Why I built The MindCounsel
A different kind of psychiatric practice — built around the belief that a careful evaluation is itself a form of treatment.
Reginald Casilang, DNP, PMHNP-BC, FNP-BC
Founder · The MindCounsel · Telehealth Psychiatry, California & Hawaiʻi
I spent years working in high-volume psychiatric settings — seeing what a 20-minute intake could and could not accomplish. For patients with straightforward presentations, it was often enough. But for patients who had already been through one, two, three providers without clarity, it was not. The evaluation was too brief to catch what mattered.
I built The MindCounsel specifically for that second group. The patients who have tried the standard approach and are still searching for an explanation that actually fits. The ones who arrive with a folder of records and a list of every medication they've been on, because they've been told different things by different people and they want someone to finally look at the whole picture.
What I noticed — and what I wanted to change
Psychiatric diagnosis is not always a one-time event. In practice, it is a working hypothesis that gets revised as more information comes in. A good evaluation gathers enough information from the start to make that hypothesis as accurate as possible. A rushed evaluation makes an early guess and adjusts medication when things don't work — sometimes for years.
I also noticed something that does not get discussed often enough: the medical side of psychiatric symptoms. As a provider dual-certified in both psychiatric-mental health and family medicine, I began to see patterns that single-specialty clinicians sometimes miss. Thyroid conditions presenting as mood disorders. Sleep disorders being treated as anxiety. Hormonal shifts that looked like treatment-resistant depression. These are not rare edge cases — they are common, and they are regularly overlooked when psychiatry and medicine are evaluated separately.
The MindCounsel is built around the idea that slowing down — really reviewing someone's history, their prior medications, their medical picture — is not a luxury. It is the foundation of accurate care. That is what this practice is structured to provide.
Training and board certifications
“In psychiatry, diagnostic precision matters. Small differences in interpretation can lead to significantly different treatment paths. A careful evaluation is not slower care — it is more effective care.”
Reginald Casilang, DNP, PMHNP-BC, FNP-BC
Why Hawaiʻi matters to this practice
As a Filipino-American provider, I understand something specific about how mental health care can feel for patients whose family and cultural background was not designed around the idea of going to a psychiatrist. There is often real hesitation — about what it means, what the family will think, whether the provider will understand the context.
Hawaiʻi has a large Filipino and Pacific Islander population, and it is significantly underserved in psychiatric care — particularly in Medicaid and QUEST plans. I expanded The MindCounsel to Hawaiʻi in part because the need is real, and in part because being able to speak with a patient in Tagalog when English does not fully carry the meaning is not a small thing. Language and cultural context shape how someone describes what they are experiencing — and that directly affects clinical accuracy.
The MindCounsel is in-network with HMSA PPO, HMSA QUEST, and AlohaCare in Hawaiʻi. Telehealth is available statewide.
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