Policies

Our services cater primarily to patients aged between 7 and 70. However, there are some exceptions. We might occasionally see younger children, around 5 or 6 years old, with straightforward symptoms of ADHD. Conversely, patients in their 60s diagnosed with dementia may be better served by a neurologist or a psychiatrist specialized in geriatric psychiatry.

Every patient, irrespective of age, needs to be open to undergoing a psychiatric evaluation as part of their treatment. If a patient is 18 or older, they should provide their own signature to consent to treatment, unless they have a legal guardian due to a disability.

We also request that all patients who are able, fill out the online intake form themselves. We kindly ask family members to refrain from completing the forms on behalf of the patient, unless the patient is unable to do so due to their age or a disability.

Other Considerations for Patients < 18 years of age

All legal guardians (aka both parents, in most cases) must be amenable to his/her/their treatment.

“Unwilling” Children: For young children, we understand that they may not be eager or capable to participate in the intake process. In such cases, we can rely mostly on information provided by the parents or guardians. However, it's important that we have an opportunity to interact with the child on video at least once during the initial intake.

“Unwilling” Teens: In the case of older children or teens, they might possess the capacity to make choices about their medication or to express their willingness to engage in discussions with a healthcare provider. So in some cases, while their parents may feel they need treatment, the teen is unwilling to participate in the clinical intake. We are comfortable conducting an intake solely with parents, but please be aware that we are unable to prescribe medications unless we've had a direct and meaningful interaction with the patient, once they reach a certain age (unless there's a disability involved).

We do not perform any legal evaluations, including but not limited to, custodial evaluations or providing recommendations on home placements, as we don't possess forensic training.

At present, our practice does not provide medically assisted treatment (MAT) for substance use disorders, nor do we offer outpatient detox services for alcohol, benzodiazepine, or opiate use. However, we encourage you to explore the following resources for this higher level treatment

Substance Abuse and Mental Health Services Administration (SAMHSA): SAMHSA runs a confidential and anonymous helpline (1-800-662-HELP) available 24/7, 365 days a year, providing information on substance use disorders and referrals to local treatment facilities, support groups, and community-based organizations.

National Institute on Drug Abuse (NIDA): NIDA provides a comprehensive directory of drug treatment centers across the country. Their website also offers a wealth of information and resources to help understand substance use disorders.

The American Society of Addiction Medicine (ASAM): ASAM is an organization dedicated to improving the addiction care profession. They offer a "Find a Provider" feature on their website that can help patients locate addiction specialists and treatment centers in their area.

As a policy, we typically avoid prescribing benzodiazepines or specific sleep medications like Ambien, Lunesta, or Sonata for insomnia. Our approach is due to concerns about physiological and psychological dependence, as well as potential long-term side effects linked to their prolonged use.

However, in unique circumstances, we may consider prescribing these medications under the following conditions
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If a low dose is used infrequently, less than twice a month, to manage particular anxiety-inducing situations such as a severe fear of flying.

We may also consider continuing the medication if a patient comes to us already prescribed what we consider "reasonable doses" of a benzodiazepine or a "Z-drug" hypnotic sleep agent, and they have demonstrated a long-standing pattern of responsible use. Please note, we will not increase the dose and will require a note from the previous prescriber agreeing that it is appropriate to continue the medication in question.

Stimulants used for ADHD treatment have proven to be extremely beneficial for many patients, reducing the risk of addiction among those with ADHD. However, there are instances where these medications can be misused. Therefore, we have a stringent policy regarding the prescription of stimulants, encompassing all methylphenidate and amphetamine-based compounds (some commonly recognized brand names include Adderall, Adderall XR, Concerta, Ritalin, Ritalin LA, Ritalin SR, Vyvanse, Focalin, Focalin XR, Daytrana, Quillivant XR, QuilliChew ER, and Adzenys XR-OD).

We expect you to strictly follow your medication instructions, keep us informed about all your medications, supplements, and vitamins, and understand the potential risks associated with prescribed medications. Be aware that we may conduct random drug tests and inconsistencies or signs of substance issues could lead to discontinuation of your care, as could misuse of medication, or seeking similar medications from different doctors. Please note that we may share your medical records with other medical providers or pharmacies if necessary, and early refills of controlled substances are not permitted without a valid police report in case of theft. Finally, understand that if you violate these terms, misuse your medication, or fail to disclose a history of substance abuse, you bear sole responsibility for any negative consequences, and we reserve the right to discontinue your care if there's any suspicion of misuse or mishandling of your prescribed medications.

Our team comprises professionals who have not pursued special fellowships in forensic psychiatry, and as such, we don't conduct evaluations for legal or court-related purposes. This includes, but isn't limited to, custody evaluations, court-ordered psychiatric assessments, violence risk assessments, and school fit/placement evaluations.

In the uncommon instance where our clinical expertise is called upon for a legal matter, we maintain the right to consult a forensic psychiatrist or a lawyer specializing in mental health. This action is undertaken to ensure we provide the highest standard of care for our patients while upholding legal and ethical guidelines.

Please note, any legal consultation and associated work, including preparing documents, travel, court appearances (virtual or in-person), document review, or collaboration with council, will be the patient's responsibility. The expenses will be billed at our standard clinical and administrative rates for the respective services provided.

We are committed to gaining a deep understanding of our clients' needs and conditions. As part of this commitment, we usually complete short-term disability or FMLA paperwork only after at least four months of collaborative work. Please note, filing for permanent disability is an exception, not a norm, and is undertaken only when strict criteria are met.

We are committed to gaining a deep understanding of our clients' needs and conditions. As part of this commitment, we usually complete short-term disability or FMLA paperwork only after at least four months of collaborative work. Please note, filing for permanent disability is an exception, not a norm, and is undertaken only when strict criteria are met.

When it comes to long-term disability, we take extra precaution. We consider these applications only if we have worked with the patient for a minimum of eight months and if the underlying psychiatric condition has led to multiple recent inpatient psychiatric hospitalizations, as well as an inability to maintain employment, despite adherence to various treatment protocols aimed at managing the specific disorder. This ensures we make well-informed decisions for the welfare of our patients.

If we perceive a patient to be at immediate risk to themselves or others, we are legally and ethically bound to ensure that advanced care is sought. In cases where patients decline such care or cannot provide proof of pursuing it, we will engage your local emergency services.

Here is more on how to find higher level care in your area:

Substance Abuse and Mental Health Services Administration (SAMHSA): SAMHSA's Behavioral Health Treatment Services Locator is a comprehensive directory of mental health treatment facilities across the United States. Website:
https://findtreatment.samhsa.gov/
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National Alliance on Mental Illness (NAMI): NAMI offers an array of support and education programs for individuals living with mental health conditions, their families, and the community at large. They also provide a help line for individuals who may need assistance finding mental health resources in their area.
Website: https://www.nami.org/Home

Mental Health America (MHA): MHA offers a wide array of resources on mental health, including a tool for finding local affiliates who can provide services and supports including education, advocacy, and direct services.
Website: https://www.mhanational.org/

The APA, or American Psychological Association has a comprehensive list of phone numbers for various disorders and emergencies:
https://www.apa.org/topics/crisis-hotlines

In case of an immediate crisis, the National Suicide Prevention Lifeline can be reached at 1-800-273-TALK (8255), or text "MHA" to 741741 to talk to a trained crisis counselor. Website: https://suicidepreventionlifeline.org/

For immediate safety concerns, please call 911 or go to the nearest emergency room