. 

What impressed us most was Talkiatry’s long sessions. The service’s appointments are double the length of most other online mental health companies: Psychiatric intake sessions last 60 minutes and follow-up appointments last 30 minutes. We felt these longer sessions promoted a higher level of patient care because they gave us plenty of time to explain our situation and gave providers time to get all of the information they needed from us to form a complete picture of our mental health. We found the psychiatrists to be professional yet kind and conversational and we loved feeling like we had enough time to ask questions. Those positive experiences, coupled with the thorough sign-up process, made us feel confident about the appropriateness and personalization of the treatment plan that was provided.

When it came to finding a provider, we loved how Talkiatry asked what we were looking for, like if we preferred they specialize in a certain condition or have specific cultural knowledge or sensitivity. Then we could select a provider from a list of those with availability or peruse suggested matches.

One thing to be aware of with Talkiatry is that care is only available via health insurance—there is no self-pay option. Another downside is that the service is not available to residents of Alaska, Delaware, Hawaii, Idaho, New Mexico, North Dakota, South Dakota, or Wyoming.  Also, if you’re looking for same-day or next-day care, Talkiatry likely shouldn’t be your first choice: Most initial visits occur about a week from sign-up. But wait times to see an in-person psychiatrist are typically much longer, perhaps even several months, depending on your location. Talk therapy is also available on Talkiatry, but it requires a referral from one of its psychiatrists. 

One area we had to investigate before recommending Talkiatry’s medication management services was its record of responsible prescribing practices. This is a particularly important concern when a service provides psychiatric care for young children. It’s not uncommon for telehealth companies to get into hot water for allegedly overprescribing certain psychiatric prescriptions. 

Given Talkiatry’s ability to prescribe controlled substances, such as stimulants for attention-deficit/hyperactivity disorder (ADHD) or benzodiazepines for anxiety, we wanted to be especially prudent about assessing its provision of medications. Our research and testing show we can be confident about Talkiatry’s approach to medication and the appropriateness and general reliability of its prescribing practices. In our survey, three-quarters of Talkiatry users reported having between two and four appointments before being prescribed medication. This is good news since we prefer that psychiatrists see patients more than once before determining if medication is a good idea and which one might be the best fit.

Plans & Pricing
  • Insurance Accepted: Accepts plans from five of the biggest health insurance providers: Aetna, BlueCross BlueShield, Cigna, Optum, United Healthcare, and more; accepts some Medicare plans
  • Subscription Required: No, pay-per-session service
  • Out-of-Pocket Costs: Varies by insurance; you can input your insurance information before signing up to get an estimate of your copay 
What Users Say

We surveyed 100 users of Talkiatry:

  • 86% rated Talkiatry as very good or excellent overall
  • 87% rated their therapist’s qualifications as very good or excellent
  • 96% said that most or all of their needs were met at Talkiatry
  • 95% are likely or very likely to recommend Talkiatry to a friend or someone like them
  • 42% said they were using Talkiatry solely for psychiatry or medication management

Best for Patient Support : Talkspace


  • Price: $276 to $436 per month for therapy subscriptions
  • Is Insurance Accepted?: Yes
  • Type Of Therapy: Couples Therapy, Individual Therapy, Medication Management, Psychiatry, Teen Counseling

Get $85 off your first month with code VERYWELL85.

Why We Chose It 

Talkspace emphasizes easy accessibility to its experienced mental health care providers by allowing you to message your provider any time with guaranteed responses within one day, five days a week, and offering text-only therapy for even more convenience. Access to care is one of Talkspace’s major strengths, with well-qualified therapists and psychiatric providers often available within 48 hours after completing a brief assessment questionnaire. Talkspace has a particularly broad network of providers, which helps in terms of accessing more specialized care for certain diagnoses. Talkspace's psychiatrists can help with a range of conditions such as anxiety, depression, bipolar disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), postpartum depression, and panic disorder.

Pros & Cons
Pros
  • Easy to use, accessible platform

  • Treats wide range of mental health diagnoses

  • Large network of providers available in most states

  • Asserts 150 million Americans can access service via insurance

  • Can participate in appointments via the app or website

  • Can message providers between sessions

Cons
  • Text-based therapy is not ideal for everyone

  • Psychiatric services can be costly if you pay out-of-pocket

  • Provider assigned to you from a small number of preselected choices

Our Testing

We had 11 people from across the country test out Talkspace, hailing from California, Florida, Indiana, Iowa, Kansas, Minnesota, Missouri, New York, North Carolina, and South Dakota. Given its wide insurance coverage, ability to treat a wider range of conditions than other platforms, availability of both medication management and therapy services, and the ability to message providers between sessions, we think Talkspace is a great option.

Overall, we had a positive experience and the providers we met with were warm, patient, and understanding. Although therapy services are available via video, phone call, live chat, or asynchronous text, psychiatry services are only accessible via video visits—however, we love that you can message your provider at any time between visits, a rarity among telepsychiatry services. Talkspace truly makes mental health care accessible from anywhere by allowing you to schedule and participate in your appointments on the Talkspace app or website and letting you be in contact with your psychiatrist anytime you need them.

"The app makes it very easy to access my account and access any messages my provider sends. I still prefer the sessions from my laptop, but I do find the app helpful and would recommend downloading it at the beginning."

—Talkspace tester, who sought therapy after experiencing trauma

One thing of note that we found was that our second provider was often a better fit for our needs than the ones we were initially matched with. That wasn’t a problem given the many provider choices available to us and how easy it was to switch providers. Talkspace’s psychiatry fees are also higher than many other platforms and may be out of reach for many due to cost. And, like most telehealth services, Talkspace cannot prescribe controlled substances, so it may not be a great fit in certain cases.

Plans & Pricing
  • Insurance Accepted: Accepts plans from most major insurers, including Aetna, Cigna, Optum, UnitedHealthcare, Carelon, and Regence; accepts some Medicare plans; doesn’t accept Medicaid
  • Subscription Required: No subscription for psychiatry, which is pay-as-you-go; subscription required for therapy
  • Out-of-Pocket Costs: Varies by insurance; psychiatry/medication management costs $299 for an initial evaluation and $175 for a follow-up session; psychiatry bundles include an initial evaluation and three follow-up sessions for $725 (new members only); follow-up session psychiatry bundles also range from $140 per session for nine sessions to $159 per session for three sessions; a messaging-only therapy subscription plan starts at $69 per week; live therapy plan starts at $99 per week and includes messaging and four live sessions a month; and couples therapy starts a $109 per month.
What Users Say

We surveyed 100 users of Talkspace:

  • 92% rated Talkspace as very good or excellent overall
  • 89% rated their therapist’s qualifications as very good or excellent
  • 95% said that most or all of their needs were met at Talkspace
  • 97% are likely or very likely to recommend Talkspace to a friend or someone like them
  • 19% said they were using Talkspace for psychiatry or medication management

Best for Ease of Use : Thriveworks


  • Price: Varies by insurance; self pay starts at $200 per session
  • Is Insurance Accepted?: Yes
  • Type Of Therapy: Couples Therapy, Family Therapy, Group Therapy, Individual Therapy, Medication Management, Psychiatry, Teen Counseling
Why We Chose It 

If you’re looking for an online mental health service with the convenience and ease of use of a large company, but the feel of a boutique private practice, look no further than Thriveworks. Many companies claim to offer a variety of services, but once you get to the website you can’t see how to sign up for that specific offering. At Thriveworks, things are straightforward and simple. Simply click on which service you need—psychiatry, individual therapy, family therapy, child therapy, or couples counseling—and you’ll see a list of providers and available appointment slots. Best of all, it doesn’t hide tons of info behind a member paywall, so you can peruse provider profiles, insurance details, prices, and appointment availability without signing up.

Pros & Cons
Pros
  • Wide range of appointment times

  • Easy scheduling

  • Can see provider bios, prices, insurance info, and available appointments before sign-up

  • Can choose your provider

  • Q&A coach available 24/7

  • Accepts most major insurance plans

  • Individual therapy for children and adults, couples therapy, and family therapy available

Cons
  • Psychiatry/medication management not available in all states

  • Platform more disjointed when coordinating with med management

  • Providers for teen/child services not as plentiful as adult services

Our Testing

The five people who tested Thriveworks—from Kansas, Kentucky, Missouri, Massachusetts, and New York— signed up for various services, including child therapy, adult therapy, and couples counseling. And although we did not test its psychiatry services specifically, the fact that one of the most common words in our testers’ reports of their Thriveworks experience was “easy” makes us confident that searching for a psychiatrist is also simple. From signing up, finding information on the website, and getting ahold of customer service to scheduling sessions, switching providers, or adding a psychiatrist to your care team—you name it, we found it easy. 

Therapy services are available to children (any age) and adults, while psychiatry services are available to anyone age 14 and up. We were impressed to find that most of the prescribers at Thriveworks are psychiatrists rather than general practitioners or physician’s assistants. Providers with specialized training in psychiatry are better equipped to diagnose mental health conditions and prescribe the appropriate medications. We feel confident that Thriveworks’ ease of use, coupled with its highly qualified providers, insurance acceptance, and range of appointment times make it a great choice for people who don’t want the task of finding the mental health care they need to turn into yet another complicated, time-consuming project. 

Our testers found that therapy appointments were often available within 48 hours, and Thriveworks asserts it will do its best to get you an appointment with a therapist within three to five days of signing up. As for psychiatry services, Thriveworks says most users can see a provider within seven days of signing up. We found that if you live in a larger state, you will likely be able to find an appointment within three to five days.

One caveat is that the network of psychiatrists is smaller and more limited at Thriveworks than its network of therapists. We found that provider availability for adult therapy was much more robust than for psychiatry or child/teen services. In many areas, filtering our search for providers who offered teen/child therapy or psychiatry dramatically reduced our list of provider options. 

Plans & Pricing
  • Insurance Accepted: Different providers accept different insurance plans, but you can filter therapists by the insurance plans they accept; Thriveworks accepts major insurance plans such as BlueCross, Anthem, Optum, UnitedHealthcare, Aetna, Cigna, Humana, and many others
  • Subscription Required: No
  • Out-of-Pocket Costs: Varies by insurance and provider (rates can be found on provider bio pages); self-pay options start at $300 for a first psychiatry/mediation management session and $210 for subsequent sessions; therapy starts at $200 for a first session and $170 for subsequent sessions
What Users Say

We surveyed 100 users of Thriveworks:

  • 88% rated Thriveworks as very good or excellent overall
  • 90% rated their therapist’s qualifications as very good or excellent
  • 96% said that most or all of their needs were met at Thriveworks
  • 96% are likely or very likely to recommend Thriveworks to a friend or someone like them
  • 24% said they were using Thriveworks for psychiatry or medication management

Best for Flexible Scheduling : Doctor on Demand


  • Price: $129 - $299 per session
  • Is Insurance Accepted?: Yes
  • Type Of Therapy: Individual Therapy, Medication Management, Psychiatry, Teen Counseling
Why We Chose It

Doctor on Demand is a large telehealth site that offers medical as well as mental healthcare services, including therapy and medication management. The company stood out among the 82 other services we assessed for having same-day and next-day appointments available in many areas, offering night and weekend appointments, and providing 24/7 coaching services. Doctor on Demand also boasts an impressively broad selection of highly qualified providers, high customer satisfaction ratings, and a collaborative care model that allows your therapist and psychiatrist to work together. Also notable is that the company offers treatment for a wide array of psychiatric diagnoses and can treat children as well as adults. With simple scheduling and acceptance of insurance, Doctor on Demand makes it easy to find affordable care quickly.

Pros & Cons
Pros
  • Evening and weekend appointment times available

  • Same-day or next-day appointments may be available (depending on location)

  • Mental health services available to children ages 1 to 17 (with guardian participation)

  • Checks insurance coverage and shows your copay during sign-up

  • Available nationwide

  • Can schedule and participate in appointments via web portal or app

Cons
  • Can be pricey if out of network

  • Can’t see list of accepted insurance plans until during sign-up

  • Must create an account to see providers and appointment availability

Our Testing

We tested Doctor on Demand's teen psychiatry services and individual adult therapy services in Pennsylvania, as well as adult therapy in North Carolina. We sought treatment for anxiety as well as support with navigating difficult family dynamics, and overall we had positive experiences. We love that the service allows patients access to specialized care with insurance and offers appointments during a much wider timeframe than most other companies. And we found that psychiatrist appointment openings were far more plentiful than therapy sessions.

We love that Doctor on Demand fosters communication and collaboration among the members of your care team, a rarity at most large telehealth services. That means if you’re seeing both a therapist and a psychiatrist at the company, they work together to share notes about your case to improve the overall care you’re receiving.

We really appreciated that as soon as we entered our insurance information, we were shown our copays for various visit types. This was helpful to have before we booked any appointments. Doctor on Demand often offers one of the fastest initial access times for a mental health provider: You may be able to score an appointment within a few hours, depending on your location, insurance, and schedule. This wide appointment availability comes with caveats, of course. If you live in a smaller state, have a limited timeframe for when you can schedule appointments, or prefer to choose an appointment by the provider rather than by the soonest opening, it can take significantly longer. This can add days or even weeks (we waited three weeks for a first appointment in one case) in order to schedule with a preferred provider.

When searching for a provider, we could filter the list of provider options based on their availability, specialty/focus area, gender, and language; however, one thing we didn’t like was that we couldn’t filter based on our preferences for provider race, religion, or sexuality. We were also concerned that there was nothing denoting “LGBTQIA+ ally” or “BIPOC cultural sensitivity” on provider bios. Explicitly designating themselves as culturally aware and/or queer-affirming is increasingly important for mental health providers. While we felt it was important for potential patients to be aware of these lacking features, please note that we have no reports of Doctor on Demand providers being intolerant, and the company backs up its commitment to diversity with data about the identities of its providers.

Plans & Pricing
  • Insurance Accepted: Doctor On Demand accepts most major insurance plans, including BlueCross BlueShield, UnitedHealthcare/Optum, Humana, and Medicare; FSA/HSA accepted
  • Subscription Required: No
  • Out-of-Pocket Costs: Varies by insurance; an appointment with a psychologist is $134 for a 25-minute session and $184 for a 50-minute session; it's $299 for an initial 45-minute consultation with a psychiatrist and $129 for 15-minute follow-ups.
What Users Say


We surveyed 100 users of Doctor on Demand:

  • 88% rated Doctor on Demand as very good or excellent overall
  • 91% rated their therapist’s qualifications as very good or excellent
  • 95% said that most or all of their needs were met at Doctor on Demand
  • 97% are likely or very likely to recommend Doctor on Demand to a friend or someone like them
  • 34% said they were using Doctor on Demand for psychiatry or medication management

Best for Budget : LiveHealth Online


  • Price: $85-100 per therapy session; $185 or less for an initial psychiatry session; $80 per follow-up
  • Is Insurance Accepted?: Yes
  • Type Of Therapy: Children's Therapy, Couples Therapy, Family Therapy, Individual Therapy, Medication Management, Psychiatry, Teen Counseling
Why We Chose It 

One of the biggest barriers to mental health care is high out-of-pocket costs. That’s why we love LiveHealth Online. It offers one of the widest networks of highly qualified providers at one of the lowest costs, with an easy-to-use, comprehensive platform. After the initial $185 psychiatric intake appointment, follow-up visits with a psychiatrist are $80 each. These prices are less than half the national average for psychiatric care, which is around $500 for an initial session and $200 for follow-up sessions. Talk therapy sessions at LiveHealth Online cost $85 per visit with a therapist or $100 per visit with a psychologist, on the lower end of the national average cost. Even better, you don’t need to pay a membership fee or pre-pay for a large bundle of sessions.

Pros & Cons
Pros
  • Per-visit out-of-pocket costs lower than most other services

  • Available in all 50 states

  • Covers most common psychiatric conditions

  • Accepts insurance

  • Talk therapy also available for ages 10 and up

  • Can schedule and participate in appointments via website or app

  • LGBTQ-affirming providers denoted with “ally” rainbow flag on profile

Cons
  • Doesn't take as many insurance plans as some other companies

  • Initial psychiatry visit may be up to a two-week wait

  • Psychiatric care only for ages 18 and up

Our Testing

LiveHealth Online is a well-organized, easy-to-use telehealth site offering virtual medical and mental health services in all 50 states. We assigned two people to test its mental health services, one from California and one from Ohio. An initial psychiatric assessment costs $185 and follow-up sessions are $80, which are prices almost unheard of in the psychiatry industry. In addition to affordability, we loved that LiveHealth Online makes care more accessible by allowing you to participate in video appointments via its website or phone app. That means you can truly access care from just about anywhere.

The fact that LiveHealth Online’s providers receive additional training on how to deliver care virtually really showed in our experience. It was clear that providers had experience and expertise in delivering mental health care online. This is a special skill that we have discovered not all online providers possess.

We had a mix of good and not-so-good experiences with LiveHealth Online's services. We appreciated that at the beginning of appointments, therapists laid out clear expectations for the session and detailed their expertise and availability. While we found that most of our providers were helpful and easy to talk to, one used antiquated, offensive language concerning trans people despite being identified as an LGBTQIA+ ally on their profile. If you or someone you love is a member of this group, another site may be a better fit. Still, the low out-of-pocket prices at LiveHealth made it stand out as a good resource for those who cannot afford the usual exorbitant prices of psychiatric services. In addition, the app was easy to navigate and the in-app sound and video quality were great. 

Evening and weekend appointments are available, and there is a provider on call 24/7 if you have an urgent issue or question, such as a problem with medication or side effects. Unfortunately, though, we found that it may take longer to get an appointment at LiveHealth Online than at some other telehealth services. The company states you should be able to find an appointment within 14 days. While that’s still a lot sooner than most in-person services, if you need care more quickly, another service might serve you better. The longer wait time likely reflects LiveHealth Online’s popularity with customers who appreciate the low cost of its services. If paying out of pocket, the affordability and overall quality make LiveHealth Online worth the wait. But, as with several other telehealth platforms, LiveHealth's providers cannot prescribe controlled substances, so it is not ideal for people whose conditions may benefit from those medications.

Plans & Pricing
  • Insurance Accepted: Yes, including most Anthem BlueCross and BlueShield, Anthem BlueCross, BlueCross and BlueShield of Georgia, Empire BlueCross and Empire BlueCross Blue and Shield health plans
  • Subscription Required: No, pay-per-visit model with no monthly fees
  • Out-of-Pocket Costs: Varies by insurance; out-of-pocket costs are $185 for an initial consultation with a psychiatrist and $80 for each subsequent visit; talk therapy sessions are $85 to $100, depending on your therapist’s level of experience.
What Users Say
  • 90% rated LiveHealth Online as very good or excellent overall
  • 94% rated their therapist’s qualifications as very good or excellent
  • 98% said that most or all of their needs were met at LiveHealth Online
  • 98% are likely or very likely to recommend LiveHealth Online to a friend or someone like them
  • 24% said they were using LiveHealth Online for psychiatry or medication management

Best for Provider Options : MDLIVE


  • Price: Up to $179 for therapy; up to $299 for psychiatry
  • Is Insurance Accepted?: Yes
  • Type Of Therapy: Individual Therapy, Medication Management
Why We Chose It

As one of the largest telehealth companies in the U.S., MDLIVE makes connecting with an experienced, credentialed prescriber much more convenient and accessible. MDLIVE is an easy-to-use telehealth platform offering comprehensive mental health services. MDLIVE stood out among the 82 companies we looked at for its abundance of well-vetted provider options across most of the country.

Pros & Cons
Pros
  • Choose your provider from an easy-to-use directory based on profiles and availability

  • Accessible services, including 24/7 customer support

  • Mental health services available to ages 10 and up

  • Can schedule and participate in appointments via website or app

  • Transparent pricing

  • Can message provider anytime in patient portal

Cons
  • No controlled substances prescribed

  • Full list of accepted insurance plans not available until signing up

  • May have technical issues with video appointments

Our Testing

Among our five MDLIVE testers from Connecticut, Missouri, Michigan, Iowa, and Florida, what impressed us most was the wide range of providers available. MDLIVE asserts that its clinical network is the largest in the nation. Plus, the company is available in all 50 states, Washington DC, and Puerto Rico. Thanks to its large network of vetted, licensed, and board-certified providers, MDLIVE offers access to psychiatric treatment for a wide array of diagnoses, typically within a week. While provider and appointment availability varies by state (as with all services), we believe that compared to other large telehealth companies, MDLIVE offers exceptional access to a high number of qualified providers. 

For example, our testing found 24 therapists available in New York, with six of those having an open appointment within the next two days; California boasted an especially long list of providers (both therapists and psychiatrists), though the wait for appointments was closer to weeks than days.

We were impressed by the providers’ experience levels and varying types of expertise. Most providers had at least several years of experience. We also found that MDLIVE’s mental health services are available for children and teens ages 10 and up, a rare offering at most telehealth companies. You can choose your provider directly from an easy-to-navigate index when you register. Most providers who treated us were equal parts helpful and compassionate, professional and approachable. However, in one case we found the provider cold and it seemed like they were more interested in taking notes than engaging with us. Still, overall we found that being able to read provider profiles and choose one for ourselves based on their specialties, attributes, and availability meant we were usually able to find a good match for our needs.

Among the downsides we discovered at MDLIVE were technical issues with video sessions. During one of our sessions, the screen suddenly froze multiple times, then cut out before the appointment was supposed to be over. We also had some difficulties putting in insurance and having scheduled appointments disappear, which was frustrating. Another area of potential concern is whose interests the company prioritizes. Cigna now owns MDLIVE and insurance companies are known to guard their bottom line above all else. Given that, our experts felt users should be on alert for any behavior that seems to be prioritizing the concerns of the company over those of the patient. Like most telehealth services, MDLIVE does not prescribe controlled substances. In addition, the company does not treat certain conditions such as ADHD, acute psychosis, active substance use requiring detox, and moderate to severe autism.

Plans & Pricing
  • Insurance Accepted: Yes, including Cigna, Humana, BlueCross BlueShield, Aetna, and Medicare in some areas
  • Subscription Required: No
  • Out-of-Pocket Costs: Varies by insurance; out-of-pocket psychiatry appointments cost up to $299 for the initial evaluation, then up to $159 for subsequent sessions; therapy appointments cost up to $179 for an initial appointment, then up to $140 per session
What Users Say
  • 88% rated MDLIVE as very good or excellent overall
  • 89% rated their therapist’s qualifications as very good or excellent
  • 100% said that most or all of their needs were met at MDLIVE
  • 97% are likely or very likely to recommend MDLIVE to a friend or someone like them
  • 24% said they were using MDLIVE for psychiatry or medication management

Compare the 9 Best Online Psychiatry Services of 2024

Best For
Price
Is Insurance Accepted?
Does it Accept HSA/FSA?
Type Of Therapy
Communication Options
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Teladoc Health Best for Availability Up to $119 per therapy session, $299 for initial psychiatry appointment and $129 per follow-up Yes Yes Couples Therapy, Individual Therapy, Medication Management, Psychiatry Audio, Video Chat Learn More
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Monument Best for Alcohol Use Disorder Starts at $15+ per month Yes Yes Group Therapy, Individual Therapy, Medication Management, Peer Support Messaging, Video Chat Learn More
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Brightside Best for Anxiety and Depression $95-$349 per month Yes Yes Individual Therapy, Medication Management, Psychiatry Messaging, Video Chat Learn More
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Talkiatry Best for Medication Management Depends on your insurance Yes. BCBS, Optum, Cigna, UnitedHealthcare, Aetna, Medicare, and others Yes Individual Therapy, Medication Management, Psychiatry Video Chat Learn More
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Talkspace Best for Patient Support $276 to $436 per month for therapy subscriptions Yes Yes Couples Therapy, Individual Therapy, Medication Management, Psychiatry, Teen Counseling Audio, Live Chat, Messaging, Phone, Video Chat Learn More
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Thriveworks Best for Ease of Use Varies by insurance; self pay starts at $200 per session Yes Yes Couples Therapy, Family Therapy, Group Therapy, Individual Therapy, Medication Management, Psychiatry, Teen Counseling Audio, Phone, Video Chat Learn More
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Doctor on Demand Best for Flexible Scheduling $129 - $299 per session Yes Yes Individual Therapy, Medication Management, Psychiatry, Teen Counseling Audio, Video Chat Learn More
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LiveHealth Online Best for Budget $85-100 per therapy session; $185 or less for an initial psychiatry session; $80 per follow-up Yes Yes Children's Therapy, Couples Therapy, Family Therapy, Individual Therapy, Medication Management, Psychiatry, Teen Counseling Video Chat Learn More
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MDLIVE Best for Provider Options Up to $179 for therapy; up to $299 for psychiatry Yes Yes Individual Therapy, Medication Management Video Chat Learn More
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Guide to Choosing the Best Online Psychiatry Service

  • Price: Cost and insurance coverage are clearly important factors, so you should review fees and insurance plans accepted before signing up for any service. Know your monthly budget and whether or not you want to pay per session or a monthly fee for a set of recurring services. Also, decide whether you’re OK with paying a membership fee in addition to service fees. Consider the length of appointments, provider qualifications, and additional perks (like the ability to message your provider) when calculating the value for money. Some online psychiatry services may also offer financial assistance. For example, service fees may be able to be waived or reduced, and some psychiatrists may offer sliding-scale pricing. It’s always worth emailing customer service to inquire about making services within your financial reach. 
  • Treatment area: The focus of an online psychiatry service is also important: does it specialize in care that includes your particular diagnosis or age group? (For example, certain sites specialize in care for ADHD or depression and anxiety but not much else.) Can it treat multiple issues that you may have (such as additional co-occurring conditions like substance use)? Do you have access to a therapist in addition to a psychiatrist/prescriber? How broad is the service's network of providers where you live, and what are their qualifications? If you’re looking to find out whether or not you’re experiencing a diagnosable condition and what that is, you’ll want to start with a more general online psychiatry service.
  • Medication options: The particular medications/prescribing services available are important to check. Most companies are not allowed to prescribe controlled substances. Some may have less experience or comfort with certain types of medications or diagnoses. Access for refills or discussing urgent side effect issues should also be considered. Also, check if medication is a separate charge or included in the service fees.
  • Scheduling: Scheduling is one of the best potential advantages of online psychiatry companies, but only if the service actually has good availability for a wide range of times, and with the same provider each time instead of a more worrisome random provider approach. Ease and accuracy of scheduling is also important. If you have a specific need for appointments that fall outside of normal business hours, look for services with the widest range of scheduling options. And be sure to consider if you’re willing to wait a bit longer for service in order to secure appointments at a specific time.
  • Choosing a provider: You’ll want to consider credentials and experience: Did the provider attend well-established or well-known academic training programs? Are they actively board-certified, and in what specialties? Is their identity or cultural background similar to your own? Additionally, you'll want to be sure the service has a relatively easy way to switch to a different provider in the event you don’t feel that the first one is a good match. Look for services that ensure easy access to customer support for technical issues (such as video signal problems) or billing concerns.

Are Psychiatry Services Right for Me?

Online psychiatry can be helpful if you live in a remote area with limited in-person providers, have a schedule that makes it difficult to fit in appointments, have difficulties leaving the house, or want a therapist with a specific identity that’s not common where you live. Choosing an online provider might also be helpful if you’re concerned you’ll need to switch psychiatrists or medications and are looking for support quickly.  

Online psychiatry services are typically not intended for people in severe distress or crisis.

What If I'm Having Thoughts of Harming Myself?

Anyone with thoughts, urges, or plans of suicide or self-injury, or mental health symptoms that endanger their own or others’ well-being, should seek in-person emergency care ASAP by calling the Suicide & Crisis Lifeline at 988 or going to their nearest or preferred hospital emergency room. Other free mental health resources include:

Frequently Asked Questions

  • What Conditions Can Online Psychiatrists Help Me With?

    Psychiatrists are physicians with medical training, (i.e., MD or DO degrees, which take four years to complete) as well as psychiatric residency training, which takes another four years. They can treat a wide array of mental health conditions and are trained to diagnose patients and treat them using both psychotherapy and psychopharmacology. Some specialize or have additional board certification in particular diagnoses (like mood and anxiety, alcohol use, or eating disorders) or age groups (like child/adolescent or geriatric). Online psychiatrists often cannot treat more severe mental health conditions or prescribe controlled substances. For these services, in-person psychiatry would be necessary.

  • Are All Prescribers of Mental Health Medication Psychiatrists?

    People with different qualifications and training are also permitted to prescribe medications, such as primary care physicians, psychiatric nurse practitioners, physician assistants, and, in a few states, psychologists. These other prescribers usually do not have the same amount of rigorous time and training regarding human physiology and pharmacology in combination with psychiatric expertise as psychiatrists, but some have sufficient experience to prescribe medications for routine or mild mental health conditions.

  • What Is the Difference Between Teletherapy and Telepsychiatry?

    Teletherapy is a more general term referring to psychotherapy conducted remotely online. There are numerous licensed and trained specialists who can provide teletherapy, such as licensed mental health therapists, social workers, psychologists, and psychiatrists. Telepsychiatry refers to the practice of psychiatry conducted remotely online and usually refers to services provided specifically by a psychiatrist who does an initial history-taking and diagnostic biopsychosocial assessment, followed by recommendations for treatment involving psychotherapy and/or medication. Psychiatrists are trained in and can also conduct psychotherapy, but a more common treatment model is to split care with a designated psychotherapist and have the psychiatrist focus on medication management.

  • How Do You Know Online Psychiatrists Are Qualified?

    Even if the telehealth platform asserts it screens provider credentials, before making an appointment, you should conduct a quick online search to see whether they have an active medical license in your state, active board certification from the American Board of Psychiatry and Neurology, and no signs of unusual medical board complaints or legal issues.

  • Do I Need to Currently Be Seeing a Psychiatrist to Receive Medication?

    As with any medication, it’s important to receive periodic follow-ups from your qualified prescriber to make sure continuing your medication at its current dosage is the appropriate plan. For psychiatric conditions, psychiatrists are best able to determine with you what the right medication and the most appropriate follow-up period is. Sometimes if a medication is very stable, routine prescribing can be continued by a primary care provider instead.

  • Do Online Psychiatrists Accept Insurance?

    This depends on the psychiatrist and the platform. Some may screen and validate that your insurance is in-network ahead of time; others may not accept insurance upfront and make you do paperwork and send out-of-network bills instead, which can be time-consuming and have higher copays or fees. All of the telepsychiatry services listed in this roundup accept several health insurance plans.

How We Tested and Reviewed Online Therapy Services

We evaluated 82 online therapy companies and therapist directories in order to compile this list.

Firsthand Experience

As part of our research, we signed up for talk therapy at all 55 online therapy companies we reviewed. We tested each company's therapy services, and if the company offered other services (such as couples therapy and kid or teen therapy) we tested those too. Our testers are located all across the United States and abroad, meaning we have extensive information about each company's services in a variety of areas.

User and Brand Surveys

In addition, we surveyed more than 8,000 therapy users: 100 at each of the 55 online therapy companies and the 27 therapist directories we tested. We collected over 100 different data points in which we asked users to evaluate each company's services, from their therapist's qualifications to whether they found a therapist who met all their needs to how they'd rate the company overall. We also sent questionnaires to each company we considered, asking for their perspectives on the services they provide, and we interviewed former patients and therapists at the companies where possible.

Research

In addition to the extensive research we performed on each of the 55 online therapy companies we reviewed, we also researched dozens of therapy directories. We tested each by searching for appropriate therapists for 37 hypothetical scenarios that might lead someone to search for a mental health provider across 18 ZIP codes. We then rated the results by how well the therapists we found in each directory could address each scenario, looking into whether it listed competent, licensed therapists who were qualified to treat these issues.

Expert Recommendations

Once we completed this testing and these surveys, we evaluated our findings with the help of three licensed therapists—Amy Marschall, PsyD; Nic Hardy, PhD, LCSW; and Hannah Owens, LMSW—in order to make our recommendations. These therapists provided extensive insight into the ethics and efficacy of online therapy as well as information about relevant therapeutic modalities and approaches.

Best Online Psychiatry Service

VERY WELL MIND / Amelia Manley

Article Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Zhu JM, Zhang Y, Polsky D. Networks in ACA marketplaces are narrower for mental health care than for primary careHealth Affairs. 2017;36(9):1624-1631. doi:10.1377/hlthaff.2017.0325

  3. Sun CF, Correll CU, Trestman RL, et al. Low availability, long wait times, and high geographic disparity of psychiatric outpatient care in the US. Gen Hosp Psychiatry. 2023;84:12-17. doi:10.1016/j.genhosppsych.2023.05.012

  4. National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder (AUD) in the United States: Age groups and demographic characteristics

  5. Mintz CM, Hartz SM, Fisher SL, et al. A cascade of care for alcohol use disorder: Using 2015–2019 National Survey on Drug Use and Health data to identify gaps in past 12‐month care. Alcoholism Clin Exp Res. 2021;45(6):1276-1286. doi:10.1111/acer.14609

  6. Substance Abuse and Mental Health Services Administration. Mental health and substance use co-occurring disorders.

  7. American Psychiatric Association. What are anxiety disorders?.

  8. American Psychiatric Association. What is depression?.

  9. U.S Department of Health and Human Services. Protecting youth mental health: The Surgeon General's Advisory.

  10. Association of American Medical Colleges. A growing psychiatrist shortage and an enormous demand for mental health services.

  11. U.S. Drug Enforcement Administration. DEA serves order to show cause on Truepill Pharmacy for its involvement in the unlawful dispensing of prescription stimulants.

  12. Association of American Medical Colleges. Exploring barriers to mental health care in the U.S.

Jean Kim

By Jean Kim
Jean Kim, MD, MA, is a psychiatrist and writer from the Washington, DC area.

Edited by
Olivia Campbell
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Olivia Campbell is a health and parenting editor at Dotdash Meredith. She is the author of the New York Times bestseller “Women in White Coats: How the First Women Doctors Changed the World of Medicine.”

Learn about our editorial process
and
Simone Scully
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Simone is the health editorial director for performance marketing at Verywell. She has over a decade of experience as a professional journalist covering mental health, chronic conditions, medicine, and science.

Learn about our editorial process