Second Opinions
When the diagnosis has never quite fit.
Some patients have been in treatment for years without ever feeling confident in the diagnosis. The medications change, the label changes — depression, then bipolar, then ADHD, then back — and improvement never lasts. Others are simply told they are "treatment-resistant," which too often means the treatment was aimed at the wrong target.
A psychiatric second opinion is a structured answer to that uncertainty: your records reviewed, your history retaken from the beginning by a physician trained not to assume the chart is right, and a written formulation you and your current clinician can act on.
Who this is for
- Diagnoses that keep changing — or one that never explained everything
- Four or more psychiatric medications with no coherent plan (deprescribing is a core service of ours)
- "Treatment-resistant" depression or anxiety that has not responded to multiple trials
- Psychiatric symptoms alongside neurological findings, head injury, or unexplained physical symptoms — where our neuropsychiatric training matters most
- A major treatment escalation on the table and a family that wants a fresh set of eyes first
How it works
- 1. Records ahead of timePrior evaluations, medication history with doses and durations, labs, imaging — reviewed before we meet.
- 2. A fresh evaluationBroadband rating scales, then a 60-minute structured diagnostic interview that starts from zero rather than from the chart.
- 3. A usable answerOur formulation, our confidence level, what would confirm it, and a concrete roadmap — shared with your current clinician with your consent, or the basis for transferring care to us if you prefer.
Common questions
When should I get a psychiatric second opinion?
When the diagnosis has never quite fit, when medications keep changing without lasting improvement, when you have accumulated four or more psychiatric medications, or when you have been labeled treatment-resistant. A second opinion is also reasonable before any major treatment escalation.
Will this disrupt my relationship with my current psychiatrist?
No. A second opinion is a consultation, not a transfer of care. With your consent we share our written formulation with your current clinician, and many referrals come from psychiatrists themselves. If you prefer to transfer care to us afterward, that is your choice.
What do you actually review?
Your records — prior evaluations, medication trials with doses and durations, labs, and any imaging or testing — followed by standardized rating scales and a fresh 60-minute structured diagnostic evaluation that does not assume the existing diagnosis is correct.
What do I receive at the end?
A clear verbal walkthrough and, when requested, a written diagnostic formulation: what we think is going on, how confident we are, what would confirm it, and a concrete treatment or deprescribing roadmap you and your clinician can act on.
Is a second opinion covered by insurance?
It is billed as a standard psychiatric evaluation, so in-network coverage applies (Aetna, Anthem Blue Cross, Cigna, Lyra Health — varies by physician). Self-pay rates are on our insurance page.