Psychiatric Consultation

When treatment hasn't worked
the way it should

Careful, individualized psychiatric care for adults who want a more thorough evaluation — not a faster prescription.

Many patients arrive after months or years of treatment that never fully made sense. This practice offers a second-opinion level of evaluation: a careful diagnostic process, a fresh clinical perspective, and a thoughtful medication strategy built around your specific history.

Commonly sought for
Diagnostic Clarification Second Opinions Medication Reassessment Complex Cases
This may feel familiar

You may have been told you have anxiety, ADHD, depression, or "a little of everything" — yet the overall picture still feels incomplete. Or medication has helped somewhat, but not in a way that fully explains what has been going on. This is often where a more careful reassessment becomes most valuable.

Schedule in California Schedule in Hawaiʻi

Appointments are limited to maintain a careful, individualized pace of care.

Telehealth visits across California and Hawaiʻi  ·  For patients seeking a more careful, individualized approach

Board-certified in Psychiatry & Family Medicine  ·  Reginald Casilang, DNP, PMHNP-BC, FNP-BC
The MindCounsel

Not designed to be high-volume care.

Designed to be careful, deliberate, and clinically precise — with enough time and attention to actually understand what is happening, and why.

Dr. Reginald Casilang, DNP, PMHNP-BC, FNP-BC
Your Provider

Reginald Casilang, DNP

PMHNP-BC  ·  FNP-BC  ·  Board-Certified Psychiatry & Family Medicine

Dr. Casilang is a doctoral-prepared nurse practitioner with dual board certification in psychiatric-mental health and family medicine. This uncommon combination means your evaluation isn't limited to psychiatric symptoms in isolation — it includes a full medical lens, which matters more than most patients realize.

He practices telehealth-first across California and Hawaiʻi, and has built The MindCounsel specifically to offer the kind of careful, unhurried evaluation that is difficult to find in high-volume outpatient settings.

Philosophy

A different kind of psychiatric care

Many patients arrive after months — or years — of treatment that never quite fit. Medications adjusted without a clear rationale. Visits that felt rushed. Diagnoses that didn't fully account for the clinical picture.

This practice is structured around a careful diagnostic process. We prioritize clinical clarity before treatment change — so that decisions are grounded in a thorough understanding of your history, not an approximation of it.

Dual board certification in psychiatric-mental health and family medicine allows for a fuller picture — one that accounts for the medical contributors to psychiatric symptoms that are often missed when the two are evaluated separately.

Patient Fit

Is this the right fit?

This may be a good fit if:
  • You've been in treatment but still feel uncertain about your diagnosis
  • You want a second-opinion level evaluation
  • You value careful, evidence-based medication decisions
  • You prefer a slower, more deliberate clinical approach
This may not be the best fit if:
  • You're seeking immediate medication changes without a full evaluation
  • You prefer very brief, high-frequency visits
What to Expect

Your first visit

Your initial evaluation is typically 60 minutes.

We review your history in detail — including prior diagnoses, past treatments, what has worked, and what hasn't. Prior records are welcome and reviewed carefully.

The goal is a thorough, accurate understanding of your clinical situation before any recommendations are made.

Clinical Approach

Why this approach

In psychiatry, diagnostic precision matters. Small differences in interpretation can lead to significantly different treatment paths — some of which are correct, and some of which extend the time a patient spends without adequate relief.

A careful, unhurried evaluation — including a thorough medication history and a structured review of prior diagnoses — leads to more stable, more effective outcomes. It avoids the trial-and-error that comes from treating an incomplete picture.

Common Questions

Frequently asked

Do you prescribe medication?

Yes, when clinically indicated. Medication decisions are made collaboratively, with a clear explanation of the rationale, expected benefits, and what to monitor.

Do you accept insurance?

In California, visits are scheduled through Headway. Accepted plans include Aetna, Cigna, United Healthcare, Anthem Blue Cross, and others. Insurance eligibility is verified through Headway at the time of scheduling.

In Hawaiʻi, care is available for patients with Med-QUEST coverage, including HMSA and AlohaCare. (Med-QUEST is Hawaiʻi's Medicaid program — qualifying patients can schedule directly through the patient portal.)

Do you offer second opinions?

Yes. Many patients come specifically for diagnostic clarification or treatment reassessment. Prior records are welcome and reviewed carefully as part of the evaluation.

Schedule

Request a consultation

If this approach sounds like what you have been looking for, you can request an appointment below. Select the state where you are located.

California

California Patients

Accepted plans include Aetna, Cigna, United Healthcare, Anthem Blue Cross, and others. Insurance eligibility verified through Headway at scheduling.

Schedule in California
Hawaiʻi

Hawaiʻi Patients

Care is available for patients with Med-QUEST coverage, including HMSA and AlohaCare. (Med-QUEST is Hawaiʻi's Medicaid program.) Scheduling through the patient portal.

Schedule in Hawaiʻi
Have a question first? Send a message below.
Contact

Send a message

If you have a question before scheduling, or aren't sure which state option applies to you, use the form below. Messages are reviewed personally and you can expect a response within 1–2 business days.

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This form is not monitored in real time and is not appropriate for urgent concerns. If you are experiencing a psychiatric emergency, please call 988 or 911. No protected health information should be submitted here.