It is estimated that 25% of Americans have a mental health condition, yet more than half of those do not seek treatment. The barriers in accessing psychiatry can relate to a lack of services available in the local area, difficulty attending appointments in-person, and fear of stigma associated with seeing a psychiatrist.
Online therapy helps overcome a number of these barriers, offering convenient access from the comfort of your own home. Its rising popularity is perhaps no surprise as we are all becoming more comfortable holding a range of important meetings over virtual platforms.
Around the world, 2020 has also seen a loosening of restrictions on prescribing through telemedicine. In response to the Covid-19 pandemic and the need to reduce in-person consultations, the laws and guidelines on remote prescription of drugs have been updated, making telemedicine in general, and online psychiatry in particular, a very viable option.
We have thoroughly tested and compared all of the major online psychiatry providers in 2020 and here will present comparative details of the strongest providers right now, in order to help you decide which one is best for you.
- Why you should trust us
- What characteristics of online psychiatrists should you consider?
- Company snapshot #1: BetterHelp
- Company snapshot #2: Talkspace
- Company snapshot #3: MDLive
- Company snapshot #4: Teladoc
- Company snapshot #5: Amwell
- What's the difference between a psychiatrist and a psychologist?
- What are some disorders that a psychiatrist can treat?
- How online psychiatry works
- Online psychiatry vs. in-person psychiatry
- How we evaluate health service companies
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This guide, like all health-related content on this website, is thoroughly vetted by one or more members of our Medical Review Board for accuracy. Additionally, we extensively analyze each health-related service we review. We evaluate the entire customer experience from signing up use of the product or service, and then offer unbiased, marketing-jargon-free analysis based on the latest scientific evidence and medical standards.
Modes of communication
While contact with a psychiatrist through conventional routes is usually through a routine in-office appointment, online psychiatry offers a range of ways to contact your therapist. All platforms offer video calls as standard for a remote consultation, but some also have the option of voice calls, live chats or a messaging system. Choosing the modality that works best for you is likely to lead to faster progress.
An advantage of online psychiatry is that you don’t have to travel to your therapist’s office. This means it is easier to access different doctors and find one with whom you’re comfortable.
Psychiatrists need to be based and licensed in your state in order for them to provide diagnoses or prescriptions. On some platforms it is possible to view a directory of the doctors available in your state; choosing a provider that has a good number of doctors increases your chances of finding a therapist who works well with you.
Online psychiatry is usually cheaper than in-person therapy, but the pricing and structure vary across platforms. Some platforms work on a subscription basis, where a monthly payment covers a certain amount of contact with the therapist, while others are based on a per-visit price.
In addition to the price per visit, you should consider the length of the sessions offered to make sure it fits with your expectations.
Some online therapy providers can accept insurance and health plans to cover or contribute towards the costs of their services. If you have insurance, it’s a good idea to check if your particular program is listed with each platform so you know what is covered before you sign up.
The sign-up process for each provider is different, but often starts with inputting your data into a form or questionnaire. The amount of information you have to provide varies: for services that include diagnosis and prescription, you will need to provide your full name and address details but for some other therapies it may be possible to just use a nickname and not provide any identifying information at all.
The platform will undertake a process through which you are matched to a therapist who is licensed to work with you and can help you meet your objectives.
- On some platforms this is performed by an algorithm based on a questionnaire you complete
- Other platforms have a human element through live chat with a member of staff to better understand your needs
- In some cases there is a directory you can browse to select the doctor you prefer.
Privacy and confidentiality
Licensed psychiatrists are bound by state and national laws related to privacy and confidentiality of your data and clinical information. Additionally, all online telehealth platforms are obliged to follow HIPAA regulations to ensure the security of your data. The amount of personal information you have to share depends on the platform, some allowing you to even use a nickname for therapy sessions in order to avoid sharing identifying information. However, for your online psychiatrist to be able to prescribe medication or to coordinate with your PCP, it will be necessary to provide your personal information. This is a difference between online psychiatry and the types of online counseling in which prescriptions are not offered.
One of the best-known platforms in online therapy and counseling, BetterHelp connects patients with a variety of licensed and experienced counselors and therapists, including psychiatrists. They are our Editors’ Choice for best online therapy for most people, for a variety of reasons. (You can learn more about the broader landscape of therapy by visiting our guide to the best online therapy.)
BetterHelp counseling works on a subscription basis, for unlimited contact with your designated counselor. This includes written messages as well as live sessions, which can take the form of text chats, audio and video calls. Subscriptions are charged monthly or quarterly, at a rate working out between $40 and $70 a week. The platform does not accept insurance but offers significant financial aid discounts for qualifying patients.
All BetterHelp counselors are based in the United States, but the service is available worldwide. For continuity, you will work with the same therapist throughout your treatment. If you are unhappy with your therapist, you can request to change at any time.
While you can state during the application process the kind of help you are seeking, you cannot specifically request to be matched to a psychiatrist unless you utilize an often-overlooked feature: the “Find a Therapist” tool at the bottom of the BetterHelp website. (Check out our full BetterHelp review for more information about this.)
Diagnoses and prescriptions?
Once matched to psychiatrists on the BetterHelp platform, they will be able to perform counseling and behavioral therapy for you. However, they are currently not permitted to make diagnoses or prescribe treatment directly through the platform.
At one time, there was a fairly convenient path available for BetterHelp patients to get a prescription. If a BetterHelp therapist determined that you could benefit from a prescription medication – for instance, in order to treat depression or anxiety more effectively – then in many U.S. states the therapist was able to connect you with a prescribing psychiatrist through a telemedicine company called Brightside. Brightside would have been able to prescribe medication to about 75% of the U.S. population, covering the following states:
- New Hampshire
- New Jersey
- New York
- South Carolina
- West Virginia
However, this relationship no longer exists. So while we consider BetterHelp to be the best overall for online therapy, it is not the right path for those needing to see a psychiatrist who can prescribe medication.
- Very affordable monthly subscription for unlimited contact, rather than pay-per-session.
- Financial aid offered to qualifying patients.
- Easy to change counselors if you are unhappy.
- Can see therapists of different backgrounds, including psychiatrists
- Service available worldwide.
- The best flexibility in how to interact meaningfully with your therapist – through messages, voice or video calls.
- Free 7-day trial.
- Psychiatrists cannot directly prescribe medication.
- Referring relationship with Brightside no longer exists.
With some of the most affordable and flexible online therapy service, BetterHelp is our top choice for online therapy in 2020 for a multitude of reasons. Right now it is not possible to access full psychiatry services – diagnoses and prescriptions – directly through the BetterHelp platform. If that is what you sense you need, we still encourage you to try BetterHelp for ongoing, valuable therapy. You can try it for a week for free! We predict you will find it valuable. And your BetterHelp therapist can likely help you determine whether you need to see a psychiatrist separately.
Talkspace has been offering online therapy since 2012. In 2018 they launched a psychiatry service, covering everything from initial consultations to prescription management.
Unlike other platforms, the Talkspace sign-up process begins with a live chat with a matching agent who can answer any questions you have and provide you three options of psychiatrist or psychiatry-specialized nurse practitioner for you to choose from. Many patients find this process has a more personal touch than just completing a questionnaire.
All sessions with the psychiatrist are performed through video chat. This emphasis on video is very valuable here, and something that isn’t really the case with Talkspace’s non-psychiatric therapy service. The psychiatric video chats are hosted on the Talkspace app, which is available for all smartphones and tablets; currently it is not possible for these video calls to be done on your computer.
Talkspace psychiatry services operate on a pay-per-visit setup, with the initial consultation costing $199 and follow-up appointments costing $125. Talkspace partners with certain insurance and Employee Assistance Program providers to cover the costs of some of their services. As a pay-per-visit service, Talkspace psychiatry isn’t intended to be as much about ongoing mental health counseling as it is about getting a prescription and discussing the prescription as needed; Talkspace recommends its Talkspace therapy program for those who seek ongoing counseling.
All Talkspace practitioners are based in the US and you will be matched with one who is licensed in your state. By default you will consult with the same psychiatrist as needed throughout your treatment, but can change psychiatrist if you request. Talkspace services are not available outside of the US.
- Talkspace psychiatrists prescribe medication as needed.
- Matching patient to provider is done by a person, not an algorithm.
- The patient makes the final decision of which doctor to see.
- Accepts some insurance and health plan providers.
- Initial consultation is cheaper than many telemedicine providers.
- Follow-up appointments are expensive, which can make the service less cost-effective in the long-term.
- Only video consultations offered.
- Consultations via app on phone or tablet with limited screen size.
Talkspace offers online psychiatry services with the human touch of being able to talk to a member of staff during the sign-up process and allowing the patient to choose between a few doctors. The initial consultation ($199) offers good value and overall Talkspace provides a very convenient service, but long-term it can become less of a cost-saving opportunity compared to in-person, traditional methods. The best way to keep this convenient and cost-effective is to rely on it only when needed for medication reasons, which is the basic intent; those seeking more ongoing counseling attention ought to subscribe to an additional program on top of this.
MDLive Behavioral Health was established in 2014, offering psychiatric care as well as counseling. In 2017, they became the first platform to offer telepsychiatry in all 50 states.
Patients usually start with counseling and are then referred to one of the MDLive psychiatrists in addition to a counselor if needed. When signing up for psychiatric services, patients are able to select the psychiatrist they would prefer, based on a psychiatrist’s online profile on the MDLive directory. Some patients like the autonomy that this gives them, compared to being automatically matched with a doctor. It is usually possible to schedule the first session for the same week.
MDLive psychiatry consultations are conducted via video or audio call and last between 15 minutes and one hour. The first visit costs $284 and follow-up appointments are $108. MDLive partners with a number of insurance and health plan providers so it is worth checking if your treatment will be covered.
- Long-established and reputable company.
- The patient selects a doctor from a directory, which some prefer.
- Can consult by phone or video call.
- Accepts a range of insurance and health plans.
- Follow-ups are cheaper than some competitors.
- Sessions can last longer than minimal 15 minutes as needed.
- A much more expensive first consultation cost than other providers like Talkspace.
MDLive wouldn’t be our top recommendation for someone who has never tried online psychiatry, because the initial fee is so high. However, the low follow-up pricing and the comparatively generous session durations (as needed) make MDLive a solid long-term option for people who have already tried online psychiatry before and know that this telemedicine process works well for them.
Teladoc offers remote psychiatrist consultations as part of their mental health services. The sign-up process involves quite a long form with your personal information and insurance or health plan information. You select which type of provider you want to connect with, and are then provided with a directory of doctors in order to make your choice.
Teladoc’s consultations occur by phone or video. Initial sessions are typically between 45 and 60 minutes long, while follow-up psychiatry appointments are shorter. Teladoc accepts a number of insurance and employer health plans but you can also access the services as a self-pay patient. The first visit costs $229, and follow-up appointments are $119 for self-pay patients, or under $99 if covered by your health plan.
The Teladoc system usually schedules you with the same doctor throughout your treatment for continuity. However, if you would like to switch you can request to do so.
- Accepts a range of insurance and health plans.
- Patients choose doctors from a directory.
- Can consult by phone or video call.
- Health plan coverage makes the follow-up consultation prices more affordable
- Relatively high follow-up consult price for self-pay patients.
Teladoc provides telepsychiatry through phone and video call, allowing the patients to select the doctor they wish to see. The pricing structure can be relatively expensive in the long-term for self-pay patients, but Teladoc works with a range of insurance and health plans that may be able to cover the costs.
Amwell offers online psychiatry within the US. Once you input your data, the Amwell platform presents you with options of psychiatrists who are licensed to work in your state. Some patients like the freedom to select their provider, while others feel that this step took a lot of time.
Amwell psychiatry appointments happen via live video sessions. In the event that there are technical difficulties with the video platform, an audio call is the back-up plan.
One fairly unique aspect is that the video platform supports three-way video calls, meaning the patient can invite a family member or partner to join some sessions if it would be helpful. Additionally, Amwell’s video interface allows you to hide your own face from your view, which is comforting for some people who find it distracting to see themselves while talking with someone else.
The first session with the Amwell psychiatrist is 45 minutes long and costs $269; follow-up appointments are 15 minutes and cost $99. Amwell works with some insurance and health plans, so the costs of your treatment may be covered by your plan.
The psychiatry offered by doctors through Amwell does not include psychotherapy, but your psychiatrist can refer you to an online counselor or psychotherapist within the Amwell network if talk therapy and behavioral therapy would be useful for your condition.
Amwell offers a collaborative psychiatry set-up in which the psychiatrist coordinates with your primary care provider, with your consent. This ensures oversight of your medications. Amwell’s system also enables the psychiatrist to recommend prescription of controlled drugs by the PCP – medications they are unable to prescribe to you remotely – as well as requesting lab tests and other diagnostics.
As psychiatrists can only work within the state where they are located and licensed, Amwell offers that you can update your location if you are out of your normal state and connect to a new psychiatrist who is licensed in the state where you are temporarily located.
- Low follow-up appointment cost compared to other providers.
- Collaborative approach with the patient’s PCP, which facilitates great care and the prescription of a wider spectrum of medications if needed.
- Platform supports three-way video sessions so family members can join.
- Works with insurance and health plans.
- Short follow-up sessions.
- Initial consultation is more expensive than some providers like Talkspace.
Amwell’s telepsychiatry services could be the most affordable long-term solution for people without insurance, thanks to the low follow-up appointment cost. The company prioritizes a collaborative approach, involving the patient’s PCP with permission and facilitating for family members to join the psychiatry sessions if needed.
While psychiatrists and psychologists are both professionals who help patients in the field of mental health, there are significant differences between the two roles.
Psychologists usually have a doctorate degree in psychology (either a PhD or a PsyD) and internship training for several years to acquire their license. They work in the field of psychotherapy and behavioral intervention. They do not diagnose psychiatric conditions and, since they are not medical doctors, they cannot prescribe drugs. They can refer you to a doctor as needed.
Psychiatrists, by contrast, are medical doctors with a further specialization in psychiatry and mental health. They can diagnose and prescribe medication for psychiatric conditions. Some psychiatrists also provide psychotherapy, in the same way that psychologists do, or they may work alongside a counselor.
Psychiatrists are licensed to diagnose and treat mental illnesses and psychiatric disorders. An online psychologist can help with the following conditions:
- Anxiety and panic disorders
- Bipolar disorders
- Medication management
- Personality conditions
- Substance abuse
- Trauma and PTSD
Online psychiatry is not suitable for patients with a severe diagnosis or emergency situations. If you or someone you know is in an emergency situation, please call 911 or the National Suicide Hotline: 800-273-TALK (8255).
The first step to starting online psychiatric care is to sign up on the platform. Whichever provider you choose for your treatment, you will need to input a certain amount of information about yourself and your objectives for treatment. Usually there is a short form or questionnaire to complete. Some platforms also have an additional stage of discussion with a qualified member of staff to identify your priorities and ensure you are matched to the most suitable doctor.
Once connected to your doctor, you will be able to make an appointment to consult with them virtually. With most online psychiatrists, you can make your first appointment within a week of signing up to the service. Consultations usually occur through video calls, although some platforms support phone or live chat consultations. No special equipment is needed – just your phone or computer and an internet connection.
In your appointment, your psychiatrist will be able to discuss your condition with you and, for platforms that provide full psychiatry services, make diagnoses and prescribe medications. With your consent, the psychiatrist can coordinate with your primary care provider if it would help your condition – for instance, to recommend diagnostic tests or controlled drugs that cannot be prescribed remotely.
You will usually continue to consult with the same psychiatrist throughout your treatment, in order to provide continuity of care as opposed to starting over each session with a new doctor who doesn’t know your history. However, if you are unhappy with your psychiatrist, most platforms make it easy for you to switch to a different doctor.
The idea of consulting a psychiatrist online may be daunting. Some patients worry that they won’t be comfortable opening up to a therapist through a virtual connection. For a growing number of people, however, the idea of seeing a psychiatrist from the comfort of their own home without having to commute to the therapist’s office or juggle childcare is a huge plus.
Online psychiatry tends to have an easier start-up process, enabling patients to get the help they need faster than the conventional in-person system. Many platforms can get new patients their first online appointment within a week, compared to a two-month referral process through the primary care physician.
Remote care has been found to be particularly useful for some groups of patients who have difficulty accessing in-person services. This includes:
- People living in remote areas that make travel to the nearest in-person provider more cumbersome.
- Patients with physical limitations or anxiety disorders.
Overall there are fewer missed appointments with online psychiatry compared to in-person psychiatry.
Psychiatrists need to be licensed to practice in your state in order to treat you and prescribe medication. This means that people who often cross state lines, for example for work, can only access their psychiatrist when in their home state. Some online psychiatry platforms allow you to consult with an alternative psychiatrist if you are away from home, but this means a loss of continuity.
Another aspect making online psychiatry more accessible than conventional face-to-face appointments is the cost. An initial in-office consultation with a psychiatrist usually costs around $400, whereas the equivalent from an online provider can be as low as $199.
Nevertheless, there are some situations in which in-person psychiatry is more appropriate. As most providers state, online psychiatry is not suitable for emergency situations or patients with severe diagnoses. Most also only offer services for patients over the age of 18.
Although online psychiatrists can prescribe a range of medications, under current law they cannot prescribe “controlled” drugs, as these are federally regulated and can only be prescribed by a doctor who has met you in person. Controlled psychiatric drugs include:
- Opiates such as morphine, oxycodone, vicodin, etc.
- Medicinal marijuana
- Antipsychotics like Seroquel (quetiapine), Risperdal (risperidone), Zyprexa (olanzapine), etc.
- Controlled ADHD medications such as Ritalin (methylphenidate) and Adderall
- Benzodiazepines for anxiety and seizures, such as Ativan (lorazepam), Xanax (alprazolam), Valium (diazepam), etc.
- Other controlled substances like Ambien (zolpidem)
If your online psychiatrist prescribes you psychiatric medication, you should discuss with them in advance what you should do if you experience any adverse side effects from the medication, as it is possible they will not be available for consultation at short notice.
From a clinical perspective, telepsychiatry has been shown to be equivalent to face-to-face psychiatry, both in accuracy of diagnosis and efficacy of treatment. Nevertheless, a common theme is that patients show the greatest improvement when working with a doctor with whom they are fully comfortable.
At Innerbody Research, we customize our evaluation criteria depending on the type and nature of the health-related service. For health and medical services and products, we have five areas that we use for our evaluations, including:
Quality: How well does the company deliver its core service(s) to the customer? For testing services, does the company adhere to the latest and most advanced testing technologies and achieve a very high degree of accuracy? For non-testing telehealth services, is the quality of the service high enough that we would recommend it to loved ones without hesitation? If not, why not? Does the company have a high quality medical review board with oversight? Are their treatment options or products FDA-approved?
User-friendly: How intuitive and user-friendly is the service? Does the device, program, app, or website achieve a good degree of user-friendliness for its customers?
Value: Are you getting your money’s worth? Are there any hidden costs or charges? Does the company offer discounts?
Privacy: If health data is stored, will your data be stored securely? Are payments secure?
Customer support: Particularly in situations where ‘one size fits all’ doesn’t make sense, how well does the company help to make the service ideal for you?