Scheduling your first psychiatric appointment takes courage. Whether you've been managing on your own for years or finally got tired of waiting for things to get better, reaching out is a meaningful step - and I don't want the unknowns of what happens next to get in the way.
Here's a plain-language walkthrough of what actually happens during an initial psychiatric evaluation via telehealth, so you can show up prepared instead of anxious.
Before the Appointment
A few things to have ready:
- A list of your current medications - including dose and how long you've been taking them. Over-the-counter medications, supplements, and anything prescribed by other providers all matter.
- A rough sense of your symptom history - you don't need a perfectly organized timeline, but thinking through when things started, what makes them better or worse, and how your symptoms affect daily life will help us move efficiently.
- Any prior diagnoses or treatment history - if you've seen a therapist, psychiatrist, or other mental health provider before, note what was helpful and what wasn't.
- A private, quiet space - telehealth appointments work best when you're somewhere you feel comfortable talking openly. Your car, your bedroom, a private office - wherever you won't be interrupted.
You don't need to prepare a presentation. The purpose of the first appointment is for me to get to know you, not to test you.
What Happens During the Evaluation
The initial appointment is typically 60 minutes. Here's what we cover:
Your current symptoms
We'll start with what's bringing you in right now. I'll ask about your mood, sleep, energy, concentration, appetite, anxiety levels, and anything else that feels relevant to you. I'll also ask how long these symptoms have been present and how they're affecting your work, relationships, and daily functioning.
There are no wrong answers. I'm not evaluating you against a checklist - I'm trying to understand your experience.
Your history
Psychiatric symptoms rarely appear in a vacuum. I'll ask about your mental health history - any prior diagnoses, hospitalizations, or significant episodes - as well as your family history. Mental health conditions have genetic components, and knowing your family background helps me understand your risk profile and how you might respond to treatment.
Your medical history and current medications
Some medical conditions contribute to psychiatric symptoms, and some medications have psychiatric side effects. I'll ask about your physical health, any chronic conditions you're managing, and everything you're currently taking.
Your goals
What do you want to get out of treatment? Some people come in wanting medication. Some aren't sure. Some have tried medication before and want to revisit it. Some want to understand their diagnosis before making any decisions. I don't have a preset plan - I want to know what matters to you.
Safety
I'll ask directly about thoughts of self-harm or suicide. This isn't meant to alarm you - it's a standard and important part of every psychiatric evaluation. If you're having those thoughts, that's important information, and it opens a conversation rather than closing one.
What I Won't Do
I won't rush you. I won't dismiss what you've been through. I won't hand you a prescription without explanation. And I won't make you feel like you have to have all the answers before we can start.
What Happens at the End of the Appointment
By the end of your first visit, you'll have:
- A clear picture of my clinical impression - I'll share what I'm seeing and what I think is going on, in plain language.
- A plan - whether that includes starting a medication, continuing one you're already on, adjusting something that isn't working, or taking a more watchful approach. If we do start medication, I'll explain what it is, how it works, what side effects to watch for, and what to expect in the first few weeks.
- A follow-up scheduled - we won't leave your first appointment without a plan for what's next.
Common Questions
Do I have to have a diagnosis to be seen?
No. Many people come in without a diagnosis and leave with one. Others come in with a diagnosis they've been given but aren't sure fits. The evaluation is how we figure that out together.
Will you just prescribe me something and send me on my way?
No. Medication is a tool, not a solution on its own. Every plan I recommend is tailored to your actual situation. Some people leave the first appointment with a prescription. Others don't. There's no pressure either way.
What if I've had bad experiences with psychiatry before?
Tell me. That history matters - both what didn't work and why. I won't repeat an approach that failed you.
Is telehealth really as effective as in-person?
Research consistently shows that telehealth psychiatric care produces outcomes equivalent to in-person care for most conditions. For many people, being in a comfortable, private space actually makes it easier to open up.
Ready to Schedule?
If you're in Wyoming and ready to take the next step, I see patients statewide via telehealth and accept most major insurance plans through Headway.
