Patient resource

How does online psychiatric care work in North Carolina?

By Josephine W. Hazeley, MSN, PMHNP-BC
Board-certified psychiatric mental health nurse practitioner with a perinatal & postpartum focus — nearly two decades in psychiatric nursing, including research nursing on the trial behind the first FDA-approved postpartum-depression therapy. About your clinician

Clinically reviewed by Josephine W. Hazeley, PMHNP-BC on July 4, 2026 · Last updated July 4, 2026

Online psychiatric care in North Carolina works like an office visit moved to a video screen: you meet a licensed psychiatric prescriber for a complete evaluation, agree on a treatment plan together, and follow up by video from anywhere in the state. For most outpatient psychiatric needs, research has found telepsychiatry comparable to in-person care. The part that surprises most people is how ordinary it feels after the first five minutes.

If you have never done it, telehealth psychiatry can sound like a shortcut — a symptom questionnaire, a prescription, no real conversation. That version exists, and it is worth being skeptical of. This page describes the other version: how psychiatric evaluations, medication management, and supportive therapy actually work by video at Mindful Counseling & Wellness, a North Carolina telehealth psychiatric practice (what we treat).

What happens in a telehealth psychiatric evaluation?

The same thing that happens in a good in-person one. A psychiatric evaluation is a long, structured conversation: what you are experiencing now, when it started, what your days look like, your medical history and current medications, your sleep, your family history, what you have already tried. From there you and the clinician talk through a working diagnosis and a plan — which may or may not include medication.

At Mindful Counseling & Wellness every evaluation is conducted by Josephine W. Hazeley, MSN, PMHNP-BC, a board-certified psychiatric-mental-health nurse practitioner. There is no intake questionnaire standing in for the appointment, and no assumption that you leave with a prescription. Some evaluations end with medication, some with supportive therapy, some with a recommendation for a different kind of care entirely.

How do medication management visits work after that?

If you and your clinician decide to start or adjust a medication, follow-up visits track how it is going: symptom changes, side effects, dose adjustments, and whatever life is doing in the background. How often you meet is individualized — visits are typically closer together early in treatment, when doses are being adjusted, and space out once things are stable.

Between visits, you can contact the practice with questions about your medication rather than waiting for the next appointment.

Do I need therapy, medication, or both?

Often the honest answer is both, and they tend to work well together. Medication can reduce symptoms enough that therapy has room to work; therapy builds skills no prescription provides. Mindful Counseling & Wellness provides supportive therapy alongside medication management, and when you already have a therapist, we collaborate with them rather than replacing them. What that looks like for specific conditions is covered in more depth in our pages on anxiety treatment and depression treatment.

Does video psychiatry actually work as well as in-person care?

For outpatient psychiatric care, the evidence says yes. The American Psychiatric Association’s review of the research concludes that telepsychiatry is equivalent to in-person care in diagnostic accuracy, treatment effectiveness, quality of care, and patient satisfaction (APA — What is Telepsychiatry?). A peer-reviewed evidence review reached the same conclusion: telemental health is effective for psychiatric diagnosis and treatment across many adult populations and appears comparable to in-person care (Hilty et al., 2013).

Psychiatry also translates to video unusually well: unlike specialties built around physical exams, psychiatric care runs on conversation and observation, both of which survive the trip through a webcam.

What do you need on your end?

Three things, none of them exotic:

A private space. A parked car, a bedroom with the door shut, an office with headphones — anywhere you can speak freely for the length of a visit.
A reliable connection and a device with a camera. A smartphone is enough. You will receive a link before each visit; if the technology misbehaves, visits can fall back to phone while the problem gets sorted.
To be in North Carolina at the time of your appointment. Licensure follows the patient’s location, so you can be anywhere in the state — Murphy to Manteo — but you do need to be in it.

Who is telehealth psychiatry not for?

It is not for emergencies. If you are in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or call 911 — a telehealth intake, ours included, is the wrong door for an emergency.

Some clinical situations also need in-person care: certain conditions call for physical examination, lab monitoring best handled locally, or a higher level of care than outpatient visits provide. Part of a careful evaluation is recognizing that, saying so plainly, and referring you to the right setting.

What does it cost?

Costs depend on your insurance coverage, so we keep the details on one page rather than scattering numbers that go stale — see insurance and costs for how coverage works and how to check yours.

How do you start?

The Get Started page walks you through requesting an appointment, or you can call (919) 739-3808 or email info@mindfulcounselingandwellness.com. New patients are typically seen within 1–3 business days, by video, anywhere in North Carolina.