Cost of psychiatrist visit by state

The following estimated costs are based on cash prices that providers have historically charged on average for psychiatrist visit and will vary depending on where the service is done. The prices do not include the anesthesia, imaging, and other doctor visit fees that normally accompany psychiatrist visit.

What is the purpose of seeing a psychiatrist?

Visiting a psychiatrist can help you diagnose and treat your mental or behavioral disorder. You may need to see a psychiatrist for treatment if you’ve been diagnosed with a mental health condition or personality disorder, such as bipolar disorder or schizophrenia. Psychiatrists also treat people with behavioral problems, like eating disorders or substance abuse and addiction.

What can I expect at a psychiatrist appointment?

During your psychiatrist appointment, your doctor may check your vitals, run blood tests, or conduct psychological testing to help understand and treat your condition. After assessing your mental and physical conditions, your psychiatrist works with you to create a treatment plan to help manage your health problems.

Once you are diagnosed and a treatment plan is developed, you will receive treatment during your psychiatrist appointments. Depending on your needs, this may include prescribing medications, such as antidepressants, antipsychotics, sedatives or stimulants, and mood stabilizers.

Different medications are used to treat specific mental disorders. You may also receive psychotherapy during your appointment. It’s commonly used alongside medications to manage disorders.

How long is a typical psychiatrist appointment?

The first appointment with a psychiatrist is called an intake appointment. It may last over an hour so your doctor can learn about your medical and psychiatric history. They need to know the current medications you take and any psychiatric medications you have previously taken.

They will also ask you questions and perform physical tests. Your future appointments may be shorter depending on what treatments your psychiatrist recommends.

Do psychiatrists prescribe medication on the first visit?

Once a diagnosis is made, your psychiatrist develops a treatment plan for you that may include prescribing medications. Sometimes patients attend several appointments before they’re diagnosed and given medication, while others may receive medications sooner.

What does a psychiatrist do for anxiety?

A psychiatrist may use psychotherapy and SSRI medications to treat patients diagnosed with an anxiety disorder. These medications help block your body from reabsorbing serotonin, and the excess amount helps improve your mood and lower your anxiety levels.

Psychiatrists also prescribe benzodiazepine medications that provide short-term relief to patients experiencing acute anxiety attacks. These medications can be habit forming and are only intended for emergency use.

How do I know if I need psychiatric help?

If you’re suffering from a mental health condition that is impacting your life, you may need psychiatric help. This includes sudden changes, such as feeling intense panic or fear, or more chronic conditions like depression.

If life feels overwhelming or you don’t know how to deal with your mental health problems, visiting a psychiatrist can help.

* Savings estimate based on a study of more than 1 billion claims comparing self-pay (or cash pay) prices of a frequency-weighted market basket of procedures to insurer-negotiated rates for the same. Claims were collected between July 2017 and July 2019. R.Lawrence Van Horn, Arthur Laffer, Robert L.Metcalf. 2019. The Transformative Potential for Price Transparency in Healthcare: Benefits for Consumers and Providers. Health Management Policy and Innovation, Volume 4, Issue 3.

Sidecar Health offers and administers a variety of plans including ACA compliant and excepted benefit plans. Coverage and plan options may vary or may not be available in all states.

Your actual costs may be higher or lower than these cost estimates. Check with your provider and health plan details to confirm the costs that you may be charged for a service or procedure.You are responsible for costs that are not covered and for getting any pre-authorizations or referrals required by your health plan. Neither payments nor benefits are guaranteed. Provider data, including price data, provided in part by Turquoise Health.

The site is not a substitute for medical or healthcare advice and does not serve as a recommendation for a particular provider or type of medical or healthcare.

How much does a psychiatrist cost without insurance?

How much does a psychiatrist cost without insurance?

$250 – $500 average cost without insurance (initial evaluation), $80 – $250 average cost without insurance (follow-up visit).

Kristen Cramer

Psychiatrist cost without insurance

The average cost of a psychiatrist visit without insurance is $250 to $500 for an initial evaluation and $80 to $250 for a follow-up visit. The cost to see a psychiatrist depends on your location, whether you see an MD or psychiatric nurse practitioner, and the treatment type and tests received.

Average cost to see a psychiatrist - Chart

Initial consultation & evaluation

An initial consultation with a psychiatrist costs $250 to $500 without insurance and lasts 45 to 90 minutes on average. During this visit, the psychiatrist will ask questions to learn more about your medical and family history, mental and physical symptoms, and concerns.

The psychiatrist may also prescribe lab work or additional psychological assessments to help them make an accurate diagnosis.

By the end of the first or second visit, the psychiatrist will provide a diagnosis and develop a treatment plan. The treatment may include medications, therapy, lifestyle changes, or a combination of these approaches. The psychiatrist may also refer you to other specialists if needed.

Follow-up visit

A follow-up visit with a psychiatrist costs $80 to $250 without insurance. These visits are typically shorter than the initial evaluation, lasting 15 to 30 minutes , depending on the treatment plan.

During follow-up appointments, you'll discuss how you're doing, how the medications are working, whether to change medications or adjust the dosages, and how any other prescribed treatment methods are progressing. The psychiatrist will make changes to the treatment plan if needed.

Additional costs

Depending on the diagnosis and treatment plan, you may also encounter additional costs for other testing or treatments, including:

Prescription medications

Lab work and other physical health tests

Cognitive Behavioral Therapy (CBT), Interpersonal Therapy (IPT), or behavioral therapy

Eye Movement Desensitization and Reprocessing (EMDR) therapy

Biofeedback or neurofeedback therapy

Genetic testing

Psychiatrist cost with insurance

The cost of a psychiatrist visit with insurance depends on the insurance plan, coverage terms, and the individual psychiatrist's rates. These factors impact your out-of-pocket cost:

Co-pay – A co-pay is the flat fee you must pay to visit a healthcare provider. The amount varies from free to $100+ , depending on the insurance company, plan, and type of treatment or service.

Coinsurance – Some plans require patients to pay a coinsurance amount instead of a co-pay. The coinsurance amount is a percentage of the healthcare provider's total visit fee.

Deductible – A deductible is the minimum amount you must pay out of pocket before your insurance covers any medical costs. If you have not met your annual deductible, you'll be responsible for paying the full cost of the visit and any additional treatments the psychiatrist prescribes.

In-network vs. out-of-network – A visit with an in-network psychiatrist costs much less than seeing an out-of-network provider that doesn’t partner with your insurance company.

Referral – Some insurance plans require patients to get a referral from their primary care physician before seeing a specialist. If you need a referral to see a psychiatrist, you'll pay a standard co-pay or coinsurance fee to see your primary doctor first.

A woman talking with a psychiatrist

What is a psychiatrist?

A psychiatrist is a licensed medical doctor (MD) who specializes in diagnosing and treating mental health conditions, emotional disorders, and behavioral disorders. Psychiatrists can order a wide range of medical tests and psychological assessments to help them make a diagnosis and determine the best treatment approach.

When to see a psychiatrist

Consider seeing a psychiatrist if you're suffering from a mental health condition that negatively impacts your life, such as feeling sad all the time, experiencing panic attacks, having difficulty focusing, or dealing with an eating disorder.

Psychiatrists commonly diagnose and treat these conditions and more:

Depression or apathy

Thoughts of suicide or self-harm

Anxiety or panic attacks

Attention Deficit Hyperactivity Disorder (ADHD) / Attention Deficit Disorder (ADD)

Eating disorders, including Binge Eating Disorder, Anorexia Nervosa, and Bulimia Nervosa

Autism Spectrum Disorder (ASD)

Bipolar Disorder

Obsessive-Compulsive Disorder (OCD)

Post-Traumatic Stress Disorder (PTSD) or Complex PTSD


Insomnia, nightmares, or other sleep problems

Substance abuse or addiction

What is the difference between a psychiatrist and a psychologist?

A psychiatrist is a medical doctor and can prescribe medication. A psychiatrist conducts an evaluation, makes a diagnosis, and develops a treatment plan that may include medication, therapy, or other approaches. However, many psychiatrists don't offer talk therapy and will refer you to a psychologist for that service.

In comparison, a psychologist is not a medical doctor and cannot prescribe medication. Psychologists and licensed therapists can diagnose disorders like depression, anxiety, eating disorders, or phobias and provide talk therapy, cognitive behavior therapy (CBT), and other psychotherapy treatments.

Most doctors recommend seeing both a psychiatrist and a psychologist to address your condition medically and through psychotherapy.

Factors that affect the cost of a psychiatrist visit

Insurance coverage has the biggest impact on the cost to see a psychiatrist. If you have insurance that covers psychiatric treatment, you'll be responsible for only the co-pay or coinsurance amount after meeting your annual deductible. Individuals without insurance must cover the entire cost out of pocket.

Other factors that impact the cost include:

Psychiatrist's experience – Psychiatrists with additional training and education or an established clinical practice often charge more than new psychiatrists due to the higher demand for their services.

Specialty – Psychiatrists who specialize in treating certain conditions often charge more but are more familiar with the symptoms and challenges that come with those conditions.

Psychiatrist vs. psychiatric nurse practitioner – Psychiatrists typically charge more than nurse practitioners. Both can make a diagnosis, prescribe medication, develop a treatment plan, and order lab work or other tests. However, some states require nurse practitioners to work under the supervision of a psychiatrist.

Location – Psychiatrists' hourly rates are highest in major metropolitan areas like New York City and Los Angeles. Though most psychiatrists now offer virtual appointments online, regulations limit doctors to treating patients located within states where they are licensed to practice.

How to find an affordable psychiatrist

Many healthcare providers offer other options to make psychiatric treatment more affordable. Look for these ways to save money:

Discounts & cash-pay prices – Ask if the psychiatrist offers reduced rates for uninsured patients or individuals with high-deductible insurance plans. Some psychiatrists offer discounts if you are paying out of pocket for the full cost of the visit.

Sliding-scale rates – Some mental health practitioners offer sliding-scale rates based on income for uninsured patients. Ask your psychiatrist about this option, as many practices offer it, but don't mention it on their website.

Prescription discounts – To save money on prescription costs, look for discount cards from the pharmaceutical company or opt for generic medications when available.

Low-cost clinics – Clinics in some communities offer mental health care at a reduced price for uninsured or low-income residents.

Student health services – Many colleges and universities provide free or reduced-cost mental health services for students.

If your condition doesn't require medication, consider scheduling an appointment with a licensed professional counselor , therapist , or psychologist , as their hourly rates are lower than psychiatrists' rates.

Psychiatrist FAQs

Can a psychiatrist prescribe medication.

Yes, a psychiatrist can prescribe medication. Your psychiatrist will determine whether medication will be beneficial for your condition, and if so, will develop a treatment plan that includes ongoing medication management.

Many psychiatric medications require titration—starting at the lowest introductory dose and gradually increasing to an effective maintenance dose—along with regular monitoring. This requires periodic follow-up visits with the psychiatrist and may also involve lab work.

Do psychiatrists prescribe medication on the first visit?

After conducting an evaluation and making a diagnosis, a psychiatrist may prescribe medication on the first visit as part of a treatment plan. However, some patients require additional assessments or lab work before receiving a prescription.

How long is a typical psychiatrist visit?

A psychiatrist visit lasts 45 to 90 minutes for the initial consultation and evaluation. The psychiatrist may ask you to fill out questionnaires and complete online or written assessments before your scheduled appointment. Follow-up sessions last 15 to 30 minutes on average.

Do you need a referral to see a psychiatrist?

Most HMO insurance plans require you to get a referral from your primary care doctor to see a psychiatrist. Many PPO insurance plans allow you to see a psychiatrist without a referral from a general practitioner. Check with your insurance provider for details.

Is a psychiatrist more expensive than a therapist?

Seeing a psychiatrist usually costs more than a therapy session because psychiatrists are medical doctors with more extensive education and training. In comparison, therapy costs $100 to $250 per session with a psychologist, therapist, or licensed mental health counselor.

How to find a psychiatrist near you

When seeking mental health treatment, it's important to find a psychiatrist who makes you feel comfortable, respected, and understood. Follow these tips to find the best psychiatrist near you :

If you have specific mental health concerns—such as depression, attention deficit disorder, or an eating disorder—look for a psychiatrist who specializes in treating that condition.

Ask your primary care doctor for recommendations.

Read reviews from other clients on Thervo and Google.

Confirm the psychiatrist accepts your health insurance.

Ask about co-pays and other treatment fees.

Schedule an initial appointment to make sure you're happy with the psychiatrist's communication style and empathy.

Questions to ask a psychiatrist

Before establishing yourself as a patient, ask the psychiatrist these questions:

What are your qualifications and areas of expertise?

Have you treated other people with this condition successfully?

What treatment methods do you offer?

Will the treatment plan involve other specialists?

What improvements can I expect, and when?

Can you prescribe medication if needed?

What are the side effects of the medication?

What happens if I discontinue my medication abruptly?

Do you accept my insurance? If yes, do you bill the insurance company directly?

Do you offer discounted or sliding-scale rates for patients without insurance?

Do you offer virtual or telehealth appointments?

Using our proprietary cost database, in-depth research, and collaboration with industry experts, we deliver accurate, up-to-date pricing and insights you can trust, every time.

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Online Psychiatrist and Medication Management (We Accept Insurance)

Woman and doctor in Telemedincine video call

Online Psychiatry

Get evaluated and review treatment options with top-rated psychiatrists who can help determine if medication would be the most effective treatment for your mental health. We accept most insurance plans.

For: Men, Women, Ages 18+ (Under 18 with parental consent)

Online psychiatry, evaluations & medication management

Online psychiatry is ideal for patients who want a prescription refill , a psychiatric evaluation, or even an initial diagnosis.  Our diverse and top-rated psychiatrists can help build a plan for ongoing therapy,   medication management, and work to deliver the best possible outcome for your mental health.

Doctor On Demand is a covered benefit for over 98 million Americans. If you're covered by your employer or insurance, then you could pay $0.

For patients who do not have insurance, psychiatry visits start at $299 per initial 45 minute consultation and $129 for 15 minute follow-ups.

Minimum wait time

Make an online appointment with us and we’ll connect you with a psychiatrist within a few days.

We accept most insurance plans; however, it’s not necessary to have insurance. Virtual appointments are generally less expensive than face-to-face appointments.

Qualified and highly rated

Our licensed psychiatrists have over 15 years of experience on average with an app store rating of 4.9 out of 5.

Diverse & compassionate psychiatrists

Our mental health professionals provide an inclusive care environment.

Specialty psychiatrist

Find a doctor who specializes in specific issues like anxiety, depression, relationship issues, PTSD, trauma, stress, and more.

Get psychiatry anywhere, anytime—from your phone, tablet, or computer.

Custom treatment plan

Get the right treatment option and prescription for your unique care needs.

We are HIPPA compliant , adhere to strict confidentiality codes, and keep your information safe and secure.

Woman having a telemedicine appointment on her laptop

Our psychiatrists can prescribe evidence-based medications including:

  • SSRIs (such as Zoloft, Lexapro, Prozac).
  • SNRIs (such as Cymbalta, Effexor).
  • Wellbutrin, Buspar, Trazodone, Abilify, Strattera.
  • Any medication that is determined by your psychiatrist to be appropriate for your symptoms and is not a controlled substance. 

Please note: our online psychiatrists are not able to prescribe controlled substances. Common controlled substances include Xanax, Klonopin, Lunesta, Adderall, Ritalin, and more.

What do we treat

Our psychiatrists can help diagnose your symptoms and assist with medication management. They also treat common mental health conditions including: 

anxiety & depression

bipolar disorder

borderline personality disorder

eating disorders

and more. 

doctor on demand doctor having a live virtual session with a patient on a phone

Set up your account by downloading our app.

Once you finish registering, you’ll be able to see the cost of your visit, browse clinicians, book a visit, and more.

number 2

Schedule an online psychiatry consultation.

Find a time that works best for you with doctors available seven days a week.

number 3

Begin treatment with an online psychiatrist.

Meet with one of our board-certified psychiatrists who will diagnose your symptoms and offer a custom treatment plan. Be sure to set up a follow-up visit, so you can stay on track with your plan.

This is a great service, it uses my insurance so I'm only paying like 4 dollars for a visit to get care and certain prescriptions and its even better for psychiatric care much cheaper than in-person and allows you to get treatment without going into major debt to get help. They even have counseling on here as well. I highly recommend it and others in my household use it and with their insurance it's free. I very much appreciate the people who made this app and put the work into it because it has helped me a lot both physically and financially and mentally.

—Emma F.

Five stars

Doctor On Demand has been incredibly helpful. From counseling and psychiatric appointments, to cold/flu and maintenance medication refills. Being able to set an appointment and meet over the phone has saved me a lot of time and pay I would have lost sitting in waiting rooms. Drs have all been fantastic and very kind! Highly recommended Doctor On Demand!

—F. Mcallen

I use Doctor On Demand for my Mental Health Care. I see an awesome Psychiatrist, Dr. Audrey Jain and a wonderful therapist Carolyn Morgan. They are both excellent providers. I had a long, hard time finding mental health care. I struck gold with Dr. Jain and Carolyn. They are compassionate and caring.

—T. Cape

“I love Doctor on Demand! I work full time and am a mom of two. I find it hard to schedule in-person doctor visits due to conflicting schedules and finding childcare, but Doctor On Demand makes it so convenient and simple for me to schedule appointments for myself. Because of Doctor On Demand, I am able to have primary care, therapy, and psychiatry visits all at the tips of my fingers!” —Kelcey

“I use Doctor On Demand whenever I feel like I need guidance on my medical care or a prescription for a temporary problem that would otherwise send me to urgent care. This is the second time I’ve had the same doctor; they are helpful, friendly, honest and have a great bedside manner. I use them for therapy as well when I need to check in. Highly recommended and good in a pinch! —Dayna

How much does an online psychiatry visit cost? 

It can cost anywhere between $0 and $299, depending on your insurance. If you’re covered by your employer or insurance, you could pay $0. Sign up now to find your cost.

Psychiatrist appointments without insurance:

  • $299 for initial 45 min consultation
  • $129 for 15 min follow-up

How long are the online psychiatrist sessions?

An online psychiatrist initial session is 45 minutes. There are 15 minute follow-up appointments also available.

Am I able to switch my psychiatrist?

Yes, of course. Let Doctor On Demand know that you’d like to switch to another psychiatrist, and we can find you another psychiatrist who’s right for your needs.

Can an online psychiatrist prescribe medication?

Yes, our online psychiatrists can prescribe the full range of psychiatric medications such as Zoloft, Lexapro, Prozac; however, they are not able to prescribe controlled substances such as Xanax, Lunesta, Adderall, Ritalin, and more.

What are common types of online psychiatry visits?

Some common types of psychiatry visits include cognitive behavioral therapy (CBT), psychodynamic therapy, dialectical behavior therapy (DBT), humanistic/experiential therapy, and more. Sometimes a c mbination of therapy and medication works best. In that case, patients see a psychiatrist for medication management and a therapist for talk therapy. If you’re not sure, start with a therapist who can help you figure out what treatment may be best for you.

What types of mental health providers are available?

The Doctor On Demand behavioral health practice includes psychiatrists, psychologists,  and masters level therapists. Psychologists and psychiatrists both have doctoral degrees, usually a PhD or PsyD for  psychologists and an MD or DO for psychiatrists. Our masters level therapy clinicians have masters degrees in social work or family and marital counseling.

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What Is A Psychiatrist And How Much Does One Cost?

Whether you’re seeking mental health services for a mental health condition or are trying to find the best care for your loved one, you may be wondering how much you can expect to pay for certain care and services. The mental health world involves a variety of professionals, one of whom is a psychiatrist. Below, we’re going to cover what type of care psychiatrists provide and answer the question How much does a psychiatrist cost?

What is a psychiatrist?

A psychiatrist is a healthcare provider who is both a medical doctor and a mental health professional. They have the same training and knowledge as a general practitioner but chose psychiatry as their specialty. Psychiatrists focus on diagnosing and treating mental, emotional, and behavioral disorders.

While psychologists can also diagnose and treat mental, emotional, and behavioral disorders, they cannot prescribe medications in most states in the US. 

Why would an individual choose psychiatry? 

Those struggling with mental health concerns may be referred to inpatient or outpatient mental health services, where a psychiatrist can assess symptoms and potentially diagnose an underlying medical condition. In addition to challenges associated with mental health, problems related to your physical well-being can arise out of a mental or behavioral disorder. Because of their training and expertise, psychiatrists can assess and treat both mental and physical health concerns, though they may work with other physicians to address the latter. 

After a psychiatric evaluation, a psychiatrist may prescribe medication, and they may refer you to a therapist or psychologist if they believe therapy will be helpful. They can work with you to create a comprehensive plan for treatment and recovery.

Psychiatric care may be appropriate for any number of mental health disorders, including depression and anxiety disorders, substance use disorders, eating disorders, and behavioral disorders. They may also address physical symptoms related to these conditions or symptoms. 

Different mental illnesses often require different treatment plans. After a psychiatrist completes psychological testing and diagnoses a mental illness, they may help you develop a comprehensive treatment plan, whether it includes medication, psychotherapy, or a combination approach. Medication may not be effective or preferred by every client. In some cases, a psychiatrist may refer the patient’s care to another licensed mental health professional. 

The BetterHelp platform is not intended for any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional.

How much does a psychiatrist cost?

If you’ve decided to pursue psychiatric services, you may be wondering, How much does a psychiatrist cost? 

The cost of working with a psychiatrist can depend on where you live, your insurance, and your treatment requirements. In addition to an appointment fee, you may also be asked to pay for specific types of treatments, tests, or lab work. The average psychiatrist cost without insurance generally falls somewhere between $100 and $300 per appointment. You may pay up to $500 for the initial consultation and roughly $100 an hour thereafter for follow-ups. This fee involves the out-of-pocket costs without insurance.

To work with a psychiatrist, call them beforehand and talk with their staff to figure out what your costs could be, including any tests you might benefit from. In some cases, a psychiatrist may work with you to make your visits more affordable. Speaking to your doctor ahead of time can also help you identify potential cost-saving treatment alternatives and develop a payment plan. If you’re well-prepared, you might find ways to save.

How can I afford a psychiatrist?

When you decide to visit a psychiatrist, consider the time and education they put into obtaining their professional license. Most psychiatrists spend four years completing a bachelor's degree, four years in medical school, and four years in a residency program. For that reason, care is often not cheap. However, you can find ways to make visiting a psychiatrist more affordable.

Use your health insurance for a psychiatrist

If you have health insurance, check to see if your coverage includes a form of mental health coverage. Your insurance may require you to get a doctor’s referral for treatment from a psychiatrist. Referral costs are a common part of the healthcare continuum in the US. In addition, your plan may only cover a certain number of visits per year, and certain psychiatrists may not be covered under your plan. 

If your health insurance plan covers psychiatric visits, ensure the psychiatrist you choose is in your insurance network before scheduling an appointment. If you need help finding an in-network psychiatrist, you can contact your insurance provider.

Ask about sliding scales to reduce psychiatry costs

Not all health insurance plans cover psychiatric treatment. If your insurance coverage does not offer robust mental health care coverage, there are other options you can take to meet with a psychiatrist.  

Some community mental health clinics and the occasional psychiatrist may offer sliding scale fees. In these plans, the amount you are charged depends on your income. Those with a higher income may pay a higher fee, and those with a lower income may pay a lower fee. If you’re worried that your income may not be adequate to afford services, ask your doctor about this option.

Look for reduced-cost mental health services in your area

In some places, there are clinics that operate at an overall reduced cost so that people with low incomes or no insurance can afford their services. Though they may offer low-cost appointments, you might have to wait to get on their schedule.

How you can save on your prescriptions

If your treatment plan includes a prescription, you may be able to cut costs. Some people opt for less expensive generic versions of name-brand medications. If you’re interested in opting for a generic version, talk to your doctor and pharmacist. 

Sites like GoodRx may show you how much your medication will cost at different area pharmacies so that you can compare costs and select options. They might also offer prescription discounts that aren’t connected to your insurance.

Consider working with other mental health professionals

While you may work with a psychiatrist to diagnose your condition and potentially receive prescription medication, you can also consider working with other professionals after you receive your treatment plan. For example, if you’re living with a behavioral disorder like ADHD, a psychiatric nurse practitioner may provide more affordable—though no less comprehensive—services than a psychiatrist. 

Some psychiatrists might refer you to other mental healthcare providers and collaborate with them by continuing to prescribe medication and discuss your treatment plan. If psychotherapy is part of the plan, you may explore working with a licensed professional counselor, licensed clinical social worker, or other appropriately trained professional. You can also explore online options to find a more affordable option.

Support options 

Working through a mental health challenge and living with mental illness can be challenging. Help is out there, even if it takes some time to find a treatment option that’s right for you. While working with a psychiatrist can be helpful, it’s not the only way to treat or manage mental illness.  Online therapy  could be a valuable option if the hassle of or cost of attending in-person appointments prohibits you from receiving support. 

Research suggests that online cognitive-behavioral therapy (CBT) can be  as effective  as in-person therapy for managing symptoms of depression. Additional studies suggest that therapy combined with medication is often a more  effective treatment  method for anxiety and depressive disorders than medication alone.

Frequently asked questions (FAQs) 

Below you can find examples of frequently asked questions to discuss with your counselor.

Do you need a referral to see a psychiatrist?

No. If you’re having mental health concerns and you would like to see a psychiatrist you don’t need a referral. However, some people do receive referrals from their primary care doctors when mental health challenges are discovered during routine visits or checkups.

Can a psychiatrist prescribe medication on the first visit?

Yes. A psychiatrist is a licensed medical professional that can prescribe medication. If your psychiatrist believes you would benefit from medication based on your session, they may prescribe the best medication for you based on their findings. This process is often the same — even if this is your first visit.

What medications do psychiatrists prescribe for anxiety?

Psychiatrists and medical professionals prescribe antidepressants and anti-anxiety medications to treat anxiety and its related conditions. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed medications for anxiety. Serotonin-norepinephrine reuptake inhibitors are another example of a class of medications prescribed to treat anxiety and depression. These medications can change how serotonin is absorbed or in what concentrations it exists in the brain. 

What would you see a psychiatrist for?

People visit psychiatrists for various challenges with moderate to severe mental illness and symptoms of stress or sleep disorders. Psychiatrists prescribe medication for clients and make referrals for counseling and therapy as an extension of treatment.

What happens at your first psychiatrist appointment?

When you visit your psychiatric provider for the first time, they may provide psychiatric support and advice in the form of a treatment plan. Your treatment plan outlines what methods, medications, and psychotherapy techniques are used during the course of mental health treatment.

What does a psychiatrist do for anxiety?

When you visit a psychiatrist for anxiety, you may receive a diagnosis, a recommendation for psychotherapy services, and medication if your condition is moderate or severe. Your psychiatrist may recommend therapy sessions with a licensed provider to mitigate anxiety symptoms.

What happens during a psychological evaluation?

During a psychological evaluation, your mental health provider may ask you a series of questions about your history. Based on how you answer the questions about your life, history, experiences, and events, your provider can make an assessment or diagnosis.

Can a psychiatrist diagnose?

Yes. A psychiatrist is a licensed medical professional, like a primary care physician, who can diagnose and treat mental illness and other mental health-related issues. A psychiatrist is also licensed to write prescriptions for mental health medications.

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How Much Does a Psychiatrist Cost Without Insurance? 7 Key Questions Answered

psychiatry visit cost

Team Curative

Apr 26, 2022

Not feeling your best mentally? Whether it’s a general lack of motivation or something more serious, rest assured that you’re not alone. Mental health problems are common amongst Americans, with  nearly one in five adults  having experienced some form of mental illness in 2020.

To get help with your mental health, you might be interested in seeing a psychiatrist—a doctor who specializes in diagnosing and treating mental health problems. But if you’re on a budget and you don’t have insurance, you may be wondering, “How much does a psychiatrist cost without insurance?”

This page answers that question and helps you understand the broader picture of the costs associated with seeing a psychiatrist. By the time you’re done reading, you’ll have all of the information you need to see a psychiatrist for as low of an out-of-pocket cost as possible.

In the future, be sure to work with a trustworthy insurance company that puts the mental well-being of the patient first. A streamlined digital-first approach to managing and accessing mental healthcare services means you can get the care you need, when you need it, and go back to living your best life as quickly as possible.

What Does a Psychiatrist Do?

Broadly speaking, a psychiatrist is a doctor who specializes in treating mental health problems. Specifically, some of the problems psychiatrists help solve include: 

Acute ones, such as suddenly experiencing panic attacks, intrusive thoughts of self-harm, or hallucinations

Long-term ones, such as depression, anxiety, or a general lack of everyday wellbeing

You don’t need to know exactly what’s wrong before you see a psychiatrist—the right psychiatrist will guide you through a step-by-step process to get you feeling better again.

When you visit a psychiatrist, they will ask you a series of questions about your problems to try and determine what the underlying cause of your mental health problems is.

Since psychiatrists are licensed doctors, they have many different types of tests at their disposal—both physical and mental. 

For example, if a male patient is getting older and finding himself experiencing a lack of motivation, the psychiatrist may perform a physical test on the patient’s testosterone levels. Other times, mental health tests may be conducted just by the two of you talking—also known as psychotherapy.

Once again, because psychiatrists are licensed doctors, they have a very wide variety of treatment options available for patients, no matter the severity of your mental health issues.

The most common type of treatment that is sometimes paired with other treatment options is psychotherapy, which, as covered, is when you and your psychiatrist talk about your problems to try and come to a solution. 

Psychotherapy may be conducted alone with just you and your psychiatrist. It may also be performed in groups, usually with loved ones who are close to you and have a major impact on your life, if your psychiatrist feels that method of psychotherapy will be more helpful than one-on-one sessions.

Other times, if your psychiatrist determines that your problem is more severe, they may make use of other treatment options, such as prescribing you medication, to help solve your problem. Common psychiatric prescriptions include antidepressants, antipsychotics, stimulants, sedatives, and mood stabilizers.

How Much Does a Psychiatrist Cost Without Insurance btf

Regardless of the type of treatment your psychiatrist makes use of, similar to  dermatologist visits , it’s common to see your psychiatrist periodically so the two of you can review the state of your mental health and make adjustments to your treatment regimen as necessary.

How Is a Psychiatrist Different From a Psychologist?

Although the two types of mental health professionals perform similar duties (and their names even sound similar), they are not identical. Psychiatrists go through more training than psychologists and have a better understanding of the overall functions of the human body.

Another key difference is the type of treatment you will receive from each professional. Psychologists focus only on behavioral issues and make extensive use of psychotherapy (talking through problems). Psychiatrists do as well, but they are also able to prescribe other treatments like prescription pills due to their higher level of medical certification.

What Is the Cost of Visiting a Psychiatrist?

The cost of visiting a psychiatrist is variable depending on the scope of your visit and what the psychiatrist helps you with while you’re there.

To start, you’ll have to pay for the initial consultation. Unlike other industries where the initial consultation is sometimes free or discounted, a consultation with a psychiatrist is sometimes more expensive than follow-up visits. 

How Much Does a Psychiatrist Cost Without Insurance btf 2

Then, you’ll have to pay for regular visitation to your psychiatrist. Your psychiatrist will be able to make recommendations on how frequently you should be visiting.

Another key expense when it comes to psychiatry is the treatment options that your psychiatrist may want to make use of. These treatment options are not included in the cost to visit the psychiatrist—they’re extra.

How Much Does a Psychiatrist Cost With Insurance?

Even with insurance, it’s possible that your visits to the psychiatrist could result in minimal out-of-pocket expenses.

For the initial consultation and follow-up visits, you will likely receive at least partial coverage from your health insurance company. In many cases, you will be responsible only for a  copay , which is a flat fee you pay for certain healthcare services.

Some healthcare plans may put restrictions on how many times you can visit your psychiatrist in a month or year if you wish to receive coverage. If you exceed this number of visits in the specified timeframe, you may be responsible for the entire fee, not just the copay.

Treatment beyond psychotherapy, such as prescription pills, is unlikely to be covered in the flat-fee copay. These treatments will likely be billed on a  coinsurance  basis, meaning your insurance company covers the majority of the expense and you pay for a smaller percentage of it.

Keep in mind that coinsurance rates usually kick in only after your annual deductible has been met. A  deductible  is a fixed dollar amount that you need to pay out of pocket before your health insurance company begins helping out with certain healthcare costs. 

If you have not met your deductible, you may be responsible for the full cost of additional treatment beyond psychotherapy.

How Much Does a Psychiatrist Cost Without Insurance?

Without insurance, you’ll be responsible for both the full fees of the psychiatrist visit and the full fees of any treatment options your psychiatrist thinks will be helpful for you.

Each visit could cost  between $65 and $250 .

The exact cost will likely depend on the cost of living in your area. For example, visiting a psychiatrist in Manhattan—a part of New York City with a very high cost of living—will likely cost more than visiting one in a more rural area of the country that has a lower cost of living.

Regarding treatment, how much does it cost to see a psychiatrist without insurance? The cost of treatment options varies greatly. For prescription pills, a common treatment option recommended by psychiatrists, a monthly supply can run into the hundreds of dollars. For example,  commonly-prescribed antidepressants  can cost between $5 and $10 per dose, which is multiplied by 30 for a full month’s supply.

How Can I Pay Less for Psychiatric Care?

Not all Americans can afford to spend hundreds of dollars every month on psychiatric care—especially if these individuals were unable to afford private health insurance in the first place.

Luckily, there are a few options available to you if you wish to visit a psychiatrist but are  having trouble affording  either the visitation fees or the treatment costs.

Compare prices. Even in the same geographic area with the same cost of living, certain psychiatrists will charge more than others. “Shop around” by inquiring about fees from multiple psychiatrists near you.

Ask for a discount. If you don’t have insurance, some psychiatrists may be willing to reduce their rates for you. It never hurts to ask.

Inquire about sliding scales . On a similar note, some psychiatrists will offer to bill you based on your income. In other words, if you earn less, you’ll pay less for psychiatric visits, though treatment costs will likely remain static.

Look for low-cost clinics. Mental health clinics in your area can offer professional care while charging a fraction of what a typical psychiatrist’s office would.

Reduce prescription costs. Services like RXSaver can help you save on prescriptions, even without insurance. Also, if your psychiatrist prescribes an expensive medication, see if it’s possible and appropriate to use a less expensive but comparable prescription.

Alternate payment methods for psychiatry, such as  medical credit cards , should ideally be used only as a last resort. Since psychiatry costs are generally recurring, either in the form of follow-up visits or prescriptions, moving the costs to a credit card can result in significant unwanted debt.

How Can I Get Insurance for Psychiatric Visits?

In the long-term, the best way to see a psychiatrist and get help with your mental health problems is by having health insurance. No matter who you are or what your income is, you likely have at least one option to choose from.

Public Health Insurance

Public health insurance  refers to health insurance plans that are subsidized by the federal government. There are three popular public health insurance programs in the United States.

Medicare . Medicare is generally used by individuals who are age 65 or older.

Medicaid . Medicaid is generally used by individuals who cannot afford private health insurance.

Children’s Health Insurance Program (CHIP) . CHIP is generally used by families who earn too little to afford private health insurance, but too much to qualify for Medicaid. With CHIP, children in these families can receive free or discounted health insurance.

Private Health Insurance

Private health insurance refers to any non-public health insurance plan you enroll in. The most common type of private health insurance plan is a group workplace plan. A derivative of a group workplace plan is a small business health insurance plan. 

Not all private health insurance plans are the same. Some cost more than others, and some are more restrictive than others in regards to which professionals you can visit and how frequently you can visit them.

How Much Does a Psychiatrist Cost Without Insurance btf 3

For example, a health maintenance organization (HMO) is usually the cheapest type of private health insurance plan you can enroll in. However, it’s also the most restrictive. You may be restricted to visiting only a few psychiatrists in your area. If you don’t get along with any of them, you may find your health insurance plan to be less useful than you had hoped.

A preferred provider organization (PPO) is another popular type of private health insurance plan where you have more flexibility regarding the psychiatrists you can see. In some cases, you can receive coverage even if you see a psychiatrist that is outside of the approved list of medical providers of your particular health plan, which allows you to test out many psychiatrists to see which one you get along with best. This increased flexibility usually comes at the cost of a higher monthly premium.

Learn more about enrolling in a new private health insurance plan to make sure you get the best deal for you in particular. 

Before you make your final decision, make sure you’re covered for psychiatric services, and it’s also wise to check to see which prescription medications you’re covered for, as those are common treatment options recommended by psychiatrists.

How much does a psychiatrist appointment cost without insurance? It depends on where you live, but in general, expect to pay between $65 and $250 for each appointment if you don’t have insurance, which is similar to the fees a chiropractor charges. 

Remember that you will also be responsible for paying for any additional treatment options, such as prescription pills, that are not covered in the cost of the actual visit to the psychiatrist.

The best way to make use of psychiatric services is to have a reliable health insurance plan that covers psychiatric services, offers affordable copays, and provides coverage for a wide range of potential psychiatric treatments beyond psychotherapy. When you work with a trustworthy insurance company that puts the mental wellbeing of the patient above all else, it’s easy to find a psychiatrist you trust and get back to living the life you want to live.

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We’re in network with most major insurances – accepting 585+ insurance plans, covering 190 million people nationwide.

Thriveworks offers flexible and convenient therapy services, available both online and in-person nationwide, with psychiatry services accessible in select states.

Find the right provider for you, based on your specific needs and preferences, all online.

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psychiatry visit cost

How much does a psychiatrist cost without insurance? Understanding psychiatric provider rates and more

Our clinical and medical experts , ranging from licensed therapists and counselors to psychiatric nurse practitioners, author our content, in partnership with our editorial team. In addition, we only use authoritative, trusted, and current sources. This ensures we provide valuable resources to our readers. Read our editorial policy for more information.

Thriveworks was established in 2008, with the ultimate goal of helping people live happy and successful lives. We are clinician-founded and clinician-led. In addition to providing exceptional clinical care and customer service, we accomplish our mission by offering important information about mental health and self-improvement.

We are dedicated to providing you with valuable resources that educate and empower you to live better. First, our content is authored by the experts — our editorial team co-writes our content with mental health professionals at Thriveworks, including therapists, psychiatric nurse practitioners, and more.

We also enforce a tiered review process in which at least three individuals — two or more being licensed clinical experts — review, edit, and approve each piece of content before it is published. Finally, we frequently update old content to reflect the most up-to-date information.

psychiatry visit cost

  • When seeking mental health services from a psychiatric provider, cost is an important factor for many individuals—and you may also be curious about whether your care will be covered by insurance.
  • Psychiatric providers who are in-network with your insurance company will always be more affordable than one who isn’t.
  • Typically, psychiatric providers will charge between $100-500 per hour for their services, but their rates will vary depending on their experience and the services they’re providing you.
  • Compared with family doctors or psychologists, psychiatric providers may charge higher rates because they are typically considered specialists who often (but not always) work through referrals.
  • Check with your insurance company, and reach out to your psychiatric provider’s office for more clarification on what you can expect to pay after your next visit.

When you seek out mental health services, inevitably the question of cost becomes a factor. How much will you end up paying? Will your insurance cover your visits? And if you don’t have insurance, you may wonder, “How much does a psychiatrist cost without insurance?” 

While getting an exact cost before your psychiatric appointment may not be completely possible, comparing psychiatric services to the rates of other mental health professionals can give you a rough estimate of what to expect. 

Psychiatrist talking to young couple in his office

How Much Does a Psychiatrist Cost with Insurance? 

Working with a psychiatrist who accepts insurance is always going to be the more affordable option. So, if you have insurance, start by checking in with your insurance provider who may be able to provide an estimate. Or, call the office or contact number of the psychiatric provider, and, depending on the services you’re needing, they may be able to tell you. 

The exact cost will depend on insurance accepted by the psychiatrist vs. insurance coverage on your insurance policy. It’s also worth noting that telepsychiatry is often the same price as an in-person visit, as the only difference is the location of the appointment, not the actual services involved. 

How Much Does a Psychiatrist Cost Per Hour? 

Psychiatrist hourly rates will vary depending on: 

  • The provider’s location
  • Services they provide
  • The provider’s experience level
  • Whether your visit is covered by insurance
  • And other unique variables

Typically, a psychiatrist or psychiatric provider will have self-pay rates around $100-500 with a median of $200 per hour on average. Providers with more experience and expertise often charge higher hourly rates. 

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Is a Psychologist Cheaper Than a Psychiatrist?

The rate for a psychologist is normally cheaper than a psychiatrist, yes. This is related to education and prescribing rights (the ability to prescribe antidepressants and other medication) that psychiatrists have over psychologists—but this is not always the case.

In some states, psychologists may also have the privilege to prescribe medications as needed. 

Why Do a Lot of Psychiatrists Not Take Insurance?

Certain psychiatrists and psychiatric providers do not take insurance for various reasons, including:

  • The psychiatrist not being credentialed or approved by a particular insurance company 
  • By choice due to the limits that some insurance companies place on care delivered by providers 

Those who are frustrated by psychiatric providers that are not in network with their insurance provider should consider whether it’s worth taking a little time to find one who is. 

Why Do Psychiatrists Charge More than Other Providers? 

Psychiatrists may have a higher rate when compared to medical or family doctors. This increase in cost is related to a psychiatrist being considered a specialist when compared to a medical or family practice doctor characterized as general practice. 

Specialists typically require a higher rate of pay. So if you’re paying out of pocket, give their office a call—and touch base with your insurance provider. 

Though psychiatric services may sound expensive, some providers (like Thriveworks ) do work with insurance companies to offer clients affordable care.

Published Apr 20, 2023

  • Medical writer
  • Editorial writer
  • Clinical reviewer

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Tamiqua Jackson is a Psychiatric Mental Health Nurse Practitioner (PMHNP) and Family Nurse Practitioner (FNP) in the states of North Carolina and Tennessee. Tamiqua has over 8 years of experience in advanced practice. She enjoys working with patients who may be experiencing depression, anxiety, attention deficit/hyperactivity disorder (ADHD), stress, sleep disorders, and other mental health issues that may affect everyday life. Tamiqua is compassionate and serves as a patient advocate.

Christine Ridley, Resident in Counseling in Winston-Salem, NC

Christine Ridley is a Licensed Clinical Social Worker who specializes in adolescent and adult anxiety, depression, mood and thought disorders, addictive behaviors, and co-dependency issues.

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Jason Crosby is a Senior Copywriter at Thriveworks. He received his BA in English Writing from Montana State University with a minor in English Literature. Previously, Jason was a freelance writer for publications based in Seattle, WA, and Austin, TX.

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The 9 Best Online Psychiatry Services That Take Insurance

Psychiatry and medication management that won’t break the bank

Brittany Elyse Vargas has been exploring topics around psychology, mental health, mind-body medicine, and psychospiritual development for the past twenty years. She’s written professionally for over ten years as a journalist, copywriter, and ghostwriter. Brittany is committed to rigorous reporting and to tackling topics on the cutting edge of the wellness, healing, and the mindfulness movements.

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Laura Dorwart is a health journalist with expertise in disability rights, mental health, and pregnancy-related conditions. She has written for publications like SELF, The New York Times, VICE, and The Guardian.

psychiatry visit cost

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

psychiatry visit cost

Sean is a fact-checker and researcher with experience in sociology, field research, and data analytics.

psychiatry visit cost

Psychiatric care can be expensive—up to $200 per session or more out-of-pocket—which is why, even when people need mental health medication, they sometimes do not seek treatment. In fact, in the U.S., 56% of people living with a mental illness do not receive treatment. The good news is that if you have health insurance, you might be able to use those benefits if you find an in-network provider. 

“Psychiatric services can get expensive when you are paying out-of-pocket, and finding someone who is in network with your plan can offset costs significantly,” says Amy Marschall, PsyD, a licensed clinical psychologist at Resiliency Mental Health . 

That said, it isn’t always easy to find a psychiatrist who takes insurance—even when looking online. According to one study, while about 89% of doctors in other specialties take insurance, only around 55% of psychiatrists do, making the search for psychiatric care that much more difficult.

To help you find the very best online psychiatry platforms, we worked with three subject matter experts to evaluate 55 online therapy companies and 25 directories, surveying over 100 users at each. We also tried and tested each service ourselves. Here are the ones we recommend that not only accept different insurance plans, but also are flexible, inclusive, and family-friendly.

Tried and Tested: Online Psychiatry That Accepts Insurance

  • Most Comprehensive: Talkiatry
  • Best for Depression: Talkspace
  • Best for Anxiety: Brightside

Best for Co-Occurring Conditions : Teladoc Health

  • Best for Bipolar Disorder: LiveHealth Online
  • Best for PTSD: Doctor on Demand
  • Best for Substance Use: Mindful Care
  • Best for OCD: LifeStance Health
  • Best for Teens: Thriveworks

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 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 Top Picks
  • Teladoc Health
  • LiveHealth Online
  • Doctor on Demand
  • Mindful Care
  • LifeStance Health
  • Thriveworks
  • See More (6)
  • Compare Providers
  • Guide to Choosing


Most comprehensive : talkiatry.

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

To fulfill its company mission of making psychiatry more accessible, Talkiatry works only with people whose insurance it accepts. Treating patients as young as 5, Talkiatry’s versatility and unique treatment model make it our most comprehensive service supporting almost anyone who needs psychiatric care.

Only takes new patients with insurance coverage

Accepts a wide variety of insurance

Provides care to children and teens ages 5 and up

Treats a wide variety of mental health conditions

First visits are 60 minutes long

Not available in every state

Therapy is only available with a referral

Doesn’t treat eating disorders or schizophrenia

We asked two people to try Talkiatry in New York to test its psychiatry services. Overall, we found it to be an excellent platform with unusually long session times and supportive clinicians who were responsive to our needs. It accepts a wide variety of insurance and in fact only accepts patients with insurance, making the process that much easier for those who need to use their insurance to pay for psychiatric services.

We appreciate that intake sessions (one hour long) and follow-up sessions (30 minutes long) are double the length of other platforms. By ensuring clinicians take their time with patients, Talkiatry proves it's a far cry from a pill mill. We had plenty of time to ask and answer questions, and some parts of the sessions even felt a little like therapy. It was nice that we could message our providers between sessions when we had concerns regarding side effects. Talkiatry impressed us with its ability to treat a wide range of conditions, from PTSD to insomnia to substance use disorder ( SUD ) and more. We feel confident recommending Talkiatry to our community.

Our experience wasn’t perfect, though. We didn’t like that one of the psychiatrists was late to the session and a bit too clinical for our taste. He didn’t have the warmth and compassion we were looking for. We were able to switch providers, but we had to call customer service to do so, and there was a waiting period to get a match and even longer for a session. We would also like to see Talkiatry ask more questions during intake to match us with the right person so there’s less of a chance of needing to switch.

The prices at Talkiatry vary widely because the company doesn’t allow patients to pay out-of-pocket. If you’d like an estimate of your potential copay, Talkiatry suggests that you contact your insurer directly.

Talkiatry is in network with most major insurance companies, including:

  • Blue Cross Blue Shield
  • UnitedHealthcare

However, Talkiatry doesn’t accept Medicaid plans at this time. 

Among the 105 users we surveyed, impressions of Talkiatry were overwhelmingly positive. Ninety-five percent of Talkiatry users rated the service positively (good, very good, or excellent). 

Eighty-one percent of users said they were satisfied or very satisfied with the company’s available providers, and 91% rated their qualifications as good to excellent. Nine out of 10 rated the number of quality providers on the platform positively. Finally, the majority of users (59%) said they were likely to continue seeing their Talkiatry psychiatrist for 12 months or more.

Best for Depression : Talkspace

  • Price: $69-$109 a week for therapy, billed monthly; $65 for additional sessions
  • Is Insurance Accepted?: Yes
  • Type Of Therapy: Couples Therapy, Individual Therapy, Medication Management, Psychiatry, Teen Counseling

With over 5,000 providers available and many insurance plans accepted, Talkspace makes it easy to find a psychiatrist who you can afford. The platform features experienced providers who specialize in depression, and you can get both therapy and psychiatry at this company.

Accepts a wide variety of insurance plans

Has psychiatrists who specialize in depression

You can get both therapy and psychiatry

Providers have seven to 10 years of experience on average

Easy-to-use website and app

Can schedule appointments up to three months in advance

Can’t prescribe controlled substances

Psychiatric care not available for children and teens

Quality of providers may vary

We asked nine people to try Talkspace ’s individual, couples, and family (parent-child) therapy services in Indiana, California, South Dakota, Kansas, Missouri, Florida, North Carolina, Minnesota, and New York. We recommend the platform because of the wide range of psychiatrists available who treat depression and the wide range of insurance plans it accepts.

Overall, we found our therapists to be good-quality providers. Conversations flowed easily, and our therapists put us at ease when it was clear that we were uncomfortable. We often left sessions feeling optimistic and empowered, seeing our issues in a new light. Sessions usually included a nice mix of listening and support alongside practical tools and plans of action. While we didn’t try Talkspace’s psychiatry services, we appreciate that you can opt for psychiatry sessions, therapy sessions, or both. Having both options means that you could potentially approach depression from multiple angles, which may be more effective than just therapy or psychiatry alone.  

We didn’t like that a few therapists were late to sessions or seemed distracted. Such an attitude made us feel reluctant to open up and trust the provider. In another case, our therapist seemed to actually talk over us instead of listening to us. The downside to a big platform like Talkspace is that not everyone will be the right fit. You might have to switch once or even a few times. Still, switching providers is pretty straightforward.

Talkspace works with many major insurers, including:

  • Allegiance Benefit Plan Management
  • Northwest Venture Partner Insurance

If you’re not covered by insurance, Talkspace also accepts payments from health savings accounts (HSAs) and flexible spending accounts (FSAs). 

Without insurance, an initial psychiatric evaluation at Talkspace costs $299, followed by $175 per appointment. Discounts for new clients are available for bundled psychiatry sessions at the following out-of-pocket prices:

  • Initial evaluation and 1 follow-up visit: $435
  • Initial evaluation and 3 follow-up visits: $735

Existing clients can purchase the following discounted packages:

  • 3 follow-up visits: $475
  • 6 follow-up visits: $890
  • 9 follow-up visits: $1,260

In our survey of 105 Talkspace users, nine out of 10 rated their overall experience with the company as good, very good, or excellent. Meanwhile, the same amount of users rated the platform’s psychiatry and medication management services positively (as good or better).

Talkspace users seemed particularly impressed with the user-friendliness of the service: Seventy-six percent of users said the sign-up process was easy or very easy. Similarly, 82% of users described the website as easy or very easy to navigate. Forty-five percent of the 105 users we reviewed sought out services through Talkspace specifically for depression.

Best for Anxiety : Brightside

  • Price: $95-$349 per month

Brightside treats many different kinds of anxiety, including generalized anxiety disorder, panic disorder, and social anxiety—all while in network with some major insurance plans. It offers tools to help you track your symptoms and improve your lifestyle habits to reduce anxiety. Brightside also offers cognitive behavioral therapy (CBT), a great treatment for people with anxiety.

Accepts insurance and FSA/HSA payments

Treats many types of mild, moderate, and severe anxiety

Provides self-care resources you can use at your own pace 

Offers crisis care in certain states

Includes a detailed intake to match you to the right provider

Can choose medication management services, therapy, or both

Insurance coverage varies by location

Only treats adults

Only works with eight insurance providers

We had three people, from North Carolina, New York, and California, try Brightside Health for individual therapy and found the platform to be an excellent resource for people with mild to moderate anxiety. While we didn’t test the medication management or psychiatry services ourselves, we found the overall quality of clinicians to be outstanding, and we’re thrilled that Brightside specializes in anxiety.

Our providers were experts in anxiety disorders like generalized anxiety, obsessive-compulsive disorder, social anxiety, and panic disorder. All had demeanors that made us feel safe, comforted, and cared for. Brightside offered helpful tools like quizzes to track our progress and symptoms, which was a great motivator and helped us learn what affected our mental health and manage those lifestyle habits more clearly. We appreciate that Brightside offers cognitive behavioral therapy (CBT), a proven method for treating anxiety, in addition to psychiatry. This therapeutic approach resonated with us, as it helped us break down thought patterns that may trigger anxious responses.

We weren’t happy, however, about prepaying for sessions and then having our provider booked for weeks. Switching clinicians wasn’t a fast process either, and when you’ve got anxiety, long delays can really impact your mental well-being. Another time, a provider was late to a session and seemed distracted. Unfortunately, both issues aren’t all that uncommon across mental health platforms.

Brightside is HSA/FSA-eligible and works with the following insurers:

  • Cigna/Evernorth
  • Optum/UnitedHealthcare
  • Blue Cross Blue Shield of Texas
  • Blue Cross Blue Shield of Montana

Users seeking specialized crisis care can only pay through their insurance. 

Self-pay Brightside users can purchase one of the following plans:

  • Medication only: Diagnosis, medication, and treatment plan for $95 per month
  • Therapy only: Weekly therapy sessions and unlimited messaging for $299 per month
  • Medication and therapy: $349 per month

Most of the users we surveyed rated Brightside highly, especially when it comes to medication management and psychiatry services. 

Ninety-three percent of the 105 Brightside users we surveyed said they would rate the company’s medication management and psychiatric care as good, very good, or excellent—this was among the highest across the 55 different online therapy and psychiatry companies whose users we surveyed. Likewise, 83% of users rated the qualifications of their licensed prescriber as good to excellent, and three-quarters rated their prescriber’s bedside manner positively. Sixty percent said they liked Brighside because their provider was available when they needed them, and the same amount turned to Brightside for help with anxiety, speaking to the company’s specialization and expertise in this area.

  • Price: $99 per therapy session, $209 for initial psychiatry appointment and $109 per follow-up
  • Is Insurance Accepted?: Yes. 60 different insurance plans accepted
  • Type Of Therapy: Couples Therapy, Individual Therapy, Medication Management, Psychiatry

Teladoc is a telehealth company that accepts a wide range of insurance plans and offers talk therapy, psychiatric care, and primary care from highly qualified providers who specialize in a wide range of mental and physical health issues. This makes Teladoc a good fit for people with co-occurring conditions who need to use their insurance to pay for services. 

Accepts many major insurance plans

Has providers with expertise in a wide range of conditions

Both talk therapy and psychiatry available

All psychiatric providers are board-certified psychiatrists 

Works with some Medicaid and Medicare plans

Flexible scheduling 

No psychiatry or medication management for kids or teens

Can’t treat certain serious mental illnesses such as schizophrenia or bipolar disorder

Can’t see which insurance is accepted before signing up 

We asked three people to try Teladoc for individual therapy from Missouri, Texas, and Ohio and found it to be a great resource for experienced, professional mental health providers. While we didn’t try Teladoc for psychiatry, we’re comfortable recommending the platform because of its high clinician quality, flexible scheduling, and the fact that it offers both mental and physical healthcare options—making it perfect for people who need treatment for both kinds of conditions.

The selection of providers at Teladoc was impressive. We loved that we could choose our own, and after going through several filters, we saw a pretty wide range of experienced providers available in our state. Having the ability to be super-specific with our needs and yet have a wide range of clinicians to choose from could be very helpful for people struggling with the complexities of co-morbid (co-occurring) conditions.

We appreciate how comprehensive Teladoc is. You can receive psychiatric help for concerns like depression, ADHD, anxiety disorders, phobias, adjustment disorders, trauma, PTSD, and OCD. Outside of mental health, the company’s offerings include primary care, pediatric care, dermatology, and nutritional counseling. This means that people with comorbid or chronic conditions—whether mental, physical, or both—can work with Teladoc to access ongoing care in a variety of areas. 

Flexible scheduling is a great feature at Teladoc—we found that nights and weekend sessions weren’t hard to get, which is great for busy working people. But we did have an issue with one therapist, who ended a 50-minute-long session after only 30 minutes. Another time, our provider made a last-minute cancellation literally minutes before the session. These issues are fixable by switching providers, but we’d have liked to avoid them altogether.

Teladoc works with many major insurance providers, including Anthem and Blue Cross Blue Shield. However, it doesn’t list all the insurance plans it works with upfront; you’ll have to sign up and enter your insurance information to find out if you’re covered.

Teladoc is also HSA/FSA-eligible and works with many Medicaid managed care and Medicare Advantage plans. 

Without insurance, a 45-minute psychiatric evaluation at Teladoc costs $299, and follow-up visits are often shorter.

Most of the 105 Teladoc users we surveyed had a positive experience with psychiatric care and medication management services, with 91% rating them as good, very good, or excellent. In fact, 89% said they were likely or very likely to recommend the company’s psychiatry and medication management services to someone else. 

Three-quarters of Teladoc users described their prescriber’s bedside manner as good or very good, and 72% said their prescriber took the time to really listen to them. Similarly, 82% of users reported that their prescriber “really took the time to evaluate [their] mental health” before prescribing medication.

Best for Bipolar Disorder : LiveHealth Online

  • Price: $80-95 per therapy session; $175 or less for an initial psychiatry session; $75 per follow-up
  • Type Of Therapy: Children's Therapy, Couples Therapy, Family Therapy, Individual Therapy, Medication Management, Psychiatry, Teen Counseling

LiveHealth Online offers high-quality psychiatric care to people with bipolar disorder, a mental health condition that most online therapy companies cannot treat. This—coupled with the fact that it accepts a wide range of insurance plans including Medicaid (which is also unusual with telehealth companies)—makes this platform stand out.

Providers with expertise in treating bipolar disorder

Accepts a wide variety of insurance, including Medicaid

Flexible availability, including nights and weekends

Offers talk therapy and urgent care visits in addition to psychiatry

Can choose your own provider

Affordable prices 

Only offers psychiatric care to adults

No live chat support available

Not available outside the U.S.  

We tested individual therapy at LiveHealth Online from California and Ohio and found it to be a great resource for highly experienced providers, many with over a decade of experience, within an easy-to-use, intuitive platform. The company stands out because of its network of providers who can treat complex conditions and mood disorders, including bipolar disorder.

Unlike many competing online psychiatry platforms, LiveHealth Online has board-certified psychiatrists who specialize in diagnosing and treating people with bipolar I or II . You can choose your own provider, which makes it easier to connect with someone who has directly relevant experience. And LiveHealth Online works with many major insurance providers and plans, making this specialized treatment for those living with bipolar disorder that much more accessible and affordable.

We liked that the website was exceptionally user-friendly and that we could schedule right from the app anytime we wanted. Providers were trained in delivering online care, which made the video experience seamless and free from the technical errors found on other platforms that can sometimes disrupt sessions. It was great to see night and weekend availability for many providers, but unfortunately, those spots were hard to snag and required scheduling weeks in advance.

LiveHealth Online works with a wide variety of insurers, including Medicaid, Anthem, Blue Cross Blue Shield, and Empire Blue Cross.

LiveHealth Online is also HSA/FSA-eligible. 

The platform’s self-pay costs are also affordable in comparison to many of its competitors. A consultation with a LiveHealth Online psychiatrist costs $175, followed by $75 for each additional follow-up visit. 

Ninety percent of the 105 LiveHealth Online users we surveyed rated their experience with the platform as good, very good, or excellent. When asked if they would recommend the platform to someone else, 87% said they were likely or very likely to do so. Eleven percent of users were seeking treatment for bipolar disorder through LiveHealth.

Many of the LiveHealth Online users in our survey pointed to the company’s convenience and flexibility when asked about its best features. Slightly less than a quarter of users (23%) primarily chose LiveHealth Online because of the availability of evening, weekend, and early morning appointments, and another 24% were looking for online scheduling. Meanwhile, 90% of users rated the platform’s helpfulness in connecting them to a therapist as excellent, very good, or good.

Best for PTSD : Doctor on Demand

  • Price: $134-$184 per therapy session; $299 for psychiatric consultation: $129 per psychiatric follow-up
  • Type Of Therapy: Individual Therapy, Medication Management, Psychiatry, Teen Counseling

Doctor on Demand offers psychiatric and medication management services that can be tailored specifically to treat people with post-traumatic stress disorder (PTSD). Specialists in PTSD provide comprehensive care while remaining in network with many insurance plans, making PTSD treatment more accessible.

Psychiatrists with expertise in PTSD available

Accepts insurance

Providers have 15 or more years of experience on average

Can select your own provider

Treatment available for kids and teens

American Sign Language (ASL) and language interpretation available upon request

Can’t message your provider between sessions

Out-of-pocket costs are relatively high

We tested individual therapy and psychiatry for our teenager at Doctor on Demand from North Carolina and Pennsylvania, respectively, and found our clinicians to be experienced and compassionate, both critical qualities for someone treating post-traumatic stress disorder (PTSD). Plus, clinicians used a variety of techniques that would be helpful for those struggling with this disorder.

We loved that our providers were on time, prepared, and attentive, something we don’t always see on other platforms. We also appreciated our son’s provider’s transparency, as they let us know right away that they didn’t specialize in kids (since our son was 17, it wasn’t a big deal to us). That sort of openness goes a long way in building trust. Clinicians offered emotionally sensitive support alongside practical advice that we could use in daily life. We appreciate this strategy of empowering patients with tools they can use when symptoms arise. 

It was great to see clinicians using a wide range of techniques, including psychoeducation and breathing exercises, to calm symptoms like anxiety (which can often crop up when living with PTSD). Education can help assure those living with PTSD that what they’re experiencing is normal, while breathing techniques are among the most effective and simple techniques for healing PTSD’s hallmark nervous system dysregulation.

Doctor on Demand works with many insurers, including Blue Cross Blue Shield, UnitedHealthcare, and some Medicaid and Medicare plans. You’ll need to sign up for an account to see the full list of insurance providers and plans accepted by the platform. 

For self-pay users, a 45-minute psychiatric consultation at Doctor on Demand costs $299. Each 15-minute follow-up visit costs $129.

In our survey, Doctor on Demand users were largely satisfied with the care they received through the platform. Ninety-four percent of users said their experience with the company was good, very good, or excellent, and 70% said they would consider seeking mental health care at Doctor on Demand again—a far higher percentage than at many of its competitors.

A quarter of the Doctor on Demand users we surveyed used the company’s psychiatry and medication management services. Eighty-four percent of users rated the psychiatric care they received through the platform as good, very good, or excellent, and nine out of 10 users also described their prescriber’s qualifications positively (i.e., as good or better). Notably, a full 17% of users said they were looking for treatment for trauma through Doctor on Demand, a percentage far higher than at any other company we reviewed.

Best for Substance Use : Mindful Care

  • Price: $20-$175 for substance use; Individual therapy: $50 for 20-minute sessions, $100 for 40-minute sessions; $35 per group session; $75-$175 for psychiatry session
  • Type Of Therapy: Group Therapy, Individual Therapy, Medication Management, Psychiatry, Teen Counseling

Mindful Care’s approach to substance abuse treatment is uniquely comprehensive, offering psychiatric care, medication management services, and medication-assisted treatment (MAT) for alcohol use disorder (AUD) and opioid use disorder (OUD), all covered by insurance.

Treatment specific to substance use disorders

Urgent appointments available

Psychiatric care offered to kids and teens ages 12 and up

Offers medication-assisted treatment (MAT) 

Offers group and individual therapy alongside psychiatric care

Many providers are nurse practitioners and certified physician assistants

Only available in six states

Can’t always select your own provider

We had two people test Mindful Care in New York for individual and group therapy and while we didn’t test it for substance use disorder, its comprehensive approach to addiction support gives us the confidence to recommend it. The platform gives users multiple ways to approach their substance use, from psychiatric to nutritional to therapeutic.

We appreciate that Mindful Care offers same-day appointments and has very responsive providers. The last thing someone needs when they’re in the midst of a craving is to have long session delays or wait for days to get a provider response. The vibe in the group therapy sessions was really nice—it felt like a safe space to share our struggles confidentially. 

Mindful Care adopts a “whole-person” approach to substance use by offering medication-assisted treatment and psychiatric urgent care both in-person and online, including individual therapy, group therapy, and substance use counseling. Medication-assisted treatment (MAT) for substance use disorders might include the prescription of naltrexone for alcohol use or buprenorphine for opioid use.

We love that Mindful Care has an online Mindful Recovery program with group therapy, care navigation, and MAT for people with alcohol use disorder or opioid use disorder. We didn’t like our Microtherapy sessions (20 minutes long), however, as they were too rushed, and we don’t recommend them for those struggling with addiction.

Mindful Care accepts Medicaid and Medicare managed plans and is in network with many insurance carriers, including:

  • Amerihealth

Without insurance, initial psychiatric consultations and medication-assisted treatments at Mindful Care cost $175. Each follow-up visit costs $75. A 15-minute recovery care management session costs $20 per session.

If paying out-of-pocket for therapy, 20-minute Microtherapy sessions are $50 each, 40-minute individual talk therapy sessions are $100 each, and group therapy sessions are $35 each.

Ninety-two percent of the 105 Mindful Care users we surveyed reported that their overall experience with the service was good to excellent, and 83% of users said they would be willing to recommend it to someone else. Five percent of our 105 surveyed users were specifically seeking substance use services from Mindful Care.

Users seemed particularly impressed with Mindful Care’s providers: Eighty-two percent were able to find a provider who met all or most of their needs, and 83% said they were satisfied or very satisfied with the available clinicians. What’s more, 95% of Mindful Care users rated the qualifications of the company’s providers as excellent, very good, or good.

Best for OCD : LifeStance Health

  • Price: $150-$300 per session out-of-pocket
  • Type Of Therapy: Children's Therapy, Family Therapy, Group Therapy, Individual Therapy, Medication Management, Psychiatry, Teen Counseling

LifeStance Health provides targeted treatment for OCD with a wider range of treatment options than many other telepsychiatry platforms, including child and adolescent psychiatry and medication management services both online and in person, all while operating in network with most major insurance plans (including, in some areas, Medicare and Medicaid).

Has providers who specialize in OCD treatment

Child and adolescent psychiatry available

Wide variety of mental health care approaches offered

Offers both in-person and online treatment

Medicaid and Medicare accepted in some states

Available only in 33 states

Prices not completely clear at first glance

Website can be confusing to navigate

We asked six people to test LifeStance Health in Illinois, New York, Florida, Oregon, Missouri, and Ohio and found it to be a solid platform with professional, confident, and empathetic counselors who treat a wide variety of needs. Given that it has providers who are trained to treat more complex disorders, we recommend it for people with obsessive-compulsive disorder (OCD).

On the whole, we loved our providers. They were professional, caring, and supportive, making us feel relaxed and safe in their presence. Building trust felt natural, and virtual sessions felt so smooth, they were comparable to in-person ones. We were happy to see that LifeStance Health offers a wider variety of specialized treatment options than many of its competitors do—including treatment specifically for obsessive-compulsive disorder (OCD) that is covered by a broad range of insurance plans. 

We did have an issue with one of our providers, who was late, distracted by her pet, and came across as unsure of herself. Her demeanor made us lose confidence in her and her ability to help us. Signing up with LifeStance Health means that, like with many other platforms, there’s a chance you’ll get someone you don’t click with. We also didn’t like that weren’t able to see the self-pay rate ahead of time and had to wait for a bill after the session.

Prices at LifeStance Health vary widely by insurance coverage, therapy type, and location.

LifeStance Health accepts most major insurance plans, including Medicare and Medicaid in some cases—the website states that providers “accept most commercial insurance plans” in the states in which they provide care. Examples include: 

  • Veterans Choice Program

To find out if LifeStance Health accepts your insurance, visit the company website, click “Insurance,” and provide your information. 

The LifeStance Health users we surveyed were particularly impressed with the quality of available providers on the platform. Eighty-eight percent rated the platform positively overall, making it one of our highest-scoring platforms. Seventy-three percent of users said they were able to find a LifeStance Health provider who met all or most of their needs. 

Meanwhile, seven out of 10 users reported that they were satisfied or very satisfied with the provider options, and nine out of 10 users described the qualifications of LifeStance Health’s providers as good, very good, or excellent. Ten percent of the 105 LifeStance users we surveyed were looking for help with OCD.

Best for Teens : Thriveworks

  • Price: $160 - $240 per therapy session, $300 - $375 for initial psychiatry/medication management session, $210 - $300 for follow-ups
  • Type Of Therapy: Couples Therapy, Family Therapy, Group Therapy, Individual Therapy, Medication Management, Psychiatry, Teen Counseling

Available online and in-person at over 380 locations across the United States, Thriveworks offers both psychiatric care and medication management services with board-certified psychiatrists to teens who are covered under any one of hundreds of insurance plans.

Psychiatric care available to teens

Accepts hundreds of insurance plans

Most users can book their first appointment in three to five days

Evening and weekend appointments available

Hires only the top 4% of providers who apply

Prices not entirely clear before signing up

No chat sessions or messaging available

We asked 10 people to try out Thriveworks from Massachusetts, Missouri, Kentucky, Kansas, Ohio, Florida, and South Dakota for individual and family therapy and found it to be a great resource for empathetic, experienced providers who can connect well with teens.

We loved seeing our teens establish a healthy rapport with their clinicians, bonding over shared interests and building trust over time. One of our daughters expressed that her Thriveworks therapist seemed to really listen to her and connect the dots between new and past issues in a way that she hadn’t experienced with previous therapists. In another case, the therapist was able to put our child at ease, getting her to open up even after a rocky start to the session, demonstrating her expertise in working with kids. We were relieved to find out that one of our therapists had kids herself, which made us more comfortable. 

That said, the whole reason the session didn’t start smoothly was because the therapist led by asking for information we’d already provided, including credit card information. She then launched into asking questions about thoughts of self-harm and depression. It was an abrupt way to start and not an ideal way to get a child to open up. We also didn’t care for how little information was requested about our reasons for seeking therapy prior to the session. We had little confidence that our therapist would be well-prepared for a session when all they had was basic details like our child’s name, their birth date, and our credit card information.

Thriveworks is in network with many insurers, such as:

Medicaid plans are accepted at a limited number of Thriveworks locations. 

Without insurance, self-pay Thriveworks clients pay at least $200 per session. Prices vary by location and provider.

Many of the 105 Thriveworks users we surveyed sought out the platform specifically because the company accepted their insurance. Around a third (33%) of users said it was the most important factor they took into consideration when selecting Thriveworks, with another 19% reporting that it was the second most important factor. Six percent of users reported looking specifically for teen counseling through Thriveworks.

Most Thriveworks users told us they were satisfied with the care they received through the platform. Over half (52%) of users said they were likely to continue receiving treatment through Thriveworks for another six months, and 50% said they were likely to keep seeing their Thriveworks therapist for another 12 months.

Compare the Tried and Tested: Online Psychiatry That Accepts Insurance

Guide to choosing the best online psychiatry that takes insurance, who is online psychiatry right for.

Online psychiatry can help children, teens, and adults with mental health conditions control or diminish their symptoms using psychotropic medication. 

“Psychiatry is an important component of mental health treatment for many,” says Dr. Marschall. “Psychiatric appointments are typically shorter than therapy sessions and focus on medication management.”

People who are experiencing difficulties with stress, anxiety, grief, anger, or trouble focusing may benefit from seeing an online psychiatrist. If you face barriers to psychiatric care, such as a busy schedule or financial stress, telepsychiatry might be right for you, especially if you need to use insurance to pay for care.

What Conditions Can Online Psychiatrists Help With? 

Online psychiatrists can help to diagnose and treat the symptoms of a variety of mental health conditions, including:

  • Major depressive disorder (MDD)
  • Anxiety disorders , such as generalized anxiety disorder (GAD) and phobias
  • Mood disorders, such as bipolar disorder  
  • Post-traumatic stress disorder (PTSD)
  • Obsessive-compulsive disorder (OCD)
  • Attention-deficit hyperactivity disorder (ADHD)
  • Personality disorders, such as borderline personality disorder (BPD)
  • Eating disorders
  • Substance use disorder (SUD)

What Types of Therapy Treatments Are Available With Online Psychiatrists? 

Online psychiatrists can diagnose mental health conditions and monitor symptoms on an ongoing basis. They can also prescribe medication, keep track of potential side effects, and adjust dosages as needed. Some psychiatrists also conduct psychotherapy, such as:

  • Cognitive behavioral therapy (CBT)
  • Dialectical behavior therapy (DBT)
  • Acceptance and commitment therapy (ACT)
  • Trauma therapy
  • Eye movement desensitization and reprocessing therapy (EMDR)

What If I'm Having Thoughts of Harming Myself?

If you are in severe distress or are having thoughts of harming yourself or someone else, online psychiatry is not the right option for you. Instead, call the U.S. Suicide & Crisis Lifeline at 988 or go to the nearest emergency room.  

The following resources may also help you or someone you know:

  • Crisis Text Line : Text HOME to 741741 or reach out via chat or on WhatsApp to talk with a volunteer crisis counselor.
  • The Trevor Project : Young LGBTQ people can call, chat, or text with a trained crisis counselor.
  • : Find behavioral health and substance abuse treatment centers in your area with this database compiled by the Substance Abuse and Mental Health Services Administration.

Frequently Asked Questions

What is online psychiatry.

Online psychiatry refers to psychiatric care and/or medication management services delivered virtually, typically via video. Your provider may be a board-certified psychiatrist or another licensed prescriber, such as a nurse practitioner. They may prescribe medication, which can be delivered to your home or a local pharmacy.

Is Online Psychiatry That Takes Insurance Effective?

Research suggests that online psychiatry can be helpful for people with a wide variety of mental health conditions. For example, telepsychiatry has been found to be effective in treating selected patients with depression, anxiety, psychotic disorders , and autism spectrum disorder (ASD). Also, studies suggest that online psychiatry can be effective for geriatric (older) patients as well as children and teens facing mental health concerns.

What Are the Benefits of Online Psychiatry That Takes Insurance?

There is evidence that online psychiatry can help to overcome many barriers to mental health care. These barriers may include:

  • Physical inaccessibility
  • Mental health stigma
  • Transportation difficulties
  • Living in a remote area
  • Communication differences 
  • Busy schedules

What Is the Cost of Online Psychiatry That Takes Insurance?

The cost of online psychiatry varies widely by insurance provider, the type of healthcare provider you’re seeing, and your location. With some Medicare plans, for example, you’ll be expected to pay 20% of the costs of each visit. Without insurance, an initial psychiatry consultation may cost $300 to $500 per visit, followed by $100 to $200 per hour for every follow-up visit.

With insurance, your copayment will vary, but may be in the range of $20 to $40 per visit .

Can Online Psychiatrists Prescribe Controlled Substances?

Yes, qualified online psychiatrists can prescribe controlled substances to treat medical conditions, including mental health conditions. However, not all online mental health platforms allow their providers to prescribe controlled medications, so availability may be limited. Examples of controlled substances used to treat mental health conditions include: 

  • Hypnotics, such as Ambien (zolpidem)
  • Stimulants, such as Adderall (mixed amphetamine salts) and Ritalin (methylphenidate)
  • Benzodiazepines, such as Ativan (lorazepam) and Xanax (alprazolam)

What Should You Expect From Online Psychiatry?

An online psychiatry session works similarly to a face-to-face session with a psychiatric care provider. Usually, you’ll sign in through a secure online portal and meet with your provider at an appointed time via video. Your psychiatrist may ask you about your current symptoms, your medical history, and any medications you’re taking, as well as what you’d like to get out of your session.

To compile this list, we researched, evaluated, and tested 55 different online therapy and psychiatry companies, specifically focusing on which companies offered psychiatric services as well as which accepted insurance. We further evaluated these companies based on specialty (treatment for specific mental health concerns or specific demographics), the number of insurance plans accepted, availability (number of states), flexibility in scheduling, which medications can be prescribed (such as controlled substances for anxiety or ADHD), and the type of provider available.

Westend61 / Getty Images

Mental Health America. 2022 State of Mental Health in America Report .

Bishop TF, Press MJ, Keyhani S, Pincus HA. Acceptance of insurance by psychiatrists and the implications for access to mental health care . JAMA Psychiatry . 2014;71(2):176-81. doi:10.1001/jamapsychiatry.2013.2862

Karyotaki E, Smit Y, Holdt Henningsen K, et al.  Combining pharmacotherapy and psychotherapy or monotherapy for major depression? A meta-analysis on the long-term effects . J Affect Disord . 2016;194:144-152. doi:10.1016/j.jad.2016.01.036

Malviya S, Meredith P, Zupan B, Kerley L. Identifying alternative mental health interventions: a systematic review of randomized controlled trials of chanting and breathwork . J Spirituality Mental Health . 2022;24(2):191-233. doi:10.1080/19349637.2021.2010631

Torous J, Bucci S, Bell IH, et al. The growing field of digital psychiatry: current evidence and the future of apps, social media, chatbots, and virtual reality . World Psychiatry . 2021;20(3). doi:10.1002/wps.20883

Greenhalgh T, Wherton J. Telepsychiatry: learning from the pandemic . Br J Psychiatr . 2022; 220(5):257-261. doi:10.1192/bjp.2021.224

Roth CB, Papassotiropoulos A, Brühl AB, Lang UE, Huber CG. Psychiatry in the digital age: a blessing or a curse? . Int J Environ Res Public Health . 2021;18(16):8302. doi:10.3390/ijerph18168302

Blue Cross Blue Shield of Michigan. Medicare help center .

By Brittany Elyse Vargas Brittany Elyse Vargas has been exploring topics around psychology, mental health, mind-body medicine, and psychospiritual development for the past twenty years. She’s written professionally for over ten years as a journalist, copywriter, and ghostwriter. Brittany is committed to rigorous reporting and to tackling topics on the cutting edge of the wellness, healing, and the mindfulness movements.

Hannah Owens is the Mental Health/General Health Editor for Dotdash Meredith. She is a licensed social worker with clinical experience in community mental health.

psychiatry visit cost

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.

psychiatry visit cost

How Much Does A Psychiatrist Cost?

  • For those experiencing suicidal thoughts, please contact the  988 Suicide & Crisis Lifeline at 988
  • For those experiencing abuse, please contact the Domestic Violence Hotline at 1-800-799-SAFE (7233)
  • For those experiencing substance use, please contact SAMHSA National Helpline at 1-800-662-4357

It’s not uncommon for people to use the labels “psychiatrist” and “psychologist” interchangeably, but these are two very different jobs with different responsibilities, educations, and professional scope. Understanding the difference between the two can help you know which professional may be right for you and be better suited for your mental health care.

What is a psychiatrist?

A psychiatrist is a medical doctor. For all intents and purposes, they have the same training and knowledge as your general doctor, but they chose psychiatry as their specialty. Because of their training and background, psychiatrists can prescribe medications to treat your condition.

This likely means psychiatrist visits will be more costly than when you choose other types of mental health professionals to work with and when you are considering how much does a psychiatric cost. They may include medication as part of your treatment plan, and they may refer you to another professional like a psychologist for talk therapy. Although medication is necessary in some instances, talk therapy offers more long-term treatments; this is why a psychiatrist often works alongside a psychologist or therapist.


Psychologists typically obtain their Ph.D. or PsyD in psychology. In general, psychologists tend to approach mental health treatment with psychotherapy and theories, so they can evaluate, assess, diagnose, and treat mental health conditions. Unlike psychiatrists, psychologists are not able to prescribe medication. For medication management, you will instead need to take advantage of psychiatric care.

Why would psychiatry be my best option?

If you’re struggling with mental health concerns, a psychiatrist will assess you for an underlying medical condition that could be causing your symptoms. They may prescribe medication, and they may refer you to a therapist or psychologist if they believe therapy will be helpful. They will work with you to create a comprehensive plan for your psychiatric treatment and recovery. You must take all these things into account when calculating how much does a psychiatrist cost and if the care is a good idea for you.

How much does a psychiatrist cost?

The cost of working with a psychiatrist will depend on where you live, your insurance provider, and your treatment requirements. In addition to their fee, certain psychiatric care, tests, and lab work all have various costs to consider. The average psychiatrist’s fee generally falls somewhere between $100 and $300 per appointment. You should expect to pay up to $500 for the initial consultation and roughly $100 an hour thereafter for follow-ups. This can fluctuate depending on the doctor and your health insurance. For this reason, how much does a psychiatrist cost is a question that has no definite answer.

If you want to work with a psychiatrist, be sure to visit or call them and have a talk with their staff to figure out what your costs could be, including any tests you might need. In some cases, a psychiatrist may be able to work with you to make your visits more affordable. Speaking to your doctor ahead of time can also help you identify cost-saving treatment alternatives where possible. If you’re well-prepared, you can find ways to save money. Keep in mind that they can provide you with professional medical advice, much like your physician. This is why their costs may be higher than with other mental health professionals.

How can I afford a psychiatrist?

While quality treatment won’t come cheap, there are options to help you make it more affordable for you. You can find a way to afford the in person care you need.

Use your health insurance

Your insurance provider is the easiest way to reduce the costs associated with getting treatment. Make sure you check to see if your insurance coverage includes a form of mental health coverage. In most cases, your health insurance will require you to get a doctor’s recommendation for treatment from a psychiatrist. This could lead to you having to pay referral costs. Also know that your plan may only cover a certain number of visits per year, and certain psychiatrists may not be covered under your plan. If you wish to mitigate costs via insurance, ensure the psychiatrist you choose is in your insurance in network providers before scheduling an appointment.

You should also be aware of the conditions of the Affordable Care Act , which was passed by the federal government that states that many healthcare providers must cover mental health problems, including things like substance abuse disorder services, and the in person care associated with treating them. If you don’t know the specifics of your plan, talk to your insurance provider about the outpatient mental health services that are available and what part you can expect the insurance cover. In some instances, you may qualify for financial assistance on mental health services as well. Check the details of your insurance coverage for the most detailed information or talk to your agent.

If you are trying to find a children’s health insurance program that offers behavioral health services or other mental health coverage options, you should talk to your health insurance company a out in network providers that provide services that are specifically for children.

Ask about sliding scales

Some community mental health clinics and the occasional psychiatrist will offer to price their psychiatric costs on a sliding scale. This means that the amount you are charged will depend on your income. Those who make more will pay more, so to speak. This may be beneficial if you are paying your psychiatrist cost without insurance. If you’re worried that your income may not be adequate to afford services, ask your primary care doctor about this option. They may be able to give you more details on how to save money when it comes to treating a mental health issue.

You may also talk to your employer about an employee assistance program, which may be useful in some fields or through certain companies. This type of program allows for you to take advantage of free or low cost mental health or behavioral health services when they are of a personal nature or work related.

Look for a reduced cost mental health clinic in your area

In many places, there are clinics that operate at an overall reduced cost, so people with low incomes or no insurance can afford their services. Though they may offer low-cost appointments, you might have to wait for a while to get on their schedule. These clinics may be a good idea if you are wondering how to pay a psychiatrist cost without insurance.

Try to save on your prescriptions

If your treatment turns out to require a prescription, this can be another area where you can cut costs. Some people opt for generic versions of the popular name brand medications. If you’re interested, make sure to ask for this at the outset if possible; you don’t want to switch medication during treatment unless you’re told to do so. There are also sites like GoodRx, which can show you the cheapest place to find your medication in your area. They’ll also offer discounts that aren’t connected with your insurance. This could also be handy for medication management.

Counselor reviews

“I have not been working with Andrea for long but I have found her to be compassionate and adaptable. I would recommend her to people who need help processing complex trauma and have found other talk therapy approaches unhelpful. She understands that while I practice and find merit in CBT type thought therapy, doing thought exercises while in the middle of a PTSD episode is unlikely to be possible. A person having flashbacks during an acute crisis is unlikely to be capable of doing thought exercises. Andrea seems to naturally understand something important that most medical professionals, in my extensive experience as both a worker and a patient, seem to miss these days: telling a person who is literally dying slowly and painfully that they should be able to meditate away that pain and carry on as normal without any medication or outside emotional support , is ridiculous. Andrea has been a breath of fresh air in that regard. She helped me realize that if a doctor or therapist isn’t able to empathize and they are approaching my problems cynically and with indiscriminate doubt, they cannot help me. Andrea is the first person in a long time that inspired me to hope they can help and trust that they will at the very least try.”

“I love working with Nancy! She’s been very empowering, very compassionate and very understanding. Whenever I text or even video call, I know she’ll be there for me and that she’ll provide me with an insight that will help me find my way. I’ve been really appreciative of this counseling services and I am so very glad I made the decision to do counseling. It’s an investment in ones health. I’ve been on psychotic meds for a whole decade and while medications numb the pain, they do not resolve it. Counseling does! I am definitely continuing to work with Nancy.”

The first step in dealing with mental health issues is acknowledging they exist. Then you can seek help. If that’s why you’re here, you’re already on the right path. Millions of others just like you have found effective treatments to heal from mental health issues. You can, too. Take the  first step today. Be sure that you are also considering all your options when it comes to taking advantage of psychiatric treatment or mental healthcare. There are options to consider when it comes to saving money or making the most of your health insurance coverage, including sliding scales, local clinics, and a related employee assistance program.

Frequently Asked Questions (FAQs)

How much is a psychiatrist fee for service?

Is consulting a psychiatrist expensive, how do i ask for a therapy fee, why do psychiatrists cost so much, is psychiatric treatment expensive, is therapy more effective when people pay a fee for it, how do you explain fees to clients, what to do if a therapy client doesn't pay, how much does a psychological cost, what are the costs of mental illness, which is more expensive psychologist or psychiatrist, why do you need a psychiatrist, can a psychiatrist give therapy, which type of psychiatrist makes the most money, how long does psychological treatment last.

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  • Study Protocol
  • Open access
  • Published: 10 June 2024

Study Protocol: Global Research Initiative on the Neurophysiology of Schizophrenia (GRINS) project

  • Jun Wang 1   na1 ,
  • Chenguang Jiang 1   na1 ,
  • Zhenglin Guo 2 ,
  • Sinéad Chapman 2 ,
  • Nataliia Kozhemiako 3 ,
  • Dimitrios Mylonas 4 ,
  • Lin Zhou 2 ,
  • Lu Shen 6 ,
  • the GRINS Consortium ,
  • Shengying Qin 6 ,
  • Michael Murphy 7 ,
  • Shuping Tan 5 ,
  • Dara S. Manoach 4 ,
  • Robert Stickgold 8 , 9 ,
  • Hailiang Huang 2 , 10 ,
  • Zhenhe Zhou 1 ,
  • Shaun M. Purcell 3 , 9 ,
  • Meihua Hall 7 ,
  • Steven E. Hyman 2 &
  • Jen Q. Pan 2  

BMC Psychiatry volume  24 , Article number:  433 ( 2024 ) Cite this article

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Objective and quantifiable markers are crucial for developing novel therapeutics for mental disorders by 1) stratifying clinically similar patients with different underlying neurobiological deficits and 2) objectively tracking disease trajectory and treatment response. Schizophrenia is often confounded with other psychiatric disorders, especially bipolar disorder, if based on cross-sectional symptoms. Awake and sleep EEG have shown promise in identifying neurophysiological differences as biomarkers for schizophrenia. However, most previous studies, while useful, were conducted in European and American populations, had small sample sizes, and utilized varying analytic methods, limiting comprehensive analyses or generalizability to diverse human populations. Furthermore, the extent to which wake and sleep neurophysiology metrics correlate with each other and with symptom severity or cognitive impairment remains unresolved. Moreover, how these neurophysiological markers compare across psychiatric conditions is not well characterized. The utility of biomarkers in clinical trials and practice would be significantly advanced by well-powered transdiagnostic studies. The Global Research Initiative on the Neurophysiology of Schizophrenia (GRINS) project aims to address these questions through a large, multi-center cohort study involving East Asian populations. To promote transparency and reproducibility, we describe the protocol for the GRINS project.

The research procedure consists of an initial screening interview followed by three subsequent sessions: an introductory interview, an evaluation visit, and an overnight neurophysiological recording session. Data from multiple domains, including demographic and clinical characteristics, behavioral performance (cognitive tasks, motor sequence tasks), and neurophysiological metrics (both awake and sleep electroencephalography), are collected by research groups specialized in each domain.

Pilot results from the GRINS project demonstrate the feasibility of this study protocol and highlight the importance of such research, as well as its potential to study a broader range of patients with psychiatric conditions. Through GRINS, we are generating a valuable dataset across multiple domains to identify neurophysiological markers of schizophrenia individually and in combination. By applying this protocol to related mental disorders often confounded with each other, we can gather information that offers insight into the neurophysiological characteristics and underlying mechanisms of these severe conditions, informing objective diagnosis, stratification for clinical research, and ultimately, the development of better-targeted treatment matching in the clinic.

Schizophrenia (SCZ) is a severe psychiatric disorder with a lifetime prevalence approximately 1% in the population worldwide, and yet we are limited to symptomatic treatments with a significant side effect burden [ 1 , 2 ]. Current antipsychotic medications for SCZ ameliorate the positive symptoms in a subset of individuals, with little or even adverse impact on negative or cognitive symptoms [ 3 , 4 ]. Major challenges in developing effective treatments for SCZ include: 1) the considerable biological heterogeneity across psychotic syndromes, and the variability in longitudinal course of SCZ, which can be indistinguishable from other psychiatric disorders like bipolar disorder (BPD), especially in its early course [ 5 ]; 2) not a single region, but interconnected circuit abnormalities across brain regions contribute to functional impairments, consistent with the complex polygenic genetic risk architecture; 3) lacking objective markers to index neurobiological deficits. Currently, treatment is therefore based on clinical symptoms and course with poor insight into underlying mechanisms. Prospects for developing novel therapeutics for SCZ will depend on our ability to 1) better understand disease mechanisms and 2) discover and validate quantitative biomarkers that tag patients’ neurobiological deficits, rather than relying on surface manifestations.

The thalamus is increasingly recognized as a critical node that supports cognitive functions in distributed brain networks, including component processes of attention, memory, executive function, and information processing [ 6 , 7 , 8 ]. With its cortical, subcortical, and cerebellar connections, the thalamus coordinates and synchronizes long-range and wide-spread brain-wide activity, and supports cognitive functions as an integrative center that shapes and updates mental representation [ 8 ]. Alterations in thalamic morphologies have been reported in both postmortem studies of patients with SCZ and through structural magnetic resonance imaging (MRI) analyses [ 9 , 10 ]. Functional MRI and diffusion tensor imaging (DTI) have consistently displayed hyperactivity between somatosensory cortex and thalamus and hypoconnectivity between frontal cortex and medial dorsal thalamus in this patient population [ 11 , 12 ]. Recently, a “trait”-like hyper-connectivity along the long-range cerebello-thalamocortical circuit, specific for SCZ, predicted psychotic conversion in high-risk individuals [ 13 , 14 , 15 ]. The emerging critical role of the thalamus in sensory processing and cognition, coupled with abnormal thalamocortical structure and functional connectivity, points to abnormal thalamocortical connectivity as key neurobiological deficits in SCZ [ 15 , 16 , 17 ].

The thalamus is involved in regulating states of sleep and wakefulness. Insomnia and other sleep disturbances have been reported in a large proportion of SCZ patients [ 18 , 19 , 20 ]. Sleep, in particular non-rapid eye movement (NREM) sleep, is a special lens through which we may quantify intrinsic thalamic and thalamocortical function without confounders from waking behaviors such as active symptoms or altered motivation. Two hallmark features of NREM sleep measured by electroencephalogram (EEG), slow oscillations (SO) and sleep spindles, reflect distinct thalamic and thalamocortical circuits [ 21 , 22 ]. The slow (1 Hz) neuronal oscillations with large amplitude are generated by cortical neurons and propagated by cortico-thalamo-cortical circuits, while spindles are bursts of oscillatory neural activity (typically between 10 and 16 Hz and ~1 second in duration) arising from reverberant thalamic interaction between thalamic reticular nucleus (TRN) and thalamocortical relay neurons and modulated by thalamocortical connections [ 23 ]. The coupling of SOs and spindles mediate information transfer and storage during sleep that underpins NREM’s role in overnight memory consolidation [ 24 ]. NREM traits show strong heritability in healthy populations [ 25 ], correlate with cognitive performances and provide objective, quantifiable markers of thalamic and thalamocortical functioning in large cohorts [ 26 , 27 ].

Impaired sleep spindle and SO activities have been reported in individuals with SCZ and their relatives [ 28 , 29 ], mostly in European and American populations [ 30 ], with relatively small sample cohorts (typically, fewer than 30 cases), limiting the power of analyses across diverse functional domains. One relatively large study, comprising 182 cases in Asian population, was reported recently; however, this study did not use high-density EEG and focused on sleep spindles without examining other aspects of sleep neurophysiology such as SO [ 31 ]. In addition, it remains unclear how these neurophysiology features are altered along the trajectory of SCZ, and whether there is increased variability at the individual level that can, if it exists, account for the heterogeneity of SCZ. Similarly, several auditory event-related potentials (ERP) measured during wakefulness are impaired in individuals with SCZ, including the auditory steady-state response (ASSR) [ 32 , 33 ], sensory gating P50 [ 34 , 35 ], and mismatch negativity (MMN) [ 36 , 37 ]. These measures also rely on uninterrupted and precise thalamocortical circuit function. However, it is unknown whether these wakefulness indicators represent similar or distinct thalamocortical dysfunctions as those observed during sleep. Most importantly, the similarities and differences of these sleep and wake EEG measures in tracking clinical symptoms, medications response, and cognitive function in SCZ patients remain unclear.

Previous studies have reported alterations in both sleep and wake EEG patterns among patients with BPD and depression [ 38 , 39 , 40 , 41 , 42 ]. However, how altered neurophysiological markers compare across SCZ and other mental disorders has not been well characterized. This is particularly relevant for BPD, a psychiatric condition similarly marked by its complexity, heterogeneity, and high heritability. BPD manifests several symptoms that overlaps with SCZ, including hallucinations, delusions, thought disorder, and others [ 4 , 43 ] Genome-Wide Association Studies (GWAS) for SCZ and BPD reveal a correlation of around 0.7 [ 44 ], and the first penetrant ultra-rare variants associated with BPD, AKAP11, is also shared with SCZ risk [ 45 ]. Therefore, investigation of similarities and differences in EEG abnormalities in individuals with SCZ and BPD is warranted.

Given the above evidence, there is an urgent need to thoroughly characterize the neurophysiological abnormities of patients with SCZ and BPD during both sleep and wakefulness, and to elucidate their stability, specificity, heritability and variation with disease trajectory, and implications for non-neurophysiological domains. Research in this area could provide insights into the pathophysiology of SCZ, BPD, and related disorders, and inform the development of innovative therapeutic strategies. Motivated by these, we conceived and launched the Global Research Initiative on the Neurophysiology of Schizophrenia (GRINS) project.

Aims and objectives

The GRINS is an ongoing collaborative research project initiated and primarily funded by the Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard and its collaborating hospitals. The clinical implementation of GRINS was launched in July 2019 at the Wuxi Mental Health Center (WMHC), also known as the Affiliated Mental Health Center of Jiangnan University, and later expended to Beijing Huilongguan Hospital, an affiliated hospital of Peking University. Both of them are large psychiatric hospitals with more than 1,300 beds. GRINS aims to comprehensively characterize patients with SCZ and other psychiatric disorders by collecting multi-domain phenotypes, including clinical, neurophysiological, genetic, cognitive, and behavioral assessments and measurements in a large representative Chinese cohort. Here, we present the GRINS protocol in detail for transparency and reproducibility. This protocol can serve as a template for large-scale sleep and wake EEG characterization in psychiatric patients, particularly for East Asian population, and as a prototype for optimizing neurophysiological measures with research objectives within this domain in future studies.

Study design

The GRINS project consists of two phases. In the first phase, we have employed a cross-sectional design to 1) verify and characterize previously reported sleep and wake EEG metrics; 2) to determine the extent of their correlations and interactions; 3) to examine the relationship between EEG metrics and clinical and cognitive measures; 4) to explore the variability of these measures within and across cases and controls; and 5) to identify potential new neurophysiological biomarkers for SCZ, individually or in combination, with a special emphasis on NREM sleep EEG metrics, such as the Chirp of sleep spindle [ 46 ]. In the second phase, in addition to the cross-sectional design, we are adding a longitudinal follow-up design and are expanding to include BPD patients. Main objectives of this phase are to ascertain: 1) the progression of sleep and wake EEG metrics with the disease trajectory, and 2) the specificity of these indicators in SCZ as compared to BPD.

The GRINS team includes clinical psychiatrists, scientists specializing in neurobiology, electrophysiology, and genetics, computational scientists, and information technologist, as well as project management professionals, in both the US and China. Dedicated assessment teams are organized for clinical evaluations and neuropsychological tests in this study (detail in section Study Management). The overall procedure for this protocol is comprised of four sessions, as depicted in Fig.  1 .

figure 1

Overall procedure of the GRINS

The study protocol of GRINS has received approval from the Harvard TH Chan School of Public Health Office of Human Research Administration (IRB18-0058), and the Institutional Review Boards of WMHC (WXMHCIRB2018LLKY003), Beijing Huilongguan Hospital (2023-07-KE), and Shanghai Jiao Tong University (M16035). Our research activities strictly adhere to the principles of the Declaration of Helsinki. All participants voluntarily take part and written informed consents are obtained from each prior to investigation. Participants are compensated for taking part in the GRINS based on local standard of living. Control subjects and outpatients are additionally compensated for transportation.

Study population

SCZ and BPD patients are recruited from psychiatric hospitals such as WMHC, and HCs are recruited from local community residents. In our research, we do not intervene in the treatment regimens of patients; all patient care and therapeutic approaches remain under the guidance and discretion of their clinical care providers.

The inclusion criteria for the SCZ group are: a) patients clinically diagnosed with “schizophrenia” based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria; b) an age range of 18-45 years and an intelligence quotient (IQ) of no less than 70; c) clinical stability sufficient to undergo an overnight sleep EEG study; and d) a finger-tapping test requirement of typing a total of ≥ 24 sequences of “1-2-3-4” during two 30-second trials with the left hand (the right hand may be used only in case of injury). The inclusion criteria for the BPD group are: a) patients clinically diagnosed with “bipolar disorder” based on the DSM-5 criteria; and the b) to d) criteria are the same as for the SCZ group. The inclusion criteria for the HC group include a) no current or previous diagnosis of any mental disorder, including mental retardation and dementia, and no family history of psychiatric illness; b) age and gender matching with the SCZ group; and c) the same prerequisites as criteria b) to d) for the SCZ group.

The shared exclusion criteria for all three groups (SCZ, BPD, and HC) are as follows: a) being outside the age range of 18-45; b) medical diagnosis of any sleep disorders such as insomnia, hypersomnia, and periodic limb movement disorder, or self-reported frequent difficulty in falling asleep and waking up easily during the night, or a STOP-BANG score of 4 or above, indicating a high risk of obstructive sleep apnea hypopnea syndrome [ 47 ]; c) use of barbiturate medications; d) drug abuse within the past 6 months, or a positive urine test at enrollment; e) presence of significant medical or neurological illness like epilepsy, or history of brain injury with loss of consciousness over 15 minutes; f) having received electroconvulsive therapy (ECT) within the past 6 months; g) a hearing threshold above 45dB at 1000Hz as determined by an audiometer; h) current pregnancy or breastfeeding; and j) legal and/or mental incompetence. Additional exclusion criteria for the case groups (SCZ and BPD) include mental disorders triggered by substances or other medical conditions.

Across the two phases, the project aims to recruit approximately 200 patients with SCZ and 100 patients with BPD, covering a range from early to chronic stage. Additionally, 200 age- and sex-matched healthy controls (HC) will be included. It is anticipated that 100 to 150 participants will be willing to engage in and complete a follow-up study in the second phase with an interval of around one year. Sample size considerations indicate that a total sample of N =170 can detect a modest effect size d=0.43 with 80% power (5% type I error rate). In the pilot study, the effect size of significantly impaired neurophysiological markers in SCZ range between 0.54 and more than 1.5 [ 48 ]. We estimate that our cohort size should be able to address the question that we aim to answer.

Study procedure

As illustrated in Fig.  1 , the study procedure is divided in to four sessions, namely, screening and recruiting, introductory interview, evaluation visit, and overnight study, as described below. During the follow-up period, participants will undergo the same procedure as above, ensuring consistency in data collection and allowing for subsequent longitudinal comparisons.

Session 1: screening and recruiting

As the study protocol requires several sessions including an overnight visit, both SCZ and BPD patients are primarily recruited from inpatient units to minimize the risk of dropout. Potential eligible patients are identified via reviewing the medical records and confirmed with their attending physician who approve patient’s clinical stability and suitability for participation. Those who are deemed suitable are then approached in person by the GRINS research team. Patients who agree to participate in the study complete the study-specific “Informed Consent Capacity Evaluation Form” (see Supplementary Material 1), to evaluate whether they fully understand the study’s procedures, potential risks and benefits, as well as their rights and obligations in participating.

HCs are recruited through advertisements. Additionally, a social media mobile application named WeChat is authorized and utilized to recruit control subjects. Eligibility screening for individuals interested in participating is conducted through the “GRINS Controls Screening Questionnaire” (see Supplementary Material 2) via phone, WeChat, or in-person.

Upon successfully passing the screening, participants (both patients and control subjects) are considered formally enrolled and assigned a unique GRINS study number. The numbers are sequentially coded for all participants and blind to group membership. Informed consent is obtained from each participant before initiating the Introductory Interview. Following the completion of the consent form, blood samples from the participants are collected.

Session 2: introductory interview

During this session, participants are required to complete specific questionnaires and tests such as the STOP-BANG questionnaire, finger-tapping test, hearing threshold test, and urine test. The short form of the Wechsler Adult Intelligence Scale—Revised for China (WAIS-RC-S), containing four subtests (information, similarities, block design, picture completion), is used to calculate the IQ of each participant. An “Enrollment Checklist” (see Supplementary Material 3) is used to further determine participant’s eligibility based on collected information.

Demographic and clinical information is collected. Details of the medications that participants are currently taking are recorded, specifying medication names, categories, and dosages. Such records facilitate subsequent analyses related to medication use. Information on handedness, extrapyramidal symptoms, tardive dyskinesia, nicotine dependence, as well as sleep habits and quality are also collected (Table 1 and Fig.  1 ). At the end of this session, participants are equipped with the Actiwatch Spectrum PRO (Phillips), a compact device designed for tracking daily activity and sleep patterns. They are instructed to wear this device continuously throughout the study, for a minimum duration of three days and nights. Additionally, participants are introduced to the sleep medicine center, which aims at familiarizing them with the study environment and procedures.

Session 3: evaluation visit

This session involves a series of clinical assessments and neuropsychological testing conducted by trained psychiatrists specialized in each domain. Patients’ diagnosis is confirmed through the Structured Clinical Interview for DSM Disorders (SCID). Controls’ medical histories are examined by a psychiatrist to rule out psychiatric disorders. Severity of psychiatric symptoms is assessed using the Positive and Negative Syndrome Scale (PANSS), and cognitive functions are evaluated using the MATRICS Consensus Cognitive Battery (MCCB). Consistent with the inclusion of patients with BPD in the second phase, symptom assessments are also expanded to incorporate the Young Mania Rating Scale (YMRS), the Hamilton Depression Rating Scale (HAMD), and the Hamilton Anxiety Rating Scale (HAMA). Additionally, the Functioning Assessment Short Test (FAST) is adopted to evaluate the functional impairment. A modified short form of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire (TEMPS-A) is used to measure participants' temperamental characteristics. Table 1 summarizes the instruments used.

Session 4: overnight study

This session includes EEG recordings in four awake ERP recording paradigms, three periods of wake resting state with eyes closed, an overnight sleep, and four rounds of motor sequence test (MST), as depicted in Fig.  2 . Briefly, the ERP tasks are conducted first, followed by a resting state EEG and then one round of MST. Another resting state EEG is performed before sleep, followed by the overnight sleep EEG recording. Upon waking the next morning, participants undergo another resting state EEG and three rounds of MSTs. The Stanford Sleepiness Scale (SSS) is administered to detect drowsiness, and there are three 10-minute ‘take a walk’ breaks following ERP or MST sessions to maintain alertness.

figure 2

Flow chart of tasks and processes during the overnight study session. ERP: event-related potentials; MST: motor sequence tests; SSS: Stanford Sleepiness Scale

Data collection

Comprehensive data are collected for each participant during the aforementioned sessions. With the exception of data from EEG/ERP, MST, and Actiwatch, all other data are documented in an electronic report form (ERF) application tailor-made for the GRINS project. This application incorporates built-in validation rules to minimize entry errors. Additionally, the timestamps of data entries are logged, offering supplementary insights for both study management and quality control.

We use the BrainAmp Standard Amplifiers (Brain Products GmbH, Germany) to record participants’ brain electrical activity signals during ERP tasks, wake resting state, and sleep period, at a sampling rate of 500 Hz. A 64-channel BrainCap (EASYCAP, GmbH) with flat electrodes is employed, featuring a customized electrode layout and channel assignment suitable for overnight sleep recordings (see Supplementary Material 4). The electrode placed under the left clavicle served as the ground, and the one placed on the forehead as a recording reference. The vertical electrooculogram (VEOG) is monitored by the electrode placed at the lower orbit of the left eye, and the horizontal electrooculogram (HEOG) recording electrodes are placed 1 cm from the outer canthus of both eyes. Bilateral mastoid electrodes are set up for subsequent EEG data preprocessing, if appropriate. Electromyogram (EMG) is recorded by placing two electrodes on the skin overlying the masseter muscle on both sides of the jaw. During the recording, the electrode impedances are kept below 10 kOhm. Different paradigms are described as below:

Part 1. Wake ERP tasks

A total of four well-established ERP tasks are run sequentially: sensory gating P50 (P50), P3 novelty (P3N), auditory steady state response (ASSR), and mismatch negativity (MMN). Stimuli are either displayed on the screen or presented through foam insert earphones using the Presentation software (Neurobehavioral Systems, NBS). All ERP data preprocessing is performed using BrainVision Analyzer (Brain Products, Germany), following established methods as previously reported [ 48 , 49 , 50 , 51 ]. Since these paradigms have been extensively utilized and reported, we provide only a brief description here.

The P50 paradigm measures auditory sensory gating function. Paired identical dual-click stimuli (S1 and S2) are presented in this paradigm. Each click is 5 ms long (2 ms rise/fall period), and a pair of clicks is presented with a 500 ms inter-click interval. The inter-trial interval is 10 seconds. There is a total of 160 click pairs averagely divided into 4 blocks that are separated by a 1-minute break. During this task, participants are asked to stay awake.

The P3N paradigm consists of 400 binaural auditory tones at 80 dB: 76% standard tones (lasting for 50 ms at 1000 Hz), 12% target tones (lasting for 50 ms at 1500 Hz), and 12% novelty tones presented as either sounds of running water or bird chirping. The three types of stimuli occur in a randomized sequence, with an inter-stimulus interval of 1000ms. Participants are instructed to click a mouse as quickly as possible when they hear the target stimuli but not respond towards both standard and novelty tones. This paradigm generates a number of response components including N1, P2, P3a, and P3b.

The ASSR paradigm elicits frequency specific oscillatory responses at 20 Hz, 30 Hz, and 40 Hz. For each frequency stimulation (in a randomized order), there are 150 trains of 1 ms white noise clicks with a 500 ms duration and a stimulus onset asynchrony of 1100 ms at corresponding rate. Participants are required to stay awake.

The MMN paradigm measures auditory processing and sensory memory. The paradigm consists of a total of 1200 stimuli, of which 85% are standard pure tones (1000 Hz, 100 ms) and 15% are deviant pure tones (1000 Hz, 150 ms), with an inter-stimulus interval of 200 ms. In this task, participants are instructed to watch a peaceful, soundless cartoon video clip. MMN is obtained by subtracting the ERP evoked by standard sounds from those evoked by deviant ones.

Part 2. Rest-state EEG recording

Rest-state EEG measures the spontaneous brain activity during quiet rest. There are a total of three rounds of rest-state EEG recording: one before and one after the first MST prior to the overnight sleep EEG, and then another before the second MST the following morning. Participants are instructed to relax, minimize movements (such as blinking or swallowing) as much as possible, and keep their eyes closed throughout these recordings. Each EEG recording lasts for no less than 5 minutes. During this time, participants are instructed to stay awake.

Part 3. Overnight sleep EEG recording

Overnight sleep EEG measures spontaneous brain activities across different stage of sleep. After completing all tasks required before the overnight sleep EEG recording session, patients take their prescribed medications. The sleep EEG recording starts when participants go to bed. A researcher in an adjacent room monitors the overnight sleep recordings. If participants need to use the bathroom during the night, they can ring a bell, prompting the on-duty researcher to pause and resume the EEG recording and assist the participants as needed.

We use Luna ( ), developed by a member of GRINS team (SP), to preprocess both resting state EEG and sleep EEG data. For a detailed methodology, please see references [ 48 ] and [ 52 ].

Motor sequence tests

MST is employed following established method [ 53 , 54 , 55 ] to assess individual’s motor memory status. Briefly, participants are instructed to tap a designated sequence of numbers (i.e., 41324 or 23142) on a four-key pad as quickly and accurately as possible (Supplementary Material 5). Each sequence undergoes a training and a testing round. Sequence A is trained pre-sleep (Round 1) and tested post-sleep (Round 2), while Sequence B is trained (Round 3) and tested (Round 4) the following morning, with a 10-minute rest in between. During training and testing, participants are asked to type using their left hand for 30 seconds per trial, followed by a 30-second inter-trial rest. There are 12 trials in Round 1 to 3, and 6 trials in Round 4. Prior to each round, there is a warm-up session during which participants are instructed to quickly click on keys labeled 3 and 4 using their right hand. Participants are prompted by screen color changes and beeps during tests. A reward is offered for total correct sequences to motivate performance. The primary indicators of interest include typing speed, accuracy, pattern consistency, and learning rate, particularly focusing on pre- and post-sleep performance.

Statistical analysis plan

In cross-sectional data analysis, our primary focus is on examining group differences and intra-group variation. We detailed the statistical methodology in our report on the results from the wave 1 data of the cross-sectional study of GRINS in 2022 [ 48 ]. For subsequent analyses, we intend to adopt similar methodologies with an emphasize on the trends or patterns of change observed over time within groups. In brief, demographic data between groups will be analyzed using appropriate methods, such as the F-test or the Chi-square test. For any variable that shows a significant group-difference or is considered relevant to our indicators of interest based on previous evidence (like age and sex), it will be used as a covariate in subsequent statistical comparisons. Based on the nature of the data, logistic regression or linear regression, incorporating important covariates, will be used to assess group differences in variables of interest, explore associations across variables, and develop prediction models for diseases. For longitudinal analyses, we will use linear mixed models to account for correlated repeated measurements. We will test for missing observations that are not missing completely at random (MCAR), especially if missing status correlates with other measures. Cluster-based permutation testing is employed to control for false positive rates arising from the multiplicity of tests across different channels and frequencies. We will also conduct sensitivity analyses to address potential confounders, such as age and sex, with special consideration given to assessing the impact of medications. In addition, we will examine subgroup differences among medications when there are 10 or more patients using a particular medication. Individually, all measures will be transformed to approximate normality as needed (e.g., applying a log-transform to spectral power metrics), and statistical outliers will be removed prior to the main analyses.

Study management

A specialized research team at WMHC is assembled for the execution of the GRINS project, organized into five groups due to the extensive range of clinical evaluations and neuropsychological tests involved. Each group is responsible for assessing different aspects: SCID, PANSS, Cognition (MCCB), mood status (HAMA, HAMD, and YMRS), and other areas. Prior to the formal launch, every team member underwent relevant training tailored to their specific roles and responsibilities within the study. All assessors received hands-on training from experts at Beijing Huilongguan Hospital and the Second Xiangya Hospital to ensure inter-rater reliability.

Weekly online meetings are conducted to monitor the progress of the project, attended by the principal investigators from both the US and China, the project manager, the coordinator, and researchers from GRINS. During these sessions, we discuss weekly research updates, assign upcoming tasks, report on data quality control results, and more. Feedback from participants and research staff is regularly gathered to identify areas for improvement. The Office of Regulatory Affairs & Research Compliance of Harvard TH Chan School and the Institutional Review Board of WMHC also provide additional onsite reviews to help address deficiencies and promote better organization and implementation.

Data are routinely backed up to secure servers. Security of and access to data have been designed to protect group membership (blind) and data breaching. For instance, members of the MCCB evaluation team can view participants’ basic demographic information and have full access to the MCCB section, but they cannot access other data. In contrast, members of the analysis team are not permitted to access grouping information until the data analysis at the individual level is finalized.

Preliminary data quality control checks are conducted weekly, focusing on data integrity, consistency, and reliability. These checks utilize both software scripts and manual reviews. For instance, an age validation procedure involves juxtaposing the age input into the electronic system with the age deduced from the participant’s date of birth, facilitating the identification and correction of discrepancies. The power spectral density of each sleep EEG is graphed to inspect for any signs of harmonic interference. Results stemming from these quality control measures are collectively reviewed and deliberated upon during our regular online meetings, as abovementioned.

The GRINS project endeavors to comprehensively characterize the neurophysiological abnormities of SCZ and other psychiatric illnesses, primarily focuses on the thalamocortical system. Dysfunction in the thalamus and its cortical connections is believed to be related to the dysregulation of dopamine and glutamate neurotransmission, both of which are implicated in the pathophysiology of SCZ [ 56 ]. The thalamocortical system plays a pivotal role in the integration of sensory information and in the processing of higher cognitive functions such as perception, attention, and memory. These functionalities are intrinsically linked to various symptoms of SCZ, including hallucinations, delusions, and cognitive deficits [ 57 , 58 , 59 ]. Previous research also suggests that thalamo-cortical circuits are responsible for generating slow-wave activity and NREM sleep spindles [ 53 , 60 ], while abnormalities in sleep architecture and neurophysiology have been repeatedly reported in individuals with SCZ [ 18 , 19 , 20 ] and may correlate with their clinical symptoms [ 31 ]. By integrating and conducting in-depth analysis of multidimensional neurophysiological metrics associated with thalamocortical system, it becomes possible to ascertain the roles of, and further clarify the mechanisms behind, potential neurophysiological markers for SCZ.

Currently, the GRINS project has successfully enrolled over 300 participants, and data collection is ongoing. Analysis of the pilot study dataset, comprising 72 cases and 58 controls, indicated excellent data quality and validated key wake and sleep EEG abnormalities observed in SCZ populations from Europe and America [ 48 ]. This suggests that the study protocol can capture the key neurophysiological parameters of SCZ. With data from additional participants and longitudinal follow-up studies, we will be able to better understand the significance of neurophysiological markers for SCZ and the underlying mechanisms.

Conducting a time-consuming overnight study like GRINS on patients with psychiatric disorders poses unique challenges. The experience and strategies we have accumulated thus far may offer insights for future research in this domain: Firstly, we endeavored to streamline the study process, ensuring clarity and ease of understanding. To minimize potential errors during critical steps, we established standardized operating procedures and guidelines for research team members. These include instructions on correctly positioning and setting the BrainCap, naming conventions for various data sets, and precautions for the overnight study. Also, we created multiple groups for lengthy clinical assessments. In this setup, every research staff can easily understand their roles and responsibilities, thereby enhancing the efficiency and accuracy of the study.

Various measures are implemented to prevent nervousness, fatigue, and resistance among participants, thereby enhancing their cooperation. We educate them about EEG basics and safety prior to the overnight study, with a special focus on demonstrating the electrode cap to alleviate any potential concerns. A pre-visit to the sleep center is arranged to reduce new-environment anxiety, aiming to minimize the “first-night effect” [ 61 ]. During the overnight study, we intersperse active tasks within passive paradigms and schedule breaks between tasks to maintain alertness and minimize drowsiness. Performance-based rewards are offered to boost focus and concentration. Additionally, snacks are prepared for participants in case of nighttime hunger.

In our study, we uphold several key ethical considerations: We avoid interfering with any patient’s clinical treatment and ensure that patients fully understand the study by utilizing an “Informed Consent Capacity Evaluation Form”. In the context of Chinese society, where family often plays a crucial role in decision-making, we also inquire about the patient’s willingness to involve family members in the decision-making process. If a family member advises against participation, we respect this decision and ensure it doesn’t impact the patient’s medical services. Additionally, we consult with the patient’s attending physicians to confirm clinical stability for the overnight study and, when necessary, station security guards near the sleep laboratory for added safety.

It should be noted that while necessary criteria are used to ensure participant safety and streamline the study process, certain limitations may be introduced. For example, the recruitment of clinically stable patients may limit the representativeness of the study sample. In addition, patients are primarily recruited from inpatient unit. While this minimizes the risk of dropout, the hospital-imposed routine may not reflect naturalistic sleep/wake rhythms and circadian patterns. At the same time, allowing the joint use of benzodiazepines and mood stabilizers may affect certain aspects of sleep EEG [ 62 ], although group differences between SCZ and controls still persisted even after statistically controlling for the effects of medication in our pilot results [ 48 ]. Last but not the least, the study design involved a single overnight EEG recording session. Despite the fact that we did not observe the “first-night effect” in previous studies [ 62 , 63 ] and our efforts to mitigate it in the current study, its potential influence on the results may not be completely disregarded.

The GRINS project is dedicated to deepening our understanding of the neurophysiological abnormalities associated with SCZ, by employing a large sample size across multimodal measurements. The pilot results successfully validated key neurophysiological phenotypes of SCZ in the Chinese population and affirmed the project’s feasibility. Through GRINS, we are generating a valuable multi-dimensional dataset with the potential to uncover neurophysiological biomarkers for SCZ and other psychiatric disorders, and their underlying mechanisms. This protocol offers the flexibility to be applied across psychiatric disorders and to integrate additional biological research methodologies and goals. Such discoveries may inform objective diagnoses, patient stratification, prognostic predictions, and the development of innovative therapeutic strategies for these conditions.

Availability of data and materials

All data will be shared with the research members of the GRINS consortium as they become available. Anonymized individual-level data from the pilot study is accessible in the Dryad archive ( ). Additional anonymized, individual-level data will be made available to researchers outside the GRINS consortium upon request following publication. Please direct inquiries to JP at [email protected].


Abnormal Involuntary Movement Scale

Auditory steady-state response

  • Bipolar disorder

Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard

Diagnostic and Statistical Manual of Mental Disorders

Diffusion tensor imaging

Electroconvulsive therapy


Edinburgh Handedness Inventory-Short Form


Event-related potentials

Functioning Assessment Short Test

Fagerstrom test for nicotine dependence

global explained variance

global mean field power

Global Research Initiative on the Neurophysiology of Schizophrenia

Genome-Wide Association Studies

Hamilton Anxiety Rating Scale

Hamilton Depression Rating Scale

Horizontal electrooculogram

Intelligence quotient

Missing completely at random

MATRICS Consensus Cognitive Battery

Mismatch negativity

Magnetic resonance imaging

Motor sequence test

Non-rapid eye movement

Positive and Negative Syndrome Scale

Pittsburgh Sleep Quality Index

Structured Clinical Interview for DSM Disorders

  • Schizophrenia

Slow oscillations

Stanford Sleepiness Scale

Temperament Evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire

Thalamic reticular nucleus

Vertical electrooculogram

Short form of the Wechsler Adult Intelligence Scale—revised for China

Wuxi Mental Health Center

Young Mania Rating Scale

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GRINS Consortium members: Clinical Research Team — Chenguang Jiang, Yifan Sun, Jun Wang, Guanchen Gai, Duxing Li, Zixuan Huang, Jikang Liu, Kai Zou, Zhe Wang, Xiaoman Yu, Limin Chen, Xuezheng Gao, Hongliang Zhou, Guoqiang Wang, Yi Su, Wei Zhu, Michael Murphy, Meihua Hall, Shuping Tan, Zhenhe Zhou. Data analyses — Nataliia Kozhemiako, Lei A Wang, Yining Wang, Lin Zhou, Shen Li, Dimitrios Mylonas, Michael Murphy, Robert Stickgold, Dara S Manoach, Meihua Hall, Jen Q Pan, Shaun M Purcell. Molecular Genetics — Lu Shen, Shenying Qin, Hailiang Huang. Project management — Zhenglin Guo, Sinéad Chapman, Jess Wang, Lin Zhou, Hailiang Huang, Yi Su, Shuping Tan, Jun Wang, Zhenhe Zhou, Jen Q Pan, Steven E Hyman. (co-)Principal Investigators — Zhenhe Zhou, Dara S Manoach, Hailiang Huang, Shaun M Purcell, Meihua Hall, Jen Q Pan.

the GRINS Consortium

Chenguang Jiang 1 , Yifan Sun 1 , Duxing Li 1 , Zixuan Huang 1 , Jikang Liu 1 , Guanchen Gai 1 , Kai Zou 1 , Zhe Wang 1 , Xiaoman Yu 1 , Limin Chen 1 , Xuezheng Gao 1 , Guoqiang Wang 1 , Wei Zhu 1 , Jun Wang 1 , Zhenhe Zhou 1 , Zhenglin Guo 2 , Sinéad Chapman 2 , Jess Wang 2 , Lei A Wang 2 , Yining Wang 2 , Lin Zhou 2 , Steven E Hyman 2 , Jen Q Pan 2 , Nataliia Kozhemiako 3 , Shaun M Purcell 3,9 , Dimitrios Mylonas 4 , Dara S Manoach 4 , Yi Su 5 , Shuping Tan 5 , Lu Shen 6 , Shengying Qin 6 , Michael Murphy 7 , Meihua Hall 7 , Robert Stickgold 8,9 , Hailiang Huang 2,10 , Hongliang Zhou 11 , Shen Li 12

1 The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, China

2 Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States

3 Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, United States

4 Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, United States

5 Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China

6 Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China

7 Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, United States

8 Beth Israel Deaconess Medical Center, Boston, United States

9 Department of Psychiatry, Harvard Medical School, Boston, United States

10 Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, United States

11 Department of Psychology, The Affiliated Hospital of Jiangnan University, Wuxi, China

12 Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China

This project is supported by the Stanley Center for Psychiatric Research at the Broad Institute of MIT and Harvard, and the Beijing Huilongguan Hospital, and the Wuxi Mental Health Center.

Author information

Jun Wang and Chenguang Jiang contributed equally to this work.

Authors and Affiliations

The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, China

Jun Wang, Chenguang Jiang & Zhenhe Zhou

Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States

Zhenglin Guo, Sinéad Chapman, Lin Zhou, Hailiang Huang, Steven E. Hyman & Jen Q. Pan

Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, United States

Nataliia Kozhemiako & Shaun M. Purcell

Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, United States

Dimitrios Mylonas & Dara S. Manoach

Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China

Yi Su & Shuping Tan

Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China

Lu Shen & Shengying Qin

Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, United States

Michael Murphy & Meihua Hall

Beth Israel Deaconess Medical Center, Boston, United States

Robert Stickgold

Department of Psychiatry, Harvard Medical School, Boston, United States

Robert Stickgold & Shaun M. Purcell

Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, United States

Hailiang Huang

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  • Chenguang Jiang
  • , Yifan Sun
  • , Duxing Li
  • , Zixuan Huang
  • , Jikang Liu
  • , Guanchen Gai
  • , Xiaoman Yu
  • , Limin Chen
  • , Xuezheng Gao
  • , Guoqiang Wang
  • , Zhenhe Zhou
  • , Zhenglin Guo
  • , Sinéad Chapman
  • , Jess Wang
  • , Lei A. Wang
  • , Yining Wang
  • , Steven E. Hyman
  • , Jen Q. Pan
  • , Nataliia Kozhemiako
  • , Shaun M. Purcell
  • , Dimitrios Mylonas
  • , Dara S. Manoach
  • , Shuping Tan
  • , Shengying Qin
  • , Michael Murphy
  • , Meihua Hall
  • , Robert Stickgold
  • , Hailiang Huang
  • , Hongliang Zhou
  •  & Shen Li


JP, SH, MH and SP conceived the project initially, and designed the study with contributions from DM, RS, HH and ZZ. CJ and JW implemented clinical protocol and collected subject level data together with the clinical research team members. JP and ZZ supervised the overall project, with contributions from ZG and SC together with the Project management team. JW drafted the manuscript together with JP, with input from ZG and CJ. All authors have reviewed and approved the manuscript for submission.

Corresponding author

Correspondence to Jen Q. Pan .

Ethics declarations

Ethics approval and consent to participate.

The GRINS project has been approved by the Harvard T.H. Chan School of Public Health Office of Human Research Administration (IRB18-0058) and the Institutional Review Boards of Wuxi Mental Health Center (WXMHCIRB2018LLKY003) and Shanghai Jiao Tong University (M16035). Written informed consent is obtained from each participant before the commencement of the investigation. The manuscript does not contain any sensitive information about individual participants in the GRINS project.

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Not applicable.

Competing interests

The authors declare no competing interests.

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Wang, J., Jiang, C., Guo, Z. et al. Study Protocol: Global Research Initiative on the Neurophysiology of Schizophrenia (GRINS) project. BMC Psychiatry 24 , 433 (2024).

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Received : 25 January 2024

Accepted : 31 May 2024

Published : 10 June 2024


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This week, I’m joined by Johann Hari, New York Times bestselling author, journalist, and speaker, to explore his journey into the world of the new weight loss drug phenomenon: Ozempic. Johann shares his surprising firsthand experience injecting himself weekly with the drug for over a year, leading to dramatic weight loss but also complex side effects. We discuss the staggering potential of these “magic pills” to curb the global obesity epidemic, but also the alarming risks like thyroid cancer, pancreatitis, and muscle wasting. Johann provides a nuanced look at the bigger picture—examining the role of pharmaceutical profit, societal pressures around body image, and whether medicalizing thinness addresses root causes. His investigation stretches from the science labs of Iceland to the food culture of Japan. This discussion ultimately confronts sobering philosophical questions about the ethics of pharmaceutical shortcuts versus growth through struggle. Please enjoy! Show notes + MORE Watch on YouTube Newsletter Sign-Up Today’s Sponsors: InsideTracker: Use code RICHROLL at checkout and enjoy 10% OFF the InsideTracker Subscription and any plan 👉 Seed: Use code RICHROLL25 for 25% OFF your first order  👉  On: 10% OFF your first order of high-performance shoes and apparel w/ code RICHROLL10 👉  Momentous: Save up to 36% OFF your first subscription order of Protein or Creatine, along with 20% OFF all of my favorite products 👉 Squarespace: Use the offer code RichRoll to save 10% off your first purchase of a website or domain 👉  Peak Design: 20% OFF thoughtfully designed carry solutions 👉 SriMu: Get 22% OFF artisanally crafted plant-rich cheeses w/ code RRP 👉 Check out all of the amazing discounts from our Sponsors 👉 Find out more about Voicing Change Media at and follow us @voicingchange

  • 2 hr 11 min
  • © 2012-2023 Rich Roll Enterprises, LLC. All rights reserved.

Customer Reviews

10.8K Ratings


In the name of all things glorious, please, more Roll On shows. Once a month would be a treat and standout in the landscape of noise.

Sam Harris episode

I’m wondering why there was no pushback or interrupting in this episode like they’re normally is when someone comes on who is dogmatic. Harris being a known anti Muslim , and once again couching the Israeli genocide as a good versus evil dynamic. He goes so far as to suggest antisemitism to those who disagree. Not only does Rich not shut this spew down, he asks him to expand on it. Shameful We can do better, and we normally do on this show.

My absolute favorite podcast

Listening to Rich feels like hanging out with a good friend, who has really interesting friends. His voice puts me at ease like the Calm app. I count on Rich to deliver relevant info and I trust his opinion about the products that sponsor his show. Most notable is Rich’s vocabulary- he uses diverse and articulate language, its a real treat to learn from him.

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    Initial evaluations with a psychiatrist usually run $250 to $300, with follow-up sessions lasting 30 to 60 minutes for $100 to $200 each. Virtual visit options with a psychiatrist on the GoodRx Telehealth Marketplace can start at $99 per session and sometimes less.

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