Psychiatrists and Psychiatric Mental Health Nurse Practitioners (PMHNPs) both assess, diagnose, and treat mental health conditions. The main distinction is their education and training.

A psychiatrist is a physician (MD or DO) who completes medical school and specialized residency training in psychiatry. A PMHNP is an advanced practice registered nurse who completes a master’s or doctoral program with specialized education and clinical training in psychiatric mental health care.

Both can prescribe medication, provide psychotherapy, and develop personalized treatment plans within their scope of practice. The services each offers depend on their training, experience, and practice setting.

At Still River Psychiatry, I provide care as a board-certified PMHNP, with an emphasis on careful assessment, collaborative treatment decisions, and ongoing support.

Diagnosis begins with listening to your experiences. During an evaluation, we’ll discuss your symptoms, health history, life circumstances, and how you’re functioning day to day. Questionnaires and other assessments may help clarify the picture, but they don’t determine a diagnosis on their own.

I consider how your symptoms fit established diagnostic criteria while exploring other possible explanations, such as sleep difficulties, medical conditions, or medication effects. We’ll review the findings together and discuss next steps. Sometimes, understanding a condition takes more than one visit, and a diagnosis may be refined as we learn more over time.

Mental health conditions usually develop through a combination of factors rather than a single cause. Genetics, brain function, physical health, and life experiences can all play a role. Trauma, ongoing stress, relationship difficulties, and limited support may also contribute.

Each person’s experience is different, and having risk factors does not mean someone will develop a mental health condition. These conditions are not a personal failure or a lack of willpower. Understanding the factors affecting you can help us shape care around your needs.

Changes in how you feel, think, or manage everyday life can signal a need for support. You might notice ongoing sadness, worry, irritability, difficulty concentrating, or changes in sleep, appetite, and energy. Pulling away from relationships, losing interest in favorite activities, or struggling at work or school can also be signs that something needs attention.

These experiences don’t automatically mean you have a mental health condition. When they persist, worsen, or interfere with your life, an evaluation can help you understand what’s happening and explore your options. You don’t have to wait until things feel unmanageable to reach out.

If you’re experiencing thoughts of suicide or self-harm, call or text 988 for immediate support. For immediate danger or a medical emergency, call 911.

Yes. Recovery is possible, and it looks different for everyone. For some, it means symptoms resolve. For others, it means managing an ongoing condition while building a fulfilling, meaningful life.

Treatment, practical coping skills, and supportive relationships can all play a part. Progress may include setbacks, and needing continued care does not mean you’ve failed. Together, we’ll focus on your goals, adjust treatment as your needs change, and support your well-being over time.

If you or someone you care about is experiencing a mental health crisis, support is available:

• For immediate danger or a medical emergency: Call 911 or go to the nearest emergency department.

• For emotional distress or a mental health crisis: Call or text 988 to connect with the Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. You do not need to be experiencing suicidal thoughts to reach out.

• For in-person crisis support in Bend: Visit the Deschutes County Stabilization Center, located at 63311 NE Jamison Street, Bend, OR 97703. Walk-in services are available 24/7, with no appointment needed.

Please do not wait for a response to an appointment request, email, or portal message if you need immediate help.

You deserve care that is respectful, thoughtful, and centered on your needs. As your psychiatric mental health nurse practitioner, my responsibilities include:

• Listening with respect: Taking your experiences and concerns seriously while honoring your identity, background, and preferences.

• Protecting your privacy: Safeguarding your information and explaining confidentiality, including situations when disclosure may be required or permitted by law.

• Providing a thorough evaluation: Understanding your symptoms, health history, and life circumstances to guide diagnosis and treatment.

• Explaining your options: Discussing recommended treatments, alternatives, potential benefits, and risks in clear language, with time for your questions.

• Making decisions together: Developing an individualized care plan with your informed consent and meaningful participation.

• Prescribing thoughtfully: Considering medication safety, monitoring your response and side effects, and adjusting treatment when appropriate.

• Communicating clearly: Reviewing findings and next steps, setting expectations for response times, and explaining how to obtain urgent support.

• Coordinating care: Working with other healthcare professionals when appropriate and authorized, and helping with referrals when your needs fall outside my services.

• Supporting your safety: Assessing safety concerns, developing a safety plan when appropriate, and connecting you with crisis resources or a higher level of care when needed.

• Maintaining professional standards: Respecting boundaries, practicing within my expertise, and continuing to strengthen my knowledge and skills.

My goal is for you to feel informed, respected, and involved throughout your care.

Good care is a partnership. You can help us work together effectively by:

• Sharing openly: Provide accurate information about your symptoms, health history, medications, supplements, and substance use. Let me know about changes in your health or circumstances.

• Keeping appointments: Attend visits on time and follow the cancellation policy when you need to reschedule. Come prepared to discuss progress, concerns, and side effects.

• Participating in decisions: Ask questions, share your preferences, and speak up when something doesn’t feel right. You deserve to understand your options.

• Communicating about your treatment plan: Follow the plan we agree on, and let me know if cost, side effects, or other barriers make it difficult. We can discuss adjustments together.

• Using medication responsibly: Take medication as prescribed, never share or sell it, and request refills according to practice procedures. Discuss medication changes with me before making them.

• Completing recommended monitoring: Attend follow-up visits and complete any agreed-upon laboratory tests or other monitoring needed for safe care.

• Supporting care coordination: Tell me about treatment you receive elsewhere and discuss appropriate information sharing with your other providers.

• Treating others respectfully: Help maintain a safe, respectful environment for staff and other patients, including respecting others’ privacy.

• Keeping your information current: Update your contact, insurance, and billing details, and ask the scheduling and billing team about financial responsibilities or concerns.

• Knowing where to seek urgent help: Use crisis and emergency services when immediate support is needed rather than waiting for a routine message response.

If you’re having difficulty meeting any of these expectations, please let us know so we can discuss what support or adjustments may help.