Psychiatry and Medication Management

Understand what’s happening
Medication management for your mental health

When symptoms are affecting your mood, focus, sleep, relationships, or daily routine, the right evaluation can help you make sense of what is going on. Defina Health provides thoughtful medication management with care that is coordinated, evidence-based, and built around your needs.

  • For depression, anxiety, mood changes, trauma, and more
  • Helpful when symptoms are unclear, overlapping, or not improving
  • Medication management with therapy coordination in one practice
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Accepting new patients Insurance accepted
When to consider care
1

Symptoms are affecting daily life

Mood, anxiety, sleep, focus, trauma, or substance use concerns are making it harder to function.

2

Treatment has not fully worked

You have tried therapy, medication, or self-management, but symptoms are still getting in the way.

3

You want a clearer plan

A psychiatric evaluation can help clarify what is happening and what next steps may be appropriate.

A better starting point

We begin by understanding the full picture, then build care around what you actually need.

Schedule an evaluation
Accepting new patients Insurance accepted
What is psychiatry

Psychiatric care that goes beyond a prescription

Psychiatry is a medical specialty focused on diagnosing and treating mental health conditions using a combination of clinical evaluation, medication management, and coordinated care.

A psychiatric provider at Defina is not just someone who prescribes medication and sends you on your way. Your first appointment is a thorough, 60-minute clinical evaluation covering your symptoms, history, any previous treatments, and your goals. From there, we build a care plan that is designed around you, and we track how it is working at every follow-up using validated clinical measures. If something is not working, we catch it early.

Defina's psychiatric providers also work directly alongside our therapists or also provide therapy. They share clinical notes and adjust your plan together. Most patients find this makes a real difference, especially those who have been in therapy and psychiatry separately and felt like the two sides of their care were never in communication.

Psychiatry

Medical diagnosis and medication management

Your psychiatric provider evaluates your symptoms against clinical criteria, diagnoses, prescribes and adjusts medications, screens for co-occurring conditions, and monitors your response at every visit.

Therapy

Skills, patterns, and the work of change

Your therapist works with you on thought patterns, behaviors, coping strategies, and the underlying experiences that drive your symptoms. CBT, psychodynamic, and other evidence-based approaches.

In person or online

Psychiatry and medication management are available in San Francisco and by telehealth across California.

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What to expect

How psychiatry works at Defina

Three visits is typically enough to establish a diagnosis, start a care plan, and see your first indicators of whether the approach is working. Here is what that looks like.

Your initial evaluation

A 60-minute clinical conversation, not a form-filling intake. We go through your symptoms, your history, previous treatments, what has and has not worked, and what you are hoping to get out of care.

Full symptom and history review Screening for co-occurring conditions Discussion of diagnosis and treatment options Initial care plan, including medication if appropriate In-person or by secure video

Follow-up

On average these visits happen two to four weeks after starting, we check in on how you are responding. Medication often takes four to eight weeks to produce full effect, but we track symptoms often.

PHQ-9, GAD-7, PC-PTSD-5 or others depending on your condition Dose or medication adjustment if indicated Side effect review and management Coordination with your Defina therapist if applicable

Ongoing care

Once you are seeing improvements, follow-ups can shift to monthly or every few months depending on your condition and individual plan. The same provider throughout.

Consistent provider relationship Symptom tracking you can see over time Proactive adjustment before problems escalate Flexible between in-person and telehealth

You will not leave a visit with a prescription unless it clinically makes sense. The first appointment is about understanding your situation completely. We discuss options, answer your questions, and build a plan with your input. No decisions are made without you understanding why and being part of the decission.

How Defina's psychiatric care is different

Most psychiatric care is not made for evolving needs.
Our adaptive model is

The standard model has you bounce around from one place to another to get comprehensive care. Here is how Defina is built differently.

At most practices
At Defina Health San Francisco
Care coordination

Your psychiatrist and therapist work in separate systems. They rarely communicate. You repeat your history at every appointment and translate between providers yourself.

Care coordination

Your psychiatric provider and therapist are in the same practice. They share clinical notes and coordinate your treatment plan. You tell your story once.

Tracking progress

Follow-ups are often 15 minutes. Progress is assessed by asking "how are you feeling?" You may not know whether your medication is working until an episode has already passed.

Tracking progress

Every follow-up includes a validated clinical measure, the PHQ-9, GAD-7, or PC-PTSD-5 depending on your condition. Progress is visible and documented. Adjustments happen before time is wasted.

Complex presentations

Most telehealth outpatient practices refer out patients with treatment-resistant depression, serious mental illness, or co-occurring substance use. You may be handed a list of phone numbers.

Complex presentations

We treat treatment-resistant depression with Spravato, serious mental illness, dual-diagnosis, and co-occurring conditions. These are not edge cases for us. They are what we were built for.

Medication decisions

Medication is sometimes prescribed with minimal explanation. Side effects are managed reactively. Patients often feel like passive recipients of a decision already made.

Medication decisions

Every medication decision is explained: what it is, why we are recommending it, what to expect, and what the alternatives are. Nothing is prescribed without your full understanding of the reasoning.

Clinical practice rooted in evidence

Defina was co-founded by UCSF-trained clinicians who believe care should be rooted in data not guesswork.

Clinical measures at every single visit

PHQ-9 for depression, GAD-7 for anxiety, PC-PTSD-5 for trauma. Not annual screenings. Not check-ins. Validated tools at every follow-up, so you and your provider can see your actual trajectory.

Certified Spravato clinic in San Francisco

One of a small number of REMS-certified Spravato (esketamine) clinics in San Francisco. For patients with treatment-resistant depression, this is an FDA-approved, insurance-covered option we administer in-office.

Complex and co-occurring conditions accepted

Dual-diagnosis substance use and mental illness, serious mental illness, and patients who have been through multiple unsuccessful treatment attempts. We build this clinic for all levels of care.

Get started at Defina Health

Psychiatry that builds on itself
visit after visit

If you have been putting this off, this is the moment.

In-network: Anthem, Blue Shield, Aetna, Cigna, United Healthcare, Medicare & most CA plans.  Most patients pay $0–$40 per visit. We verify coverage before you start.
HIPAA-protected
Your information stays private
Symptoms tracked
PHQ-9, GAD-7 and more
Seen within 3–5 days
Most new patients

999 Sutter Street, San Francisco · Telehealth throughout California

Book a psychiatric evaluation · Defina Health
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Have questions? Text us at (415) 417-1929

If you are in crisis, call or text 988 or go to your nearest emergency room.

Common questions

Questions about psychiatric care at Defina

No. You can book directly without a referral. You also do not need a prior diagnosis. Many patients come to us having never had a formal psychiatric evaluation, and the first appointment is where we start building that picture together.
A psychiatrist is a medical doctor who specializes in mental health, with full prescribing authority. A psychiatric nurse practitioner (PMHNP) has advanced training in psychiatric evaluation and prescribing, and in California practices with the same clinical scope as a psychiatrist in most outpatient settings. Defina's psychiatric providers are PMHNP-BC trained, including Genesis Javaherian, PMHNP-BC, who trained at UCSF. Therapists provide talk therapy but do not prescribe medication.
We are in-network with Anthem (Carelon), Blue Shield, Aetna, Cigna, United Healthcare, and Medicare, among other California plans. Most patients with in-network coverage pay between $0 and $40 per visit. We verify your specific coverage before your first appointment so you know your costs before you start.
For most psychiatric conditions, research shows that telehealth produces outcomes comparable to in-person care. Evaluation, medication management, and follow-up all translate well to video. Some patients start in person and shift to telehealth as their schedules change. Others begin by video and come in when they want to. Both options are available throughout your care, and your provider stays the same either way.
That is completely fine. We can provide psychiatric care, including evaluation, diagnosis, and medication management, while you continue working with your existing therapist. With your consent, we are also glad to coordinate with them directly, sharing clinical notes and staying aligned on your care plan.
If you are starting a new medication, the first follow-up is typically two to four weeks later to review your response and make early adjustments. Once you are stable, follow-ups usually shift to monthly and then quarterly, depending on your condition and plan. Some patients require more frequent contact during complex periods. Your provider will recommend a schedule that fits your clinical needs.
Yes. Most outpatient practices decline to treat schizophrenia and serious mental illness. Defina was built to include these patients. We provide ongoing psychiatric care for schizophrenia, schizoaffective disorder, first-episode psychosis, and other complex presentations, with experience in clozapine management and coordination with families and community supports.