Choosing Therapy’s Scoring Criteria for Online Psychiatry Platforms
Online psychiatry can be a convenient and cost-effective way to receive mental health-related medication management. Deciding which online psychiatry platform is the right fit for you can be an overwhelming task. Choosing Therapy can guide you in the right direction by providing in-depth, personally researched reviews, as well as multi-category ratings of the top online psychiatry platforms currently available. Our goal is to help consumers choose the best online psychiatry platform that will match both their expectations and desired treatment goals.
Before scoring an online psychiatry platform, we consider several significant factors. Below you’ll find a list of our online psychiatry scoring criteria, including how we define the key categories and features, what we look for when we rate them, and a breakdown of our star rating system.
Psychiatric Appointment Features
Having options for ways to attend appointments is important, as it greatly impacts your access to care. The best online psychiatry platforms will offer at least two options for attending a live initial assessment and subsequent follow-up appointments.
These appointment options include:
- Video calls
- Phone calls
- Live instant messaging
In addition to attendance options, it should also be clear how patients access them, whether it be in the platform’s app, on their website, or by downloading a secondary application like Zoom or Google Meets or through a third-party telehealth software platform. Patients should be aware ahead of time of the duration of each appointment, which should afford them ample time to be assessed and informed of treatment options and/or progress. . We look for platforms that offer initial face-to-face assessments that are 30 minutes or longer, with an ideal length of 45 minutes or longer. Follow-up appointments should be 15 minutes or longer and scheduled at regular intervals, with the most common being once a month when beginning a new medication.
Furthermore, ideal psychiatry platforms will allow patients to see the same provider for their initial assessment and for their follow-up care. Platforms that do not offer consistency in providers for continuity of care will receive a lower rating than platforms that do. Ideal platforms will also feature an option for patients to send written messages to their provider with any questions they have in between appointments. These messages should be sent from the platform’s app or website in a HIPAA-compliant manner, and responses should come within 24 hours.
Star Ratings for Appointment Features
5-stars – Patients can attend appointments with their provider via video, phone, or live instant messaging and it is clear how patients access these appointments. Initial psychiatric assessments are face-to-face, 45 minutes or longer and follow-up appointments are 15 minutes or longer, occurring at a higher frequency for newly prescribed medications, such as monthly. Patients have the ability to meet with the same provider throughout their care. There is an option to email or text the provider between appointments through the platform’s website or app and responses come within 24 hours.
3-stars – Patients can choose only two out of three options for attending appointments (video, phone, or live instant messaging). Initial psychiatry assessments may be face-to-face or phone visits and are only 30 minutes long. Follow-up appointments are 15 minutes long and occur at a lower frequency for newly prescribed medications, such as only every two to three months. Patients do not consistently see the same provider, or have one provider for their initial assessment and another/other for follow-up appointments. There is an option to send in-app text messages and responses come within 48 hours.
1-star – All appointments are held either via video or phone call and patients are not able to choose which option to utilize, it is unclear how to attend appointments. Initial assessments are through text only and take less than 30 minutes, with follow-up appointments lasting less than 15 minutes. It is unclear how often you will have follow-up appointments and whether you will meet with the same provider each time. There is no option to contact your provider between appointments.
Clarity of Diagnoses Treated & Prescription Options
Psychiatric platforms should be upfront and clear about which mental health diagnoses they focus on and treat. Psychiatry platforms should also have precise language around what types of prescriptions their platform allows and does not allow for, and how they are provided to the patient. Psychiatry platforms that do not offer prescriptions for certain categories of medication (i.e., controlled substances) should offer the option to coordinate with a patient’s primary care doctor to prescribe the medication if needed.
Platforms should make it clear whether medications arrive through the mail with shipping and prescription costs clearly laid out, or if patients pick up medication at a pharmacy local to them. A platform’s areas of focus and prescription options should be made available ahead of time so potential patients can make an informed decision before moving forward.
Additionally, ideal platforms will frequently ask their patients to complete various assessments, like PHQ9 and GAD7, to measure their progress and symptoms.
Please note: For platforms that specialize in a particular diagnosis (i.e., ADHD, OCD, etc.), we do not grade on this criteria. We instead grade on the diagnosis or treatment-specific criteria in the addendums below.
Star Ratings for Diagnoses & Prescriptions
5-stars – The platform is upfront and clear about which mental health diagnoses they focus on and can treat. There is precise language about which types of medications are available, controlled or non-controlled, and it is clear in what cases the platform will coordinate care with a patient’s primary care doctor. All medication is mailed directly to the patient, with shipping and prescription costs clearly laid out. Patients are asked to complete mental health assessments every two weeks.
3-stars – The platform lists diagnoses treated, however, it is vague which provider offers which specialty. The platform is clear about which types of medications are available, controlled or non-controlled, however, it is not clear if the platform will coordinate care with the patient’s primary care doctor to obtain a prescription they do not offer. Patients are asked to complete mental health assessments only once a month.
1-star – It is unclear which diagnoses are treated on the platform or which providers treat what specialties. The platform is not clear which types of medications are available, controlled or non-controlled, and it is not clear if the platform will coordinate care with the patient’s primary care doctor to obtain a prescription they do not offer. Patients are asked to complete mental health assessments every two or three months or not at all.
Crisis Management & Patient Safety
A critical component of psychiatric patient care is how a platform handles those with suicidal ideations or those in a crisis situation. During the initial intake questionnaire, when requesting services, if a patient expresses that they are in an active crisis situation, alternative crisis management resources should be made available immediately to them.
Once enrolled in services, ideal platforms have it in their safety protocol that patients with documented suicidal ideation, self-harm, or other risk factors complete safety plans with their provider. This will ensure the platform can reach out to the patient’s safety team and their local police department in the event they express they are in a crisis situation. Safety plans are crucial to help patients understand their best course of action should they have suicidal thoughts, thoughts of harming others, or other crisis issues.
In patients with documented suicidal ideation, self-harm, or other risk factors, ideal platforms will have providers assess risk at every session and provide regular follow-up appointments. Additionally, crisis hotlines and warmlines should be readily available and easy to access for patients whenever they need them.
Star Ratings for Crisis Management & Patient Safety
5-stars – The platform provides alternative crisis management resources immediately when a prospective client requests services and indicates they are in crisis. Existing patients with documented suicidal ideation, self-harm or other risk factors will complete safety plans with their provider. The platform will reach out to the patient’s safety team and the patient’s local police department in the event they express they are in a crisis situation. Crisis hotline and warmline numbers are readily available and easy to access.
3-stars – The platform provides alternative crisis management resources immediately when a prospective client requests services and indicates they are in crisis. It is unclear what safety protocols are in place to help patients with documented suicidal ideation, self-harm, or other risk factors. The platform has crisis hotlines and warmlines phone numbers present on the website as a resource and are easily accessible to patients in crisis.
1-star – The platform does not provide alternative crisis management resources immediately when a prospective client requests services and indicates they are in crisis. The platform does not accept any patient with documented suicidal ideation, self-harm, or other risk factors and asks them to find in-person care.
Geographic Location
One of the largest barriers to those seeking online psychiatry is the availability of providers licensed in their state. When reviewing online psychiatry platforms, one of the top five factors we assess is how widely available services are across the United States. Platforms that are more widely available will score higher in this category, as they serve a larger percentage of the population and increase access to care. Platforms that are more widely available also make it easier to maintain care during a move, travel, or when frequently commuting between states for work or school.
Star Ratings for Location
5-stars – The online psychiatry platform is available nationwide OR covers 50% or more of the US population.
3-stars – The online psychiatry platform covers around 30% of the US population.
1-star – The online psychiatry platform covers less than 10% of the US population.
Online Psychiatry Cost
The best online psychiatry platforms will be very clear and upfront about the expected costs for services. Whether it be a monthly subscription fee or per session cost, patients should know all expected costs prior to signing up for services. It should also be easy to understand how you will be charged, either through your credit card or FSA/HSA card, and when charges will occur. Monthly subscriptions should have no hidden costs for extra features, like webinars, worksheets, or mindfulness exercises. Likewise, platforms that offer per-session rates should not have hidden fees, like monthly membership fees or sign-up fees.
Additionally, per-session costs should be in line with the type and length of service rendered, and it should be clear if costs are based on the provider’s credentials. Online psychiatry platforms offering per-session rates should be the same or less than what it would cost to see a provider in-person. Truly great online psychiatry platforms will also offer sliding scale fees and/or financial aid of some type to make services more accessible.
Star Ratings for Cost
5-stars – Monthly subscription costs are clearly provided prior to signing up and there are no additional hidden costs. Platforms that offer per-session rates are clear about rates up front, payment due dates, and whether the cost is based on the provider’s education level. There are no additional monthly membership fees or sign-up fees and per-session costs are in line with the type and length of service rendered. There are sliding scales or financial aid available to those who qualify.
3-stars – Monthly subscription costs can be difficult to find right away, but there are no additional hidden costs. Per session rates are clear and somewhat reflective of the type and length of service rendered. It is unclear if the per-session rates are based on the provider’s education level. If there are sliding scales or financial aid available, you have to ask about this prior to signing up.
1-star – Upfront monthly subscription costs are dependent on your location and are not provided until after you have completed the sign-up process. Per session rates are very unclear, session lengths are not reflected in the cost, and there is a monthly membership fee you must pay on top of psychiatry costs. There is no financial aid or sliding scale available to anyone.
Insurance & Out-of-Network Benefits
Whether an online psychiatry platform accepts insurance will be a huge deciding factor for many seeking online psychiatry. In addition, we’re also looking at how many insurance plans are accepted and if they’re specific to certain states. We also research whether the online psychiatry platform collects and determines client eligibility for using their insurance prior to an appointment. Ideal platforms will complete this process before they see a provider.
Additionally, we look at whether a platform assists patients in using out-of-network benefits. Companies that provide a more “white glove” service when it comes to paying by insurance or using out-of-network benefits, and that make the process as easy and understandable as possible will earn more points in this category.
Star Ratings for Insurance
5-stars – Accepts insurance from many major insurance providers. The process for inputting insurance information is easy and there is a live person available if patients need help with this process. The client’s insurance is run prior to their live session with a provider and they know whether their insurance covers the service and what the out-of-pocket costs will be well in advance of a live session. OR If insurance is not accepted, the platform accepts HSA or FSA funds to pay for the cost of psychiatry or will create and submit a superbill to bill out-of-network benefits on the client’s behalf to their insurance company.
3-stars – Accepts select major insurance providers or select insurance plans by state. The process for inputting your insurance is easy, but there is not a live person available to help you with the process. Insurance may be run prior to an appointment or afterward and out-of-pocket costs can come as a surprise. The platform will accept either HSA or FSA funds to pay for psychiatry OR they will create and submit a superbill for patients, but they will not allow both.
1-star – This platform does not accept insurance at all. The platform does not accept HSA funds or FSA cards to pay for psychiatry. They offer a superbill, but patients must submit it to their insurance company themselves to bill their out-of-network benefits.
Provider Matching or Selection
Options for choosing a provider are integral to an online psychiatry platform experience. Some platforms approach this by providing matches and others allow patients to self-select.
For online psychiatry platforms that match patients with providers, we look to see if the process includes talking with a live matching agent to curate hand-picked matches, or if an algorithm does the matching. Platforms that offer more support during the provider matching or selection process will score higher than those that only use an algorithm to match patients with providers.
Furthermore, we look at how the platform’s online provider directory works, whether it is accessible/searchable by patients, and if so, what filters you can use to find providers. Directories that allow you to access and search their directory of providers, as well as filter for gender, credentials, specialty, and cost will score better than those that offer only one or two filtering options, or that are not searchable by patients.
Star Ratings of Matching or Selection
5-stars – Patients can choose to have a matching agent help them select a provider or they can choose one on their own. If patients choose their own provider, the online provider directory is easy to use and has filters for gender, credentials, specialty, and cost. The platform offers a wide range of provider specialties and these are clearly listed on the website or in the provider’s profile.
3-stars – Patients are left to select a provider without any guidance. The online provider directory is fairly easy to navigate, but may only have two or three filters available. The platform may only offer a few specialties and while these are listed on the website, it is vague which provider offers which specialty.
1-star – Patients are automatically matched with a provider through an algorithm and there is no provider directory for them to browse. The platform offers one type of specialty, which is listed on the website, and all providers on the platform are certified in only this specialty.
Extra Features & Resources
Extra features and resources, such as a space for journaling, webinars on various mental health and wellness topics, mental health coaching, and skills or psychiatry “homework” worksheets provide a lot of additional support and guidance for a person’s wellness journey. Platforms that provide these extra features within their app or website will receive a higher score than those that do not. Additionally, providing free resources, like educational articles or videos and mental health assessments, also make for a supportive and ideal platform.
Star Ratings of Features & Resources
5-stars – The platform offers a wide range of extra features in its app or through the website, like a journal space, learning webinars, mental health coaching, and homework sheets. Additionally, the platform’s website features free resources like educational articles or videos, and free mental health assessments.
3-stars – The platform offers a few extra features in its app or through the website, like a journal or homework sheets, but it may not have mental health coaching or any educational webinars. There are select free resources on the platform’s website, like educational articles or videos.
1-star – The platform offers no extra features and no free resources.
Client Interface & User Experience
When researching online psychiatry platforms, we look at how easy to navigate the main websites is, how user-friendly the sign-up process is, and how reliable the technology is while attending live sessions. We also examine how intuitive the mobile apps are that the company creates, with companies that have mobile apps scoring higher in this area. Mobile apps allow patients the ability to more easily access live psychiatry sessions, client portals, and resources.
Additionally, psychiatry platforms and their apps should be visually inviting with a modern design. Platforms that are brightly colored, appear to be out-of-date, and are not well organized will score lower in this category.
Star Ratings of Interface & Experience
5-stars – The online psychiatry platform has an app that is easy to use and intuitive. The sign-up process is quick and easy.
3-stars – The online psychiatry platform has an app and the sign-up process is easy but may ask a lot of onboarding questions.
1-star – The online psychiatry platform does not have an app and you must use a web browser to access your account. The sign-up process was complicated and took longer than 10 minutes to answer all of the onboarding questions.
Privacy & HIPAA
Digital privacy, confidentiality, and HIPAA compliance are important to consider when choosing an online psychiatry platform. An ideal psychiatry platform keeps the client’s account information, such as credit card numbers, email addresses, diagnosis, or other identifying data, private and protected by legal standards at all times. When ranking for this category, our objective is to promote companies that have transparent and ethical privacy and HIPAA policies, as well as data-sharing practices, and who consistently meet client’s privacy and HIPAA expectations. Companies that are unclear about these policies and/or exhibit unethical actions regarding privacy, security, data sharing, or HIPAA will receive lower scores.
Star Ratings for Privacy & HIPAA
5-stars – Privacy and HIPAA policies are easy to find, clearly stated, and specific. The company is transparent about data-sharing practices and consistently meets client’s expectations. There are no reports of security issues, such as personal information or credit card information being stolen or client information being sold to third parties. Patients are prompted to sign a HIPAA agreement acknowledging they are on a HIPAA-compliant platform during the sign-up process, and all HIPAA policies are adhered to.
3-stars – Privacy and HIPAA policies, as well as data sharing practices, are difficult to find and/or generic and unspecific OR there have been some incidents of users facing security issues with private information. Patients are prompted to sign a HIPAA agreement only prior to their first psychiatry session, but it was not made clear during the sign-up process the platform uses HIPAA-compliant software.
1-star – The company has no stated privacy policy. There have been many reports of security issues with private user information. The company shares member account information without informing the user. Patients are never asked to sign a HIPAA agreement and it is unclear if the platform is actually using HIPAA-compliant software.
Provider Credentials & Expertise
It is important to know exactly what credentials your provider holds, the specialty areas they treat, and if they are licensed in your state. Psychiatry platforms that make this information readily available are ideal as it gives patients crucial information immediately. In particular, licensure information informs patients whether a provider can provide them services, as well as what licensing board they could report any issues with the provider to. Additionally, knowing what mental health issues a provider can treat helps patients to identify if they are in the right place for treatment.
Online psychiatry platforms that provide detailed profiles of their providers, including information such as their credentials, states licensed in, clientele served, years of experience, and specialty areas will rank higher than platforms that do not provide this information.
Star Ratings for Credibility & Expertise
5-stars – It is clear what credentials the provider has, what states they are licensed in, which clientele they specialize in treating, and how long they have been practicing. This information is readily available through the provider’s profile, which the platform provides through its online provider directory.
3-stars – It is clear what credentials the provider has and which states they are licensed in, however, the provider’s profile is missing other key information.
1-star – It is clear that the provider has some type of credential, but it is not clear which states they are licensed in and there was no profile to read.
Customer Service
As with any service, the quality of an online psychiatry platform’s customer service is a significant rating factor. Online psychiatry platforms may be penalized in this category if it’s difficult to find customer support contact information or connect with a representative, or if it lacks channels of communication to contact support (e.g., only has email, no phone numbers listed).
We also take into consideration user reviews from trusted sources when scoring for customer service. We research and analyze positive and negative reviews that mention customer service and track when the company responds to complaints on trusted user review websites, as well as in the Apple App Store and Google Play Store when relevant. Companies that provide prompt and effective feedback and support will score higher in this category.
Star Ratings for Customer Service Category
5-stars – The platform offers excellent customer service. There are multiple channels to communicate with a representative, including email, text, chat, and phone. Responses to issues and complaints are completed within two business days. There are very few, if any, customer complaints in reviews online. When problems are reported in reviews online, the company responds efficiently and effectively.
3-stars – The platform provides an average level of customer service. There are limited channels to communicate with a representative. Response time takes more than 3 business days. The company will sometimes respond to issues reported in reviews online.
1-star – The platform provides poor customer service. You can only reach a representative through one channel. Response time takes over a week and many issues are left unresolved. The company does not respond to reported issues in reviews online.
Reliability & Longevity
Our reliability and longevity score will be determined by several key factors. These key factors include:
- How long an online psychiatry platform has been in operation
- How many providers do they have on the platform and how many states do they serve
- Which of the top insurance providers the platform works with
- How much growth has the company experienced over the past three years
- What additional services do they offer
- User reviews establish a track record for meeting client’s needs and expectations
We want to direct users toward online psychiatry platforms that will continue to grow and won’t disappear or phase out after a user purchases a monthly subscription or signs up for sessions. It’s important to note that we also conduct updates to our online psychiatry reviews, so a newer platform may receive a higher score after it has proven its reliability and longevity over time.
Star Ratings for Reliability & Longevity Category
5-stars – The platform has been in operation for more than five years and serves 50% of the US population. The platform works with the top insurance companies in the states they provide care. The platform has grown over the past three years and user reviews of the platform share very few complaints about the service. They are consistently meeting or exceeding the patient’s needs and expectations.
3-stars – The platform has been in operation for three years and can serve 30% of the US population. There are only a few major insurance companies the platform accepts and they have been working with them less than three years. The platform is still growing and user reviews mention some complaints about the service. Patients’ needs and expectations are sometimes met.
1-star – The platform is brand new and has been active for one year and serves 10% of the US population. They do not work with any insurance companies and complaints or compliments are hard to find, as there are few to little user reviews.
Addendums
Online Psychiatry for Kids & Teens
When rating online psychiatry platforms that specialize in service kids and teens, we score on this criteria in addition to the criteria listed above.
Platforms that specialize in offering online psychiatry to kids and teens should give parents/guardians clear answers to important questions and concerns prior to signing up. Ideal kids & teens platforms will:
- Explain which age groups are served.
- Have clear language around how accounts are used and managed.
- State what the role of the parent/guardian will be during live sessions.
- Offer evening/weekend appointments.
- Have specialized treatment plans geared towards teens.
- Offer age-appropriate medications that are mailed to the patients with no shipping fees.
- Parent coaching is available for free or an additional fee
Furthermore, the provider should check-in with the parent/guardian at least once a month to discuss progress being made or lack of progress being made.
Star Ratings for Kids & Teens
5-stars – The platform clearly explains which age groups are served, how accounts are used and managed, what the role of the parent/guardian is during live sessions, offers evening/weekend appointments, has specialized treatment plans, and offers age-appropriate medications that are mailed to the patient’s home. Parents can choose to engage with a mental health coach as needed for free or for a nominal fee. Providers check-in with parents/guardians at least once a month to discuss progress.
3-stars – The platform clearly explains which age groups are served, how accounts are used and managed, and offers evening/weekend appointments. It is not clear what the role of the parent/guardian will be during live sessions and there are no specialized treatment plans. Parents can choose to have mental health coaching for an additional fee on top of their child’s monthly or per-session costs. There are age-appropriate medications available and they can be shipped to the patient’s home for a fee. Providers check-in with parents/guardians every couple of months.
1-star – The platform clearly explains which age groups are served and how accounts are used and managed. It is unclear if there are evening/weekend appointments available, what the role of the parent/guardian will be during live sessions and there are no indications if the platform offers any specialized treatment plans or types of medications available. There is no parent support available at all. Providers do not check-in with parents/guardians but will give updates if asked.
ADHD Platforms
Platforms that specialize in online treatment for ADHD should be clear in which services they offer, either therapy, medication management, or both.
If the platform offers medication management only, there should be precise language around what types of prescriptions their platform allows and does not allow for, and how they are provided to the patient. Platforms that do not offer controlled substances should offer the option to coordinate with a patient’s primary care doctor to prescribe these medications if deemed necessary. It should be clear how long initial appointments are, how long follow-up appointments are, how often follow-up appointments are required, and what type of appointments (video or phone) are available.
If the platform offers therapy only, there should be at least two options for attending live sessions, weekend and evening appointment availability, and sessions that last at least 45 minutes. It should also be clear what type of live sessions are available – whether it be live video sessions, phone calls, or live instant messaging.
Ideal ADHD platforms will be able to offer both medication management and therapy services to clients. Combining medication and therapy has been proven to be an effective way to help those with ADHD symptoms.
Star Ratings for ADHD Platforms
5-Stars – This is a specialized platform that offers online therapy and medication management for ADHD. There is clear language around what types of medications are prescribed and there is an option to coordinate with a patient’s primary care provider if needed. All medication appointments and all therapy sessions will happen with the same providers each time. Initial appointments and therapy sessions should be 45-minute or longer, with medication follow-up appointments lasting 15 minutes or longer. There is an option to choose between video, phone, or live instant messaging with their providers, with weekend and evening appointments available. All appointments and sessions take place in the platform’s app or on their website, with no need to download additional applications.
3-Stars – This is a specialized platform that offers either online therapy or medication management for ADHD. There is clear language around what medications can be prescribed, but there is no option to coordinate with the primary care provider if needed. Clients and patients will have the same provider each time they have a live session, but these appointments and sessions are only 30-minutes long with medication follow-up appointments lasting under 15-minutes. You can choose between video or phone sessions, but there are no weekend appointments and you must download a secondary application to attend video sessions.
1-Star – This is a specialized platform that offers either online therapy or medication management for ADHD. There is no clear language around what types of medications are prescribed, there is no coordination with primary care providers, and it is unclear if you will have the same provider each time you attend an appointment or session. You will not meet with a provider face-to-face and will only be able to text-message with a provider. It is unclear how long text-based sessions and appointments are.
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This content was last updated 05/30/2023 by the Choosing Therapy team.
