By Jessica Yacques, PMHNP, Two Rivers Integrative Health.
Reviewed by Rebecca Moyes, PMHNP-BC · October 2026
A psychiatrist is a physician, an MD or DO, who has completed medical school and a psychiatry residency and is typically board-certified in psychiatry. A psychiatric mental health nurse practitioner, or PMHNP, is an advanced practice registered nurse with a graduate degree and national board certification in psychiatric mental health care. Both evaluate, diagnose, prescribe medication, and manage treatment over time. The main difference is the training route.
What does a psychiatrist do?
A psychiatrist evaluates mental health symptoms, makes a diagnosis, prescribes and manages medication, and follows you over time as things change. Many psychiatrists also provide various forms of psychotherapy. Just as with therapists and PMHNPs, the type of therapy a psychiatrist offers is highly individualized.
The training includes four years of medical school, a psychiatry residency, and usually board certification. Some psychiatrists go on to complete a fellowship, adding years of subspecialty training. Given their extensive general medical training, psychiatrists are well prepared for high-acuity care: patients in the hospital, people in an acute mental health crisis, and people managing several complex medical conditions alongside psychiatric ones.
What is a PMHNP, and what can a PMHNP do in Oregon?
A PMHNP is an Advanced Practice Registered Nurse (APRN) with a bachelor's degree and a graduate degree who has passed national board certification in psychiatric mental health care. We evaluate and assess, diagnose, prescribe medication, and manage ongoing psychiatric treatment. We practice independently in Oregon, where we can diagnose, treat, and prescribe medications for mental health disorders.
My own path shapes the way I practice. I have been a registered nurse since 2007. I worked as a family nurse practitioner in primary care from 2014 to 2021, and I have practiced as a psychiatric mental health nurse practitioner since 2021. When you tell me you are exhausted, experiencing a low mood, and feeling like nothing is working, my first instinct isn't to prescribe an antidepressant. It is to wonder: when was the last time someone actually checked your thyroid, iron, B12, sleep, and hormones?
| Provider | Training route | Diagnoses | Prescribes medication | Provides psychotherapy |
|---|---|---|---|---|
| Psychiatrist (MD, DO) | Medical school, psychiatry residency, board certification; some complete a fellowship | Yes | Yes | Many do |
| Psychiatric nurse practitioner (PMHNP) | Nursing degree, graduate degree, national board certification | Yes | Yes | Many do |
| Psychologist (PhD, PsyD) | Doctoral degree in psychology and licensure | Yes | No, in most states | Yes |
| Therapist or counselor (LCSW, LPC, and others) | Master's degree, supervised clinical hours and licensure | Yes, within scope | No | Yes |
How do you know which kind of prescriber is right for you?
For most outpatient psychiatric care, a psychiatrist and a PMHNP do the same work: a thorough evaluation, a diagnosis, medication when it helps, and regular follow-up.
Being a safe practitioner means knowing what you don't know. When someone's needs would be better met by a clinician with different training and skills, such as a psychiatrist, a subspecialist, or a hospital team, I will tell you, and I will help you get there. That is part of the job too.
Should you see a psychiatric provider or a therapist?
See a psychiatric provider, a psychiatrist or a PMHNP, when you want an evaluation, a diagnosis, or medication, or when you already take psychiatric medication and want someone to manage it well. See a therapist when you want regular sessions to work through what is happening. Many people want both.
| If this sounds like you | Who usually fits |
|---|---|
| You want to understand what is going on and whether medication would help | Psychiatric provider |
| You want regular sessions to talk things through | Therapist |
| You want medication support and regular therapy sessions | A psychiatric provider and a therapist |
| You suspect ADHD and have never been evaluated as an adult | Psychiatric provider |
| Your mood changes follow your menstrual cycle, as with PMDD | Psychiatric provider |
| You are stable on medication and need someone to manage it | Psychiatric provider |
What psychiatric medication management actually involves
Medication management is the ongoing work of choosing a medication, watching how you respond, and adjusting. It is not a one-time prescription.
How I do it: I try to change one thing at a time, so that when something improves we know what caused it. I order bloodwork at the start if we can. If you are struggling right now and don't have the capacity or the means to have lab work completed, we can start medication first and fill in the rest later. I always keep your budget in mind as well, prioritizing the testing most likely to tell us something we can act upon. Nutritional supplements and other holistic interventions can be integrated into your medication management plan. The more tools we have the better!
Who you will see at Two Rivers Integrative Health in Corvallis
Two Rivers provides psychiatric care in Corvallis, Oregon. Our psychiatric clinicians are Psychiatric Mental Health Nurse Practitioners.
A first psychiatry appointment here runs 90 minutes. Follow-ups are 45 minutes and can include therapy. Psychiatry, therapy, women's health, and integrative medicine are all part of the practice, so if your care grows to include another kind of provider, that may be an option here too. You are always free to choose your own providers or keep the ones you already see.
| Step | What happens |
|---|---|
| 1. Full history | 90 minutes. Symptoms, timeline, what you have already tried, and what is going on physically as well as mentally. |
| 2. Laboratory studies | Ordered based on what is needed and kept within your budget. |
| 3. Genetic testing (optional) | Useful for understanding how you process medication. |
| 4. A plan you agree to | Medication, lifestyle changes, supplements, therapy, or a combination. Whatever you have the energy for right now. |
| 5. Follow-up | 45 minutes, which can include therapy. |
Frequently asked questions
Can a psychiatric nurse practitioner prescribe medication?
Yes. A PMHNP evaluates, diagnoses, prescribes psychiatric medication, and manages it over time, including adjusting doses and changing medications.
Is there a psychiatrist in Corvallis, Oregon?
There are psychiatrists in the mid-Willamette Valley, and there are also PMHNPs who provide the same outpatient psychiatric care. Two Rivers Integrative Health provides psychiatric care in Corvallis through PMHNPs, who evaluate, diagnose, prescribe, and manage treatment.
Do I need a referral to see a psychiatric provider?
No. You do not need a referral to be seen at Two Rivers. Some insurance plans require one for coverage, so it is worth checking with your plan.
How much does psychiatric care cost?
Call (971) 368-1045 or use the contact form, and we will share our fees before you schedule. We bill primary insurance and provide a superbill for secondary or out-of-network plans. We do not accept OHP, Medicaid, or Medicare. You can also request a Good Faith Estimate before your first visit, which is your right under the No Surprises Act.
When should you see a psychiatric provider instead of a therapist?
See a prescriber when you want an evaluation, a diagnosis, or medication management. See a therapist when you want to work through something in regular sessions. Many people see both.
Can I get therapy and medication in the same place?
Often, yes. Psychiatry follow-ups can include therapy, and Two Rivers also has therapists on the team. If you already have a therapist you trust, you are welcome to keep working with them.
Closing
The training route is different. The care usually is not. What matters most is having someone take the time to look carefully, and keep looking when the first answer does not explain everything.
If you have questions about your mental health, or about a medication that is not working the way you hoped, we would be glad to take a full look with you. Use the contact form to request an appointment. We are at 257 SW Madison Ave, Suite 209 in downtown Corvallis, open Monday through Friday, 8 am to 5 pm. Already a patient? Use the patient portal.