Attention Deficit and Anxiety care, reimagined.

We look at your medical history, review your symptoms, and if appropriate, discuss your medication options with you.

Everyone reacts to medication differently. We'll be by your side at every step, adjusting and adapting your regimen as needed. When it's time to come off, we'll guide you.

You’ll be paired with a Wellness Coach who is trained to support you around techniques including positive reinforcement, emotional support and therapy referral if appropriate.

Comprehensive mental healthcare, personalized to you, from the comfort of your home.

Keep track of how you’re feeling. We’ll adjust your medication as needed, and help taper them when you’re ready. 

You’re more than just your history. Discuss your symptoms and treatment options with your mental health professional via video chat. 

Reach out to your wellness coach anytime to chat about anything that’s on your mind.

Your provider will jump on a call to assess if your treatment is working.

No more pharmacy lines, we take the headache away from making the extra trip.

Your privacy is our top priority, this spans from how we build technology to the very box you receive at home.

Our treatment plans are built by mental health professionals from top institutions.

Procrastination is easy. Getting started is even easier. 

Let’s face it: first visits with a mental health professional can be intimidating. You are about to share difficulties with emotions with someone you’ve never met. In this post, our CMO Ravi Shah answers some of the most common questions and concerns we hear from people who want to get mental health care but are afraid to take that first step. 

Why do you collect so much information before the visit? 

In short, doing so will save you time and money. A comprehensive mental health initial evaluation requires us to know a lot about you, your current situation, your medical history, and your past. You can provide much of this information yourself in writing prior to the visit. Our mental health professionals will review this information before meeting you. 

Naturally, you as a person are much more than facts about your past. By gathering more information up front, we allow you and the provider to focus the visit on really understanding  your story, your challenges, and your goals. This way the clinician can also take the time to explain your medication and other options for treatment and even answer questions about side effects or other concerns you might have. 

Our mental health experts will start by verifying your identity and asking a few basic questions about your life, where you live, what you do for work or school, etc. Then they will ask you to describe what is bothering you the most and follow up questions that are related. They may ask some questions which you have already provided, but it’s important they understand the context behind your story. They will also ask you important questions about your mental health history like symptoms of bipolar disorder, severe substance use disorders, and other related questions to ensure that Mantra is a good fit for you. 

What’s the best setting for a first visit?

For the telehealth to work optimally, we recommend you be somewhere where you have a strong WiFi connection as cellular data connections may interrupt the flow of the visit or create delays in audio or video transmission. Beyond that, you want to find a place that is private (ie no one else in the room), and where you can speak freely. The best evaluations happen when you can be completely honest with your care team. For people who work in open-floor layouts, sometimes people find a phone booth or lactation room to use for such visits so that they can maintain privacy. 

If the clinician believes a medication may help you, then they will have it delivered to your door in beautiful (and reusable!) packaging. In addition, we’ll have a coach follow-up with you to set goals for your treatment and follow-up on your medications. We are here to help you on your journey by answering questions or concerns as well as making sure the medications are making a meaningful difference in your life. If they're not (or they're causing more harm than good), then we'll help you adjust, change, or stop them as appropriate.

What’s better, telehealth or in-person treatment?

That depends in part on your condition and in part on your preferences. For many, telehealth visits feel less frightening and easier to work into their schedule (in terms of time and money). For patients with more severe mental illness, in-person care may be more appropriate. Ultimately, we believe good care can be delivered in either format, but the key is that if you are suffering, please get help in a way that works for you. At Mantra, we believe everyone deserves world-class mental health care. 

Have more questions about your first visit at Mantra? Ping me at @RaviShahMD

Preparing for your first telehealth visit: Tips from Ravi Shah, MD

Primary care is not designed to treat mental health conditions.

When you are facing a mental health challenge, like anxiety or ADHD, it's very challenging to take the extra step to ask for help. Most people seek out treatment from their primary care doctors to start. This makes sense since only about half of psychiatrists accept insurance, and out of pocket fees for private psychiatrists are high. People often face many barriers to obtaining healthcare. You may have to wait weeks or months for an appointment with a primary care doctor. When you finally get to see the doctor, it can seem as if your entire life is compressed into a 15-minute interview, where you're assessed, diagnosed, and prescribed a medication. For some, that very first medication may help. However, for many others, the first medication may not feel like it’s working or the medications may cause side effects. The primary care doctor may not have the time or expertise to advise on these issues. The result is inadequate care: wrong diagnoses, wrong medications, and/or wrong doses. 

Access to mental health experts is expensive and disjointed

After moving on from primary care, you begin researching to find a reputable and affordable professional, but soon this feels like an impossible task. It is a struggle to get appointments with the right people. You may find yourself waiting weeks or months to be seen. If you do get treatment, it may feel like the different professionals that you’re working with (e.g psychiatrist, therapist, primary care doctor) don’t talk to each other. Finding good mental health care is so time-consuming, expensive and unsatisfying that many people just give up. Fortunately, the Collaborative Care Model (CCM) was designed to address these deficiencies in our healthcare system and better meet your needs. 

The Collaborative Care Model is an innovative approach to providing mental health treatment by providing easier access to excellent mental health treatment provided by professionals working together as a team. First, evidence based scales are used in combination with an interview to help provide an accurate assessment of what’s going on. Then, medications are used in combination with coaching and problem-solving therapy to help you achieve your goals. In addition, an expert psychiatrist provides oversight to prescribers, and progress is tracked using evidence-based scales to ensure you stay on track. The whole team talks to each other, with much of the care flowing throw a care coordinator (sometimes called a coach) who makes sure that patients are receiving the best care. In over 80 randomized controlled trials the collaborative care model has been shown to deliver better outcomes, lower costs, and healthier patients.

Your team is going to proactively contact you and monitor your symptoms with evidence-based scales (e.g. PHQ-9, GAD-7) to achieve clearly defined goals. This is broadly called Measurement Based Care, and it’s a critical piece of collaborative care. It’s straightforward. You provide feedback about your symptoms to your team. Then, your team can see what’s working and what needs to be adjusted. Research shows that Measurement Based Care improves clinical results, better informs collaborative care efforts, improves clinical decisions and patient engagement in therapy. 

Improved communication between your healthcare providers

If you have ever received care from several doctors (or therapist or other professional) at once, you likely felt at times that not everyone was on the same page. For example, you may have received contradictory information, advice, and recommendations from multiple people. It can feel overwhelming when you don’t know whose advice to follow. What if there was a person whose main responsibility was to ensure that your entire treatment team was on the same page?

These types of situations are all too common and contribute to the inefficiency of our healthcare system. For example, depressed patients take an average of 10 years to get treatment after their symptoms start, while 70% of them never receive adequate care (source: WHO). This should never be the case, and is an important motivation for collaborative care.

A team-based approach is the cornerstone of collaborative care (hence the term collaborative).  This means all of your professionals are working together to build you the most effective treatment plan.  This saves you time, avoids the frustration of repeated assessments, and most importantly provides the most comprehensive care with the best outcome, all while saving you money.

Yourself – You are the most important part of your team. During traditional treatment, you may feel that your voice is not being heard. However, in collaborative care, your input and feedback are an essential part of the model.

Care manager - Your care manager is your coach. They have various forms of training and may include counselors, psychologists, or social workers. They manage your overall treatment plan, provide you with brief psychotherapy, support your medication management, and orchestrate the communication with the rest of the team.

Prescriber - A licensed professional manages the medications. This may be a primary care physician or nurse practitioner. They often start people on medications if needed. They will follow up with you to check your progress and collaborate with your coach.

Psychiatric consultant - Your psychiatric consultant will provide guidance to the coach and prescriber regarding any mental health issues, helping to troubleshoot any challenges that come up along the way.

It might sound good, but are you wondering if it actually works? Over the past 20 years, more than 80 peer-reviewed scientific studies have been published and consistently showed that collaborative care is more effective than standard psychiatric approaches for the treatment of several psychiatric conditions, including depression, anxiety, and ADHD. One such study that tracked patients for two years found that the use of collaborative care over traditional care was more effective for patients with anxiety. The improvement in care was notable as early as the first month into the study and lasted throughout. Another study shows the benefits of online collaborative care in treating anxiety and mood disorders, and that it can be superior to in-person care from a primary care physician. 

This has been further proven by meta-analyses that dug into literature to show how several tens of thousands of patients have benefited from CCM in terms of improvement of symptoms, quality of life, and decrease of costs. Despite the scientific evidence, CCM and most other integrated care models have not been widely adopted, though more and more providers (especially large academic medical centers) are turning to CCM. The growing presence of telemedicine and digital mental health care will hopefully prove to be a major catalyst for proving the effectiveness of this therapeutic approach.

If you're interested in more information on collaborative care visit the University of Washington AIMS website. The University of Washington helped pioneer the concept of collaborative care. 

There is a lot of information, resources, and support online about childhood ADHD. While it's most commonly considered a childhood disorder, many people don’t realize that adults are also impacted by ADHD. The scientific community once thought that adult ADHD was simply undiagnosed childhood ADHD, but we now know that adults can develop ADHD even if they never had symptoms of it as a child. This is very important because, even if you did great in school when you were younger or performed well in your career, more recent difficulties with inattention, impulsivity and/or hyperactivity still may be caused by ADHD. In addition, about 60-80% of children with ADHD continue having symptoms as an adult, and one-third of children with ADHD continue to meet criteria for ADHD as an adult.

ADHD stands for Attention Deficit Hyperactivity Disorder. It's a brain disorder characterized by a pattern of impaired attention and/or impulsivity. At its most basic level, ADHD is caused by alterations in certain brain circuits, mediated by chemical substances in the brain called neurotransmitters.  While that's a mouthful, the important takeaway is that we have a biological understanding of the causes of the symptoms of ADHD as well as proven treatments that can help patients. If you have ADHD, you most likely find it difficult to concentrate, remain focused on tasks until they're completed, and manage your time efficiently. It's likely that you feel fidgety and restless at times, which leads to a pattern of making impulsive decisions. 

Back in the 1980s and early 1990s ADD was the term that was widely used. It stood for Attention Deficit Disorder, and over the years, the name of the disorder has been updated to reflect the improved scientific understanding of the disorder (namely that for many patients hyperactivity, not attention deficit, may be their main symptom). If you are in the habit of saying ADD, don’t worry, clinicians will still know what you are talking about. The most important thing is to be aware of the possible symptoms of ADHD. 

Scientific studies show that ADHD has a strong genetic component.  Thus, if someone in your family has been diagnosed with ADHD (or has undiagnosed ADHD),you have a higher chance of having it as well. Studies also show that environmental factors (all your experiences and things you have been exposed to since birth) play a limited role in causing ADHD. 

At the most basic level, the symptoms of ADHD are caused by alterations in the brain’s use of neurotransmitters like dopamine, serotonin, and norepinephrine (also called noradrenaline in other countries). This scientific understanding is crucial, because these alterations in neurotransmission are the target of the most common drug treatments like Amphetamines (Adderall®), Methylphenidate (Ritalin®) and Atomoxetine (Strattera®).

If you are living with ADHD there are several different ways that it can impact your personal and professional life. Some of the things that you may experience include:

Decreased productivity. This could mean making less money than you would have otherwise (20% lower, $41K vs $52k; Biederman/Faraone, MedGenMed 2006)

Consequences from missed appointments and meetings

Difficulty with meeting deadlines, managing large projects, and responsiveness at work which makes it hard to get promoted

Compulsive eating, substance use disorders, and screen addiction

Difficulty due to impulsive decisions and emotional outbursts. 

The DSM-5 is a large book published by the American Psychiatric Association that mental health professionals use to classify mental health conditions. For the diagnosis ADHD, it is important that several symptoms of inattention or hyperactivity are present for a period of at least 6 months. These symptoms impair functioning and occur in multiple settings (such as at work and at home). Currently the DSM5 requires that at least some of these symptoms existed were present before the age of 12 (though doesn’t require that you met ADHD criteria in past). For more details on the DSM 5 criteria, click here

Do you identify with the following statements?

People with ADHD tend to identify with several of the following statements:

I struggle when it comes to paying attention to details which leads to careless mistakes. 

There aren't many things that can hold my attention. Even when I try to pay attention when someone is talking, I have a hard time listening

I have difficulty completing work or household tasks because I get side-tracked.

It's hard for me to stay organized. I lose things a lot (keys, wallet, purse, paperwork, glasses, cell phone, etc.)

I struggle with interrupting others. It’s hard for me to wait my turn. 

I tend to blurt out answers to questions before they are asked. 

I am restless and fidget a lot. Even when I’m expected to stay seated, I feel that I must get up. I struggle when participating in quiet leisure activities. 

Even if you identify with the symptoms listed above, ADHD isn't something that you can self-diagnose. Studies show that 70-75% of patients with ADHD also have another psychiatric condition, such as anxiety, depression, or substance abuse. If you think that ADHD is the cause of your struggles, it's important to talk to a mental health specialist. Until then, feel free to take our free evidence-based assessment by clicking here.

Take on each day with clarity.

What We Offer

Comprehensive mental healthcare, personalized to you, from the comfort of your home.

Comprehensive, expert diagnostic

Medication delivery & monitoring

Wellness coaching

How it Works

Procrastination is easy. Getting started is even easier.

Cancel anytime

Mantra Care

45 minute video evaluation

Monthly follow ups with your provider

Unlimited text-based coaching

Medication adjustments and tapering

If prescribed

Medication Plan

Delivered to your door

FDA approved

Discreet packaging

Why Mantra

Parked Thoughts

Preparing for your first telehealth visit: Tips from Ravi Shah, MD

What is collaborative care?

Is Adult ADHD real?