Psychiatric Evaluation in Florida & South Carolina

The short answer

A psychiatric evaluation at Stedfast Psychiatry is a 60-minute new-patient visit with a psychiatrist, psychiatric nurse practitioner or physician assistant. It covers your symptoms, history, screening scales, medications and medical factors, and ends with a diagnosis and written treatment plan. Most insurance and Medicare are accepted; the self-pay rate is $185.

Many people arrive having already been told they are anxious, depressed or "probably ADHD" by a primary care doctor, a therapist or a search engine. We take those ideas seriously, but we start from the beginning. Mood, anxiety, attention, sleep, trauma and medical problems overlap, and a treatment that is right for one is often wrong for another. Getting the diagnosis right is the fastest way to get better.

Who it is for

An evaluation is for anyone who thinks something is wrong and wants a clear answer. That includes adults who have never seen a psychiatrist, people who have been treated before and did not get better, and patients referred by a primary care physician, therapist, OB/GYN or employer. We see children and adolescents as well, with the minimum age set by the individual provider (some see patients from age four).

You do not need a referral to book, and you do not need to know what is wrong before you call. Common reasons people come to us include low mood that will not lift, worry that interferes with sleep or work, trouble focusing, panic attacks, irritability, grief that has stalled, trauma reactions, and side effects or poor response from a medication prescribed elsewhere. If you are unsure whether a psychiatrist or a therapist is the right first stop, the evaluation sorts that out: our providers can prescribe, refer for therapy, or both.

How it works

The visit is built around a structured clinical interview, the same method used in academic psychiatry. Your provider asks about your current symptoms, when they began, what makes them better or worse, and how they affect sleep, appetite, energy, concentration, relationships and work. We take a full psychiatric history (prior diagnoses, medications tried and their doses, hospitalizations, therapy), a medical history, a family history, and a substance use history. We ask about safety directly and without judgment.

Before or during the visit you complete validated screening scales. The PHQ-9 measures depression severity, the GAD-7 measures anxiety, the ASRS screens for adult ADHD, the MDQ screens for bipolar spectrum symptoms, and the PCL-5 screens for post-traumatic stress disorder. These are not the diagnosis; they are a baseline we will repeat at later visits to measure change objectively. Where a scale and your story disagree, the story wins and we ask more questions.

We also look for medical contributors. Thyroid disease, anemia, vitamin B12 or D deficiency, sleep apnea, and some medications can mimic depression, anxiety or inattention. If you have not had recent labs, we may order a basic panel (TSH, CBC, metabolic panel, B12, vitamin D) or request results from your primary care physician. With your permission we request prior psychiatric records so we are not repeating treatments that already failed. The visit ends with a diagnosis (or a short list of possibilities to clarify), a plan that may include medication, therapy, labs or a referral, and a scheduled follow-up.

About 23 percent of US adults (59 million people) lived with a mental illness in 2022, and fewer than half received treatment in the past year.

Source: NIMH, National Survey on Drug Use and Health 2022

The PHQ-9 has a sensitivity of 88 percent and a specificity of 88 percent for major depression at a cutoff of 10.

Source: Kroenke, Spitzer and Williams, Journal of General Internal Medicine, 2001

Roughly one third of patients reach remission on their first antidepressant, which is why an accurate starting diagnosis and measured follow-up matter.

Source: STAR*D trial, National Institute of Mental Health

Mental health conditions are among the leading causes of disability in the United States, accounting for a large share of years lived with disability.

Source: Institute for Health Metrics and Evaluation, Global Burden of Disease

What to expect

Plan on 60 minutes for a new-patient evaluation, in person at any of our 13 offices or by secure video for Florida and South Carolina residents. You will receive intake forms and the screening scales through the patient portal ahead of time; completing them before the visit leaves more time for conversation. Bring a list of current medications and supplements with doses, the names of past psychiatric medications if you remember them, and any recent lab results.

If the plan includes medication, a prescription is usually sent the same day, with a follow-up scheduled in two to four weeks to check response and side effects. If the plan includes therapy, we schedule it with one of our therapists or coordinate with yours. Some diagnoses, especially bipolar disorder and ADHD, may require a second visit, collateral information from a family member, or prior records before medication is started. We will tell you that plainly rather than guess.

Benefits

A clear diagnosis from a prescriber, not a label from a questionnaire
Validated baseline scales (PHQ-9, GAD-7, ASRS, MDQ, PCL-5) so progress can be measured
Medical causes screened and labs ordered when needed
Prior records reviewed so failed treatments are not repeated
Written treatment plan and a scheduled follow-up before you leave
Available in person at 13 offices or by telehealth in Florida and South Carolina

Risks and side effects

An evaluation itself carries no physical risk. The main limitation is that a single hour cannot always settle a complex picture. Some diagnoses depend on a pattern over time, and the first visit may end with a working diagnosis rather than a final one. We would rather say "we need to watch this" than start a medication for the wrong condition.

Talking about trauma, loss or suicidal thoughts can be uncomfortable, and some people feel drained afterward. Your provider will pace the conversation and will not push you into detail you are not ready for. If the evaluation finds an immediate safety concern, we will say so and arrange a higher level of care rather than send you home with a prescription.

Cost and insurance

Stedfast Psychiatry accepts most major commercial insurance plans and Medicare. A new-patient evaluation is billed as an outpatient psychiatric diagnostic visit, and your cost depends on your copay, deductible and whether behavioral health is carved out to a separate network under your plan. Our front desk verifies benefits before the visit and tells you what to expect.

If you are uninsured, out of network, or prefer not to use insurance, the self-pay rate for a new-patient visit is $185. Follow-up visits are billed at a lower rate. Labs are billed separately by the laboratory and are usually covered as routine bloodwork. Some insurers require a referral from a primary care physician for specialist visits; check your plan or ask us and we will help.

What we are trying to answer in the first hour

Every evaluation works through the same set of questions, whether the patient is 8 or 80. Is this a primary psychiatric condition, a medical problem presenting as one, a reaction to circumstances, or some mix? If it is psychiatric, which condition, and how severe? Is there anything that must be handled today, such as a safety concern, a drug interaction or a withdrawal risk? And what has already been tried, so we do not repeat it?

The structured interview covers mood, anxiety, psychosis, attention, trauma, obsessions and compulsions, eating, sleep, substance use and personality patterns. It is thorough on purpose. A patient who comes in for anxiety may turn out to have untreated ADHD driving the anxiety, or a sleep disorder driving the fatigue they called depression.

Why we order labs

Hypothyroidism can look like depression. Hyperthyroidism can look like panic disorder. Anemia and low B12 cause fatigue and poor concentration. Obstructive sleep apnea produces irritability, low mood and inattention that no antidepressant will fix. Before we attribute a symptom to a psychiatric cause, we want the common medical causes checked. If your primary care physician has drawn labs in the last six to twelve months we use those; if not, we order a basic panel.

Some medications also require baseline labs before they are started or monitoring after. Lithium needs kidney and thyroid tests. Valproate needs liver tests and a blood count. Several antipsychotics call for a metabolic panel and lipid testing. Ordering these at the evaluation avoids a delay later.

How a diagnosis becomes a plan

A diagnosis is only useful if it leads to a decision. For most conditions the plan has three parts: what we are going to treat first, how we are going to treat it, and how we will know whether it is working. The "how we will know" is where the screening scales earn their place. A PHQ-9 that falls from 18 to 7 over eight weeks is evidence; "I think I feel a bit better" is harder to act on.

Treatment options depend on the diagnosis and on you. Medication management, psychotherapy and the two combined are the usual first steps. For depression that has not responded to adequate trials of two or more antidepressants, we also offer Deep TMS at Palm Beach Gardens and Spravato (esketamine) at Boynton Beach, Palm Beach Gardens and Royal Palm Beach, and the evaluation is where eligibility for those is first discussed.

Children, adolescents and families

Evaluating a child or teen takes a different shape. We talk with the parent and the young person separately as well as together, and we ask for input from school where attention or behavior is the concern. Rating scales for younger patients (the Vanderbilt for ADHD, the SCARED for anxiety, the PHQ-A for adolescent depression) replace the adult versions. Minimum ages vary by provider; our scheduling team will match your child to a clinician who sees their age group.

What to bring and how to prepare

A list of every medication and supplement you take, with doses
Names and approximate dates of psychiatric medications tried in the past, and why they were stopped
Recent lab results, if you have them
Your insurance card and a photo ID
For minors, proof of guardianship if the attending adult is not a parent
Completed intake forms and screening scales from the patient portal

If you take nothing else from this page: you do not have to diagnose yourself before you come. That is the job of the evaluation.

Frequently asked questions

How long is a new-patient psychiatric evaluation?

Sixty minutes. The time is divided between your story, a structured review of symptoms and history, the screening scales, and the plan. Children and adolescents often need a little longer because we speak with the parent and the child separately. Follow-up medication visits are shorter, typically 20 to 30 minutes, and therapy sessions are 45 to 55 minutes.

Do I need a referral to see a psychiatrist at Stedfast?

No. You can call or book online directly. Some insurance plans, especially HMOs, require a referral from your primary care physician before they will cover a specialist visit. We check that when we verify your benefits and will tell you if a referral is needed. Medicare does not require a referral for outpatient psychiatry.

What do the screening scales actually tell you?

They put a number on severity so we can track change. The PHQ-9 scores depression from 0 to 27, the GAD-7 scores anxiety from 0 to 21, the ASRS flags adult ADHD symptoms, the MDQ flags a possible bipolar spectrum history, and the PCL-5 measures PTSD symptoms. None of them diagnoses anything alone. Your provider uses them alongside the interview, and we repeat them at follow-ups to see whether treatment is working.

Will I get medication at the first visit?

Often, yes, if the diagnosis is clear and medication is the right step. Many patients leave the evaluation with a prescription sent to their pharmacy. For some conditions we may wait for labs, prior records or a second visit, and controlled substances such as stimulants are usually not started until the ADHD evaluation is complete. If medication is not the right answer, we will say so and recommend therapy or another path.

What does a psychiatric evaluation cost?

With insurance, your cost is your copay or coinsurance after any deductible; we verify benefits before the visit. The self-pay rate for a new-patient evaluation is $185. Follow-up visits are less. Any labs we order are billed by the laboratory, not by us, and are usually covered as routine bloodwork.

Can the evaluation be done by telehealth?

Yes, for patients physically located in Florida or South Carolina at the time of the visit. A video evaluation covers the same ground as an in-person visit. A few situations call for an in-person appointment: some controlled substance prescriptions, patients who need a physical examination, and young children. We will tell you at scheduling if an office visit is required.

Can I bring someone with me?

Yes. A spouse, parent or close friend can add useful detail, especially for conditions such as bipolar disorder or ADHD where the people around you may notice patterns you do not. We will also spend part of the visit with you alone. For minors, a parent or legal guardian must attend and consent to treatment.

What if I already have a diagnosis from another doctor?

Bring it, along with any records and the medications you have tried. A prior diagnosis is useful information, but we do our own evaluation rather than inherit it. Diagnoses change over time, and a fresh look is often the reason a treatment that stalled starts to work.

Where this treatment is offered

Conditions this treats

Major Depressive Disorder Generalized Anxiety Disorder ADHD in Adults and Children Bipolar Disorder Post-Traumatic Stress Disorder Panic Disorder Insomnia Obsessive-Compulsive Disorder

If you are in crisis, call or text 988 or go to the nearest emergency room. Educational content; individual results vary. Reviewed by Dr. David Husted, board-certified psychiatrist.

Psychiatric Evaluation and Diagnosis