Which Mental Health Provider Should I Consider? A Symptom-Based Guide

The support of a good healthcare provider can make all the difference when you’re struggling with your mental health. But how do you connect to one in a sea of options? It’s easier to navigate the mental healthcare system when you know what types of providers are out there – and importantly – which type of provider may be right for your specific needs.

Here’s an overview that can help you take the next step forward with more confidence. First, a description of the different kinds of mental health providers, including primary care clinicians, psychiatrists, psychologists, social workers, counselors and nurse practitioners, and then, a symptom-based guide that walks you through how they can help address what you may be experiencing.

Primary Care Clinicians

A primary care physician (PCP) is often the first point of contact for patients with mental health concerns. PCPs can assess patients for mental health conditions like depression, anxiety, and substance use disorders using standardized screening tools.

They diagnose common mental health conditions and initiate treatments, such as prescribing medications (e.g., antidepressants) or recommending lifestyle modifications.

They provide psychoeducation, helping patients understand their condition and treatment options while promoting self-care strategies.

If specialized care is needed, PCPs refer patients to psychiatrists, psychologists, or therapists and collaborate with these professionals to ensure integrated care.

Understanding Mental Health Specialists

Not all mental health providers work in the same way. You may make the most progress with a provider who has a specific kind of background, training or treatment approach. For example, some can prescribe medication and others cannot. Here’s what to expect from each type of provider.

Psychiatrists (M.D. or D.O.)—can prescribe medication

As the National Alliance on Mental Illness (NAMI) website explains, “Psychiatrists are licensed medical doctors who have completed psychiatric training. They can diagnose mental health conditions, prescribe and monitor medications and provide therapy. Some have completed additional training in child and adolescent mental health, substance use disorders or geriatric psychiatry.”

• Medical doctors specializing in mental health treatment.
• Can prescribe medication.
• May or may not offer talk therapy.

Psychologists (Ph.D. or Psy.D.)—cannot prescribe medication

“Psychologists hold a doctoral degree in clinical psychology or another specialty such as counseling or education. They are trained to evaluate a person’s mental health using clinical interviews, psychological evaluations and testing. They can make diagnoses and provide individual and group therapy. Some may have training in specific forms of therapy like cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT) and other behavioral therapy interventions.”

• Mental health professionals with doctorate-level training in psychology.
• Generally, cannot prescribe medication, except in some states with additional training.
• Focus on assessment, diagnosis and therapy.

Licensed Clinical Social Workers (LCSW)—cannot prescribe medication

“Clinical social workers are trained to evaluate a person’s mental health and use therapeutic techniques based on specific training programs. They are also trained in case management and advocacy services,” according to the NAMI website.

• Mental health professionals with master’s-level training in social work and a clinical focus.
• Focus on talk therapy and case management.
• Can connect clients to other social resources that may be needed.

Licensed Professional Counselors (LPC or LMHC)—cannot prescribe medication

Professional counselors may work slightly differently, as the Psychology Today website describes. “Counseling tends to be shorter term, goal-oriented, and it addresses concrete, specific life challenges. By contrast, therapy with other professionals tends to be longer term, more exploratory and holistic, and it treats mental illness. Counselors often specialize in a specific area, such as marriage, addiction, grief, or abuse. For example, drug and alcohol counseling is a common form of counseling in which certified individuals help clients recover from alcohol and substance use disorders.”

• Mental health professionals with master’s-level training in counseling.
• Focus on talk therapy for individuals, couples and families.

Psychiatric Mental Health Nurse Practitioners (PMHNP)—can prescribe medication

“Psychiatric or mental health nurse practitioners can provide assessment, diagnosis and therapy for mental health conditions or substance use disorders. In some states, they are also qualified to prescribe and monitor medications. Requirements also vary by state as to the degree of supervision necessary by a licensed psychiatrist,” explains the NAMI website.

• Advanced practice registered nurses specializing in mental health.
• May be able to prescribe medication.
• May offer talk therapy.

A Symptom-Based Guide

Alt text: Image of a PHQ9 depression screening

Here are some common experiences people have. You may relate to one of these thoughts or feelings. If so, please speak with your clinician. They will be able to give you the diagnosis that may lead to the treatment plan for you.

“I’m feeling persistently sad, hopeless and have lost interest in activities.”

Possible conditions may include mild, moderate or severe depression. Providers include:

• For mild or moderate depression, a psychologist, LCSW or LPC who can offer talk therapy.
• For moderate to severe depression, a psychiatrist or PMHNP who can offer medication evaluation potentially combined with talk therapy.
• How do you know if you may need medication? The National Institute of Mental Health website explains it this way: “For milder forms of depression, psychotherapy is often tried first, with medication added later if the therapy alone does not produce a good response. People with moderate or severe depression usually are prescribed medication as part of the initial treatment plan.”

“I’m constantly worried, anxious and have difficulty controlling my fear.”

Possible conditions may include generalized anxiety disorder, social anxiety disorder or panic disorder. Providers include:

• For mild to moderate anxiety, a psychologist, LCSW or LPC who can offer talk therapy, especially cognitive behavioral therapy (CBT).
• For moderate to severe anxiety, a psychiatrist or PMHNP who can offer medication evaluation in conjunction with talk therapy.
• “While medications are sometimes necessary and part of a good treatment plan, [talk] therapy can also help you work through anxiety,” explains nurse Risa Kerslake on the Healthline “One treatment option proven to be effective is cognitive behavioral therapy (CBT). CBT is a type of therapy that works on negative thought patterns or behaviors in an effort to recognize and restructure them. In other words, CBT can help you change how you approach a situation.”

“I’m experiencing extreme mood swings, from highs to lows.”

Possible conditions may include bipolar disorder (I or II) or cyclothymia. Providers include:

• A psychiatrist or PMHNP who can diagnose the condition and offer medication management and monitoring.
• Medication management, such as the use of mood stabilizers, may be important in bipolar disorder treatment. The Cleveland Clinic website shares that “Mood stabilizers are medications that healthcare providers use to treat bipolar disorder and other mental health conditions. They specifically work for people with bipolar disorder by helping manage the high (manic) and low (depressive) mood swings that occur with the disorder. Mood stabilizers include lithium, anticonvulsants and antipsychotics.”

“I’m hearing voices or having unusual beliefs that others don’t share.”

Possible conditions may include schizophrenia, schizoaffective disorder or other psychotic disorders. Providers include:

• A psychiatrist to offer a diagnosis and medication management, often in collaboration with a professional who can provide talk therapy.
• People who are experiencing these disorders need specialized psychiatric care. They often have a variety of symptoms that require specialized knowledge for accurate diagnosis and effective ongoing treatment.

“I’m struggling with obsessive thoughts and compulsive behaviors.”

Possible conditions may include obsessive-compulsive disorder (OCD). Providers include:

• A psychologist who specializes in CBT, especially exposure and response prevention (ERP).
• A psychiatrist or PMHNP to offer medication management, especially if the OCD is severe or doesn’t respond to therapy alone.
• Specialized therapy for OCD can help people gain more control over the condition. As the Healthline website explains, “[ERP] is a type of exposure therapy and cognitive behavioral therapy (CBT) that’s been proven to be very effective at treating OCD. Due to its efficacy, it’s considered a first-line treatment for the disorder. The goal of ERP is to help people overcome what is essentially an overactive stress response to feared stimuli. Ideally, they realize they’re safer than they previously believed and that they no longer need to engage with the obsessions and compulsions.”

“I’m having difficulty coping with a traumatic event.”

Possible conditions may include post-traumatic stress disorder (PTSD) or acute stress disorder. Providers include:

• A psychologist, LCSW or LPC specializing in trauma-informed therapies such as eye movement desensitization treatment (EMDR) or cognitive processing trauma (CPT).
• A psychiatrist or PMHNP for medication management if symptoms are severe or significantly impair everyday functioning.
• EMDR is an evidence-based therapy for trauma which, despite being relatively new in the past twenty years, has proven effective. The Cleveland Clinic website shares that “EMDR therapy doesn’t require talking in detail about a distressing issue. EMDR instead focuses on changing the emotions, thoughts or behaviors that result from a distressing experience (trauma). This allows your brain to resume a natural healing process.”

“I’m struggling with substance use or addiction.”

Possible conditions may include substance use disorders or addiction. Providers include:

• A psychiatrist specializing in addiction medicine.
• A psychologist, LCSW or LPC specializing in addiction counseling.
• A certified addictions counselor.
• There are many professionals who specialize in working with individuals dealing with substance use issues or other forms of addiction. Their background and specialized knowledge can be valuable in helping people make the connections they need to move forward.

Other Important Considerations

These factors may also come into play as you research potential mental health professionals.

Insurance coverage and network. If you have an insurance plan, it may only cover certain providers.

Location and accessibility. Finding a provider in your area is helpful if you plan to visit them regularly. Some providers may offer online talk therapy services.

Personal preferences. Feeling comfortable with your provider is an important part of the process. Think about if a potential provider’s therapeutic style, gender and cultural background will work for you.

Specialized needs. You may also choose to look for a provider that focuses on specific populations, such as children, older adults or individuals with LGBTQIA+-specific needs.

How to Find a Provider

You can begin your search in several places. You might try:

Your insurance company directory. Your insurance provider likely maintains an online resource of mental health professionals in your network.

Online directories. You can browse professionals at websites such as Zocdoc (which lists providers based on who takes your insurance) and Psychology Today to see who stands out to you.

Referrals. You may ask your primary care physician, family members or close friends if they know of a provider that may be able to help you.

Local mental health organizations. Websites for groups like NAMI, DBSA, and MHA list local programs and resources that may be useful in your search.

What to Expect During Your First Appointment

You can prepare for your first appointment by writing down your relevant medical or mental health history. During the appointment, your provider will walk you through the rest of the process. For example, they’ll ask questions that will help them assess and diagnose what you’re experiencing. A Healthline article describes what a first visit with a psychiatrist might look like.

“Once you’re in your session, you can expect that the psychiatrist will ask you the reason you’re coming in to see them. They might ask in a variety of different ways, including:

‘So, what brings you in today?’               

‘Tell me what you’re here for.’

‘How’re you doing?’

‘How can I help you?’

Being asked an open-ended question might make you nervous, especially if you don’t know where to begin or how to start. Take heed in knowing that there’s truly no wrong way to answer and a good psychiatrist will guide you through the interview.”

It’s O.K. to feel and honestly express your emotions during this conversation. From there, the professional will share their thoughts with you on:

• Assessment and possible diagnosis.
• Treatment planning.
• Medication, if it’s applicable to your condition.

Thinking about starting mental health treatment can feel overwhelming but knowing how and where to begin can help you make those important first steps. Remember, if you run into a roadblock or meet with a provider who isn’t the right fit, don’t let it stop you altogether. There are many people out there who want to help you along your mental health journey.

Use this guide as a starting point to identify potential providers. Contact your insurance company or primary care physician for referrals or check out the resources below. You deserve to get the support you need to move forward.