Patient Guide

Mental Health at Your Primary Care Provider vs. a Specialist — Who Should You See?

The short answer: start with primary care. For mild to moderate anxiety, depression, ADHD, and stable mental health conditions, your primary care provider can diagnose, treat, and prescribe — often faster and more affordably than a specialist. When your needs are more complex, more severe, or not responding to initial treatment, that's when psychiatry steps in. At Burds, we're honest about where that line is — and we have strong referral relationships for when you need them.

Know Your Options

Three Types of Mental Health Providers — What Each One Does

Mental health care can involve several different provider types. Understanding who does what helps you get to the right person faster.

Your First Stop
Primary Care Provider
Diagnoses, prescribes, manages, and coordinates your overall mental health care as part of whole-person medicine.
Can prescribe?
Yes — antidepressants, anti-anxiety, ADHD medications
Best for
Mild to moderate anxiety, depression, ADHD, stable mental health conditions
Wait times
Typically shorter — same or next week
Whole-person care
Yes — mental health connected to physical health in one record
At Burds
We treat mild to moderate conditions and refer when appropriate
When You Need More
Psychiatrist
A physician specializing in mental health — advanced training, broader medication range, and expertise in complex or severe conditions.
Can prescribe?
Yes — full range including controlled substances and advanced medications
Best for
Moderate to severe conditions, complex diagnoses, treatment-resistant cases, bipolar disorder, PTSD, psychosis
Wait times
Often weeks to months — high demand in most markets
Whole-person care
Focused on psychiatric conditions — coordinates with your PCP
At Burds
We refer here when your needs exceed primary care — with warm handoffs to local resources
Talk Therapy
Therapist / Counselor
Provides counseling, psychotherapy, and behavioral health support — does not prescribe medication.
Can prescribe?
No — therapy only, no medication management
Best for
Processing, coping skills, trauma, relationship issues, ongoing behavioral health support — often alongside medication
Wait times
Varies widely — can be significant in rural markets
Works with
Often paired with primary care or psychiatry for comprehensive care
At Burds
We refer to and coordinate with local therapists and counselors as part of your care plan
Our Scope at Burds

What We Treat — and When We Refer

We're honest about what primary care does well in mental health and where a specialist is the better call. Here's exactly where we draw the line.

We Handle This at Burds

Primary care mental health — our scope

  • Mild to moderate anxiety — diagnosis, medication, and monitoring
  • Mild to moderate depression — diagnosis, medication management, and follow-up
  • ADHD — evaluation and medication management for established patients
  • Stable, well-managed mental health conditions — ongoing medication and monitoring
  • Screening for mental health concerns as part of routine care
  • Initial evaluation when you're not sure what's going on
  • Ruling out physical causes of mental health symptoms — thyroid, anemia, hormones
  • Coordinating your care with therapists and specialists
We Refer to Psychiatry or Behavioral Health

When you need more than primary care

  • Moderate to severe symptoms significantly affecting daily functioning
  • Bipolar disorder — diagnosis, stabilization, and medication management
  • PTSD — specialized evaluation and treatment protocols
  • Schizophrenia or psychosis — requires psychiatric expertise
  • Eating disorders — specialized evaluation and treatment
  • Treatment-resistant depression — not responding after two or more medications
  • Complex medication needs beyond primary care scope
  • Situations requiring more intensive or specialized evaluation

We have strong referral relationships with psychiatry and behavioral health providers nearby. When we refer, we do it with a warm handoff — not just a name on a piece of paper.

Why Primary Care First

The Whole-Person Advantage

One of the most underappreciated aspects of managing mental health in primary care is that your mental health doesn't exist in isolation from the rest of your body. And your primary care provider is the one who can see the whole picture.

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Mental health and physical health are connected — your provider should be too

Fatigue that looks like depression could be a thyroid problem. Anxiety that isn't responding to medication might be connected to blood sugar or hormone levels. Sleep disruption worsens almost every mental health condition. Chronic pain and mental health co-occur at significant rates. When your mental health care happens in the same place as your physical care — with the same provider who has your full record — those connections get caught. When they're siloed, they often don't.

Starting with primary care also means faster access. Psychiatrists in most markets have wait times measured in weeks to months. If you're struggling with depression or anxiety today, coming to see us first means getting evaluated, getting a plan, and — if medication is appropriate — getting started while the referral process happens in parallel.

Where to Start

Who Should You See First?

Use this as a starting point — and remember, your primary care provider can always refer you to the right specialist if needed.

Situation or concern → Where to start
Feeling anxious, worried, or on edge — mild to moderate, first time noticing
Start at Burds
Feeling down, sad, or depressed — mild to moderate
Start at Burds
Trouble focusing, concentration issues, possible ADHD
Start at Burds
Already diagnosed — stable condition, ongoing medication management
Burds Can Manage
Not sure if what you're feeling is physical or mental
Start at Burds
Sleep problems, fatigue, irritability — possible underlying cause
Start at Burds
Symptoms are moderate to severe and interfering with work or relationships
Burds → Refer if needed
Tried one or more medications without improvement
Psychiatry
Bipolar disorder — mood swings between depression and elevated states
Psychiatry
PTSD or trauma-related symptoms
Psychiatry + Therapy
Psychosis, delusions, or hallucinations
Psychiatry
Eating disorder — restricting, purging, or bingeing behaviors
Specialist Care
Want to talk to someone — counseling or therapy
Therapist — we can refer
Thoughts of self-harm or suicide — call 988 or go to the ER
988 / ER Now

If you or someone you know is in crisis

Call or text 988 — the Suicide and Crisis Lifeline — available 24 hours a day, 7 days a week. If there is immediate danger, call 911 or go to the nearest emergency room. Do not wait for a scheduled appointment.

Our Referral Network

When We Refer, We Refer Well

A referral from Burds isn't the end of the conversation.

When your mental health needs exceed what primary care is equipped to manage, we don't hand you a list of names and wish you luck. We have strong, established relationships with psychiatry and behavioral health providers in the area — providers we trust and coordinate with regularly. We'll make sure you get connected, and we'll stay involved in your overall care while you do.

Many patients do best with a combination of primary care and specialist support — psychiatry managing complex medication needs while Burds stays connected to the rest of your health. That coordination doesn't happen automatically; it happens because we make it a priority.

Full Breakdown

Primary Care vs. Psychiatrist vs. Therapist

Factor Primary Care (Burds) Psychiatrist Therapist
Can prescribe medication ✓ Yes — antidepressants, anti-anxiety, ADHD ✓ Yes — full psychiatric medication range ✗ No
Treats mild to moderate anxiety / depression ✓ Yes — our scope at Burds ✓ Yes — and beyond ~ Therapy only, no medication
Treats complex / severe conditions ✗ We refer for this ✓ Their specialty ~ Counseling support, not diagnosis
ADHD evaluation and medication ✓ Yes at Burds ✓ Yes ✗ No
Bipolar disorder, PTSD, psychosis ✗ We refer to psychiatry ✓ Specialized expertise ~ Therapy as adjunct
Connected to your physical health record ✓ Yes — whole-person care ~ Coordinates with PCP ~ Coordinates with PCP
Typical wait time Days to one week Weeks to months in most markets Varies — can be significant
Provides talk therapy ✗ We refer for therapy ~ Some do, most focus on medication ✓ Their primary service
Can rule out physical causes of symptoms ✓ Yes — thyroid, hormones, anemia ~ As a physician, yes — but focused on psychiatry ✗ No
Referral to other providers ✓ We coordinate everything ✓ Yes ~ Can recommend
Common Questions

Frequently Asked Questions

Can a primary care provider treat mental health conditions?
Yes. Primary care providers can diagnose and treat a range of mental health conditions — particularly mild to moderate anxiety, depression, and ADHD. At Burds Family Practice, we manage stable mental health conditions and prescribe for mild to moderate anxiety, depression, and ADHD. When a condition is more complex, more severe, or not responding to initial treatment, we refer to psychiatry or a behavioral health specialist.
What mental health conditions does Burds Family Practice treat?
Burds Family Practice manages stable mental health disorders and prescribes for mild to moderate anxiety, depression, and ADHD. We coordinate closely with psychiatry and behavioral health specialists for patients who need a higher level of care, and we have strong referral relationships with providers in the area.
When should I see a psychiatrist instead of my primary care provider?
You should see a psychiatrist when your symptoms are moderate to severe and affecting daily functioning, when you have a complex condition such as bipolar disorder, PTSD, schizophrenia, or treatment-resistant depression, when medications prescribed in primary care have not been effective, or when you need specialized evaluation or a broader range of treatment options. Burds Family Practice will refer you to psychiatry or a behavioral health specialist when your needs exceed what primary care is equipped to manage — with a warm handoff to trusted local providers.
What is the difference between a psychiatrist, a therapist, and a primary care provider for mental health?
A primary care provider can diagnose and prescribe medication for common mental health conditions like mild to moderate anxiety, depression, and ADHD, and can manage stable conditions as part of whole-person care. A psychiatrist is a physician specializing in mental health with advanced training in complex conditions and a broader range of medication options. A therapist provides talk therapy and counseling but cannot prescribe medication. The three often work together, with primary care as the entry point and coordinator.
Should I start with my primary care provider or go straight to a psychiatrist?
For most people experiencing mental health symptoms for the first time, starting with a primary care provider is the right first step. Your provider can rule out physical causes, assess the severity, prescribe initial medication if appropriate, and refer you to psychiatry or therapy if needed. Starting with primary care is typically faster — psychiatrists often have wait times of weeks to months — and your provider can coordinate your overall care as you get connected with the right resources.

Not sure where
to start?

Start with us. We'll assess where you are, talk through your options honestly, and make sure you get connected to the right care — whether that's here or somewhere else.

Schedule an Appointment Call Us: (563) 588-6659