Can an online psychiatrist prescribe medication? Yes, but with some restrictions. Limited funding, stigma, staff shortages, and high turnover rates can make access to psychiatric care a challenge in hospitals, correctional facilities, and other institutional settings.
Researchers estimate that for people living in institutional care settings, as much as 37% have depression, about 8% have an anxiety disorder, 4% have schizophrenia, and about 2% have bipolar disorder.
However, as of 2021, only 28% of the U.S. population lived in an area of the country where there were an adequate number of psychiatrists and other mental health professionals to meet their community’s needs.
Ever since the COVID-19 pandemic, telepsychiatry has been gaining popularity in prisons, residential treatment centers, and other institutional settings as a scalable, cost-effective solution for mental health treatment.
But what types of restrictions determine whether an online psychiatrist can prescribe medications? In this article, we’ll review the role of online psychiatrists and how federal, state, and institutional regulations may impact how they provide care.
The Role of Online Psychiatrists in Institutional Healthcare
An online psychiatrist — also sometimes called a telepsychiatrist or virtual psychiatrist — is a licensed mental health professional who provides psychiatric evaluations, therapy sessions, treatment plans, and medication management via telehealth.
These telehealth sessions are held via online video or phone calls and replace in-person visits.
There are several reasons why institutions are turning to telepsychiatry and online therapy to provide mental health care for the people in their care:
- Staff shortages: Many facilities struggle to retain full-time licensed psychiatrists — offering telepsychiatry eliminates the need for full-time mental health care staff.
- High patient demand: There is a growing need for mental health services in hospitals, correctional facilities, and behavioral health centers as conditions like anxiety and depression have become more prevalent.
- Cost-effectiveness: Virtual psychotherapy services are many times less expensive than employing on-site board-certified mental health professionals or taking people to in-person doctor visits.
- Regulatory compliance: Many states support telepsychiatry under healthcare accessibility initiatives.
- Reducing stigma: People in institutional settings may be apprehensive of seeking on-site mental health care due to the stigma surrounding these conditions.
Can Online Psychiatrists Prescribe Medication for Patients in Institutional Settings?
The short answer to this question is yes, but with some caveats based on federal and state regulations.
In general, online psychiatrists can prescribe medications for acute and chronic mental health conditions in therapy offices, hospitals, correctional facilities, and residential treatment centers.
To do this, they need to be licensed and registered within the state where the institution is located. While the virtual psychiatrist does not need to live in the same state, they need to be licensed in the same state where their patients live.
Each state usually has its requirements for providing telepsychiatry and prescribing medications. For example, some require a special telehealth license, while others prohibit the prescribing of controlled medications.
Most states require the patient to attend a telehealth examination with video conferencing before a telepsychiatrist can prescribe them medications.
It’s also important to note that not all health insurance covers prescriptions prescribed via telehealth for certain medications.
When an online psychiatrist is prescribing medication for people in institutional settings, the process normally includes:
- An online psychiatrist assesses patients remotely, often as part of an on-demand psychiatry program.
- Prescription for psychiatric medications is sent electronically to the institution’s designated pharmacy or in-house medical team.
- Institutional staff ensures administration and compliance.
Prescribing Controlled Substances via Telepsychiatry: What Facilities Need to Know
When answering the question, “Can an online psychiatrist prescribe medication to those in institutional settings,” one area that can sometimes be tricky is prescribing controlled substances through a telehealth visit.
Federal Rules
Typically, patients must have at least one in-person evaluation before receiving a controlled substance prescription via telehealth. However, temporary exceptions were introduced in 2020 due to COVID-19, allowing DEA-registered telehealth providers to prescribe controlled substances without an in-person visit. These flexibilities have been extended through 2025.
State Regulations
State laws vary, with some prohibiting telepsychiatrists from prescribing controlled substances or imposing strict requirements. In addition to the federal in-person evaluation rule, some states mandate follow-up appointments within specific timeframes when controlled substances are prescribed via telepsychiatry.
Institutional Policies
Can online psychiatrists prescribe medication for institutions in every state? In addition to federal and state regulations, institutions will also have their policies when it comes to authorizing online-controlled substance prescriptions via telepsychiatry. For example:
- Most hospitals allow controlled substance prescriptions via telehealth for credentialed telepsychiatry programs.
- Most residential behavioral health centers allow prescriptions for controlled substances by a telepsychiatrist with on-site physician oversight.
- Correctional facilities operate under state/federal telemedicine laws.
Common Medications Online Psychiatrists Can Prescribe for Institutional Patients
An online psychiatrist can’t prescribe any medication they wish. Let’s review some of the pharmaceutical treatment options they can prescribe via telehealth.
Mental health medications that are typically approved for online prescribing:
- Anti-anxiety medications
- Antidepressants, including SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) and SSRIs (Selective Serotonin Reuptake Inhibitors)
- Antipsychotics
- Mood stabilizers
- Non-controlled anxiety medications
- Pain relievers
Medications that require stricter regulations (or in-person evaluations):
- Sedatives/Benzodiazepines: Heavily regulated due to abuse potential.
- Opioids & other controlled substances: Generally not prescribed via telepsychiatry unless under special state and/or federal regulatory exemptions.
- Stimulants: Requires additional compliance measures.
Implementing Online Psychiatry for Medication Management in Your Facility
Once you determine whether an online psychiatrist will prescribe medication, your next step is to partner with a licensed telepsychiatry provider like FasPsych.
A telepsychiatry provider provides fully licensed online psychiatrists and other mental health professionals who fully understand federal and state telehealth prescription medication laws to ensure you and your institution are in compliance.
From there, there are a few steps to follow to add telepsychiatry services into your institution:
- Step 1: Make sure you have computers and a reliable internet connection for uninterrupted telepsychiatry visits.
- Step 2: Place a cybersecurity plan in place to ensure the confidentiality and privacy of patient medical information.
- Step 3: Ensure that telepsychiatry options are available in the different languages of your population.
- Step 4: Establish a secure telepsychiatry workflow for patient intake, initial consultation, medication management, and follow-ups.
- Step 5: Train institutional staff and clinicians on psychiatric e-prescribing protocols.
Benefits of Online Psychiatry for Organizational Decision-Makers
While the most obvious benefit of telepsychiatry is flexibility,, there are other benefits for leaders and administration to consider:
- Scalability: Expands access to psychiatric care for your population without requiring full-time, in-house psychiatry services, and most major insurances now cover online psychiatry.
- Cost Savings: Reduces overhead costs associated with hiring on-site psychiatric staff.
- Compliance & Risk Management: Ensures that psychiatric care meets legal and ethical standards for prescribing medications remotely.
- Reduces Stigma: Patients may be more willing to meet with a telepsychiatrist than a licensed therapist on-site due to the stigma surrounding mental health issues.
- Improved Patient Outcomes: Faster access to psychiatric treatment, referrals to specialties, and continuity of care help reduce mental health crises, self-harm risks, and behavioral incidents in facilities.
FAQs for Hospitals, Correctional Facilities, and Behavioral Health Centers
Can an online psychiatrist prescribe medications like controlled substances in hospitals or jails?
In some cases, yes. If the institution qualifies under telemedicine prescribing laws, psychiatrists may prescribe controlled substances remotely with oversight.
Can an online psychiatrist prescribe medications like Xanax to a patient in a facility?
Rarely. Due to its high potential for abuse, Xanax is tightly regulated and typically requires an in-person evaluation before being prescribed.
Can an online psychiatrist prescribe medications like Adderall in a correctional facility?
Only in limited cases. As a controlled substance, Adderall used to treat ADHD has a high abuse and addiction rate. Some telepsychiatry programs can prescribe stimulants under specific state and federal guidelines.
How can our institution ensure compliance with telepsychiatry prescribing laws?
Partner with a licensed and credentialed telepsychiatry provider who understands the state and federal regulations regarding telepsychiatry prescribing laws, and work with a legal team to ensure compliance with DEA, state medical boards, and institutional policies.
Telepsychiatry: A Cost-Effective Medication Management Solution
Can an online psychiatrist prescribe medication? Online psychiatrists can prescribe medications for patients in hospitals, correctional facilities, and mental health centers, but each state has its own policies, and controlled substances are subject to strict regulations.
Institutions looking to implement a secure, compliant telepsychiatry program should partner with an experienced provider like FasPsych for expert guidance and scalable mental health solutions.
If you have additional questions, contact us today to learn more about how we can help.