Many people decide they want to try medication for anxiety or depression, or want a second opinion on what they are already taking, and then hit the hard part: finding someone who prescribes, takes their insurance and has an opening this season. This guide covers where to look in Michigan, how to bridge a wait, and how to get the most from a short first visit.
Do you need a psychiatrist, or will your doctor do?
For many adults, a primary care doctor, physician assistant or nurse practitioner is a reasonable first prescriber for common anxiety and depression. NIMH notes that a primary care provider is often a good place to start and can refer you to a mental health professional. A psychiatrist or psychiatric nurse practitioner may make more sense when:
- Two or more medications have not helped, or side effects have been hard to manage
- There are questions about the diagnosis, such as whether depression might be part of bipolar disorder
- You take several medications, or have medical conditions that complicate choices
- Your doctor suggests it, or you would simply feel better with a specialist's view
For what each type of prescriber is trained and licensed to do in Michigan, read Psychologist, Psychiatrist or Counselor?. Psychologists, including Dr. Lehmann, do not prescribe in Michigan.
Where to look
- Your primary care doctor: ask for a referral and whether the practice has an embedded behavioral health team
- Your insurer: the member directory or member services line can list in-network psychiatrists and psychiatric nurse practitioners; ask which are accepting new patients
- Your health system: large Michigan health systems run outpatient psychiatry departments, often with a central scheduling line
- Your therapist: therapists usually know which local prescribers are taking patients and communicate well
- Telehealth practices licensed in Michigan, which can widen your options beyond Oakland County
If you have Medicaid or the Healthy Michigan Plan, Oakland Community Health Network's Access team determines eligibility for public mental health services for Oakland County residents. Mental Health Care With Medicaid or the Healthy Michigan Plan explains how that system works.
What to ask when you call an office
- Are you accepting new adult patients, and how long is the wait for a first visit?
- Do you take my plan, and is the prescriber in network under my mental health benefits?
- Is the first visit in person, by video or either?
- Do I need a referral or records from my doctor before booking?
- How are refills and questions between visits handled?
Write down the answers and the name of the person you spoke with. When you are depressed or anxious, a phone call can take more energy than it should; it is fine to ask a partner or friend to make the calls with you or for you.
A bridge while you wait
Waitlists for psychiatry can run weeks or months. A few options can help in the meantime:
- Ask your primary care doctor to start or adjust treatment while you wait for a specialist
- Get on more than one list, and ask each office to call you if there is a cancellation
- Common Ground's virtual Behavioral Health Urgent Care, open to people in Michigan over age 12, offers psychiatric evaluations and medication management with psychiatric mental health nurse practitioners when appropriate, without a referral, and often has same-day appointments
- Keep or start therapy, which does not depend on the prescriber's calendar
Common Ground says its virtual urgent care accepts many major plans, including Blue Cross, Blue Care Network, HAP, Molina, Priority Health and Medicaid, and is designed to connect you with an ongoing provider once the urgent need is addressed. Check your own coverage before booking.
Telehealth prescribing in Michigan
Michigan law allows a prescriber to treat you by telehealth and prescribe within their scope of practice. Controlled substances must meet the Public Health Code's additional requirements for those drugs. The law also requires a telehealth prescriber to be available for follow-up care, or to refer you to someone who is, and to refer you to nearby services, including emergency services, when medically necessary. If an online service cannot explain how follow-up works, look elsewhere.
Getting the most from a first visit
Psychiatric visits can be brief, so preparation matters. NIMH suggests bringing a list of every medication you take, including over-the-counter drugs, herbal remedies, vitamins and supplements, reviewing your family history, and writing down your questions. Also bring:
- Every psychiatric medication you have tried, the dose, how long and why you stopped
- A short description of your main symptoms and how they affect daily life
- Any alcohol, cannabis or other substance use, honestly
- Your therapist's name and a signed release if you want them to talk
Good questions to ask include how long before you might notice a change, which side effects to watch for, what to do if one appears, and when the next appointment is. NIMH notes it can take time for a medication to work, and that people should not stop a prescribed medication without help from their provider, who can lower a dose slowly and safely. Talk with your prescriber before changing anything.
Medication and therapy often work together. If you would like a therapist alongside your prescriber, therapy for depression or anxiety with a psychologist is one option. Coordinating Care Between Your Doctor, Prescriber and Therapist covers how to keep everyone on the same page.