By Rebecca Moyes, PMHNP-BC, founder of Two Rivers Integrative Health
A first psychiatry appointment is a long, unhurried conversation about what you are experiencing, your history and your life, followed by a treatment plan you help shape. At Two Rivers in Corvallis, a first appointment runs 90 minutes. You don't need to know what's going on or have a diagnosis before you come in. We do that together.
A lot of people show up really nervous, particularly if they have never worked with a mental health provider before. That's completely normal. Here is what actually happens.
What happens at a first psychiatry appointment?
The first visit is a long conversation, answering a lot of questions and sharing a lot of information. I want to understand you as a whole person: body, mind, and soul. We can't separate mental health from physical health, so we talk about all of it.
| Part of the visit | What we cover |
|---|---|
| What brings you in | What you are experiencing, when it started, what helps and what makes it worse |
| Your history | Mental health history, past treatment, medical history and family history |
| Your life | Sleep, work, relationships, stress and whether you are able to show up for life the way you want to |
| Ruling in and ruling out | Exploring which diagnoses fit, since many share symptoms |
| Your plan | Options that may include labs, genetic testing, medication, supplements, lifestyle changes and therapy |
People typically get more comfortable once we get going and they recognize they are being heard, that I'm asking thoughtful questions, and that what they have to say is the most important thing happening in the room.
What surprises people most about a first visit?
People are usually surprised by the fact that we are just having a conversation. I am warm, friendly, and curious, and I think that puts people at ease. Everyone is an expert at their own life and experience, and I want to hear all about that. I respect what they have to say, it matters so much, and it shapes the work we do together.
People often share that they were more comfortable than they expected to be, and that they have never had a care provider listen to their whole story and life history before. To be fair, most care providers can't spend 90 minutes with one patient, but at Two Rivers, we make the time. It's part of our philosophy of care.
Will I get a diagnosis at the first visit?
Sometimes, and sometimes it takes a little longer. So many diagnoses share symptoms that overlap, and it can be kind of sneaky that way. Many people are dealing with a combination of depression, anxiety and maybe some things that look like PTSD or OCD. One symptom doesn't only land in one camp.
If you've already done some reading or self-diagnosing, that's not the wrong thing to do. I just hope you'll come in open and curious, so we can do the deep dive together and rule in and rule out what we can.
Do I have to take medication?
Absolutely not. Medication is one option, and it can be a very helpful one. We also take care of many people who don't want to be on prescription medications. Depending on what's going on, a plan might include lifestyle changes, nutritional changes, lab and genetic testing, and supplements.
Therapy is always really important, though you don't have to be in therapy to see me. The evidence is clear that medication and therapy together are most effective for mental health conditions, which is why our follow-up appointments can include therapy, not just medication check-ins.
There's no such thing as my plan for patients. It's always our plan.
Which labs might be part of the workup?
These are the labs most often part of the workup. This is an exhaustive list, and it doesn't mean everyone will need all of these.
CBC (complete blood count) with differential
CMP (comprehensive metabolic panel)
NMR lipid panel with Lp(a) and ApoB
Thyroid panel with antibodies
Iron profile with ferritin
HbA1c
Fasting insulin
High-sensitivity CRP
GGT
Celiac panel
Vitamin D
Vitamin B12
Vitamin B6
Folate
Homocysteine
Methylmalonic acid
Zinc
Copper
Magnesium
Prolactin
Morning (AM) cortisol
What happens after the first appointment?
We typically see you again within two to four weeks. From there, follow-ups are often monthly for a while, depending on your plan and how things are going. As things stabilize, visits spread out to every two months, then every three, and further when you are doing well.
| Stage | Typical timing |
|---|---|
| First appointment | 90 minutes |
| First follow-up | Within two to four weeks |
| Early follow-ups | About monthly, 45 minutes |
| Once stable | Every two to three months, then further apart |
How should you prepare?
You don't need to prepare much. A few things can help:
Jot down what you've noticed. When it started, what makes it better or worse, and how it affects work, sleep and relationships.
List your medications and supplements, including anything you've tried before and how it went.
Bring recent lab results if you have them.
Write down your questions. Ask all of them. That's what the time is for.
Think about what you want to be different. It doesn't need to be specific. "I want to feel like myself again" is a great place to start.
Who will I see?
Psychiatric care at Two Rivers is provided by psychiatric mental health nurse practitioners. We practice independently in Oregon, where we can diagnose, treat, and prescribe medications for mental health disorders. I see patients from age 16 to 65.
Psychiatry, therapy, women's health and integrative medicine are all part of the practice, so if your care requires help from one of our other providers, we can meet that need here in our clinic. We collaborate as care providers to serve our patients in the most comprehensive and holistic way. You are always free to choose your own providers or keep the ones you already see.
Frequently asked questions
How long is a first psychiatry appointment? At Two Rivers, 90 minutes. Follow-ups are usually 45 minutes.
Do I need a referral? No. You do not need a referral to be seen for psychiatry at Two Rivers. Whether your insurance plan requires one for coverage is between you and your plan.
Is what I share confidential? We follow HIPAA guidelines and take privacy very seriously. The trusted relationship between a patient and provider is necessary, valuable and sacred, and we guard it carefully. PMHNPs, like other medical professionals, are mandatory reporters so there are some specific limits to confidentiality. Your provider can explain the specific limits of confidentiality at your first visit.
Can my first appointment be by telehealth? First psychiatry appointments are in person at our downtown Corvallis office. Telehealth is available for established patients.
Do you take insurance? I am in network with Aetna, ComPsych, First Choice Health, Moda, Optum, PacificSource and Regence Blue Cross Blue Shield. Insurance varies by provider, so call (971) 368-1045 and we will check your plan and share fees before you book. A Good Faith Estimate is available under the No Surprises Act.
Let us help you
If you've been struggling and aren't sure where to start, start with the conversation. It's a privilege to do this work, and it all begins with listening. Call (971) 368-1045 or use the contact form. Two Rivers Integrative Health is at 257 SW Madison Ave, Suite 209, in downtown Corvallis.
Reviewed by Rebecca Moyes, PMHNP-BC · November 2026