Choosing care
How we stack up.
There are a lot of ways to get mental health care right now. Here's an honest read on the big national options and where we actually sit in the picture.
Why we wrote this
No sales pitch, just the honest version
The quick version
How we stack up, side by side
| LiveWell | Hims & Hers | BetterHelp | Talkiatry | Done | |
|---|---|---|---|---|---|
| What it is | A real psych clinic, Oregon and Washington | A DTC pharmacy with a prescriber bolted on top | A therapy marketplace owned by Teladoc | Insurance psychiatry, run at scale | An ADHD subscription |
| How you get seen | An actual 45 to 60 minute conversation | A questionnaire somebody skims | Matched to whatever therapist is on the platform | A real psychiatrist eval, then volume | A quick eval, then a monthly script |
| Who you deal with | The same provider, who remembers you | A portal | Often a rotating therapist | A psychiatrist who might rotate out | Mostly async, mostly a refill |
| Meds and therapy | Both, and the meds support the work | Meds only | Therapy only | Meds-focused | Stimulants, ADHD only |
| What they cover | Mental health and men's health | A short prescription list | Talk therapy | Broad psychiatry | ADHD, and that's it |
| The catch | You still have to do your part | No real conversation, ever | Quality is a coin flip, and the privacy record is rough | Short follow-ups, provider turnover | Legal scrutiny, and a narrow lane |
We could sit here and tell you we're the only real option, that the big national clinics are all corner-cutting nightmares, that everyone else is selling pills out of the back of an app, and that you should just trust us because we said so. We're not going to do that, partly because it'd be a lie, and partly because anyone who reads it can tell it's a lie inside of about two paragraphs.
The truth is that Hims, BetterHelp, Talkiatry, and Done all do something well, and all of them have a catch, and the same thing's true of us. We refer patients out to other places all the time. Sometimes a guy walks in who genuinely just wants a generic ED script delivered to his door and a five minute touch base every few months, and we'll tell him outright that he's probably better off with a DTC subscription than with us. That's not us being modest, that's us not wanting to waste his money or our schedule.
So here's the honest version. Four big names you've probably already seen ads for, what each one actually is under the marketing, what they're good at, what they're not good at, and where we fit on the same map. If you read it and decide one of them's the better call for you, we're fine with that. If you read it and want to talk to us, that's fine too. Either way you got there with real information instead of an ad.
Hims & Hers
Hims is a publicly traded direct-to-consumer pharmacy company with a prescriber layer attached to the top of it. You fill out a questionnaire, a clinician reviews it, the script gets written, and the medication ships to your house on a monthly subscription. Most of the interaction's asynchronous, meaning you're not actually on a call with anyone for the vast majority of visits. The product's the convenience, the price, and the box on your doorstep, not a relationship. Hims is also in active litigation with Novo Nordisk over its compounded semaglutide, and the FDA sent it a warning letter in 2025 over how it marketed those GLP-1 knockoffs.
Hims fits guys who already know what's going on, want a basic generic script handled with as little friction as possible, and don't want or need a clinician in their life beyond that. That's a real and legitimate use case. We'll say it out loud, that crowd's better off with Hims than with us, and we've told people exactly that.
What it does well
- Transparent pricingThe cost's upfront in a way most of healthcare refuses to be, and generic ED meds and finasteride show up for less than an in-person copay used to cost.
- Clean experienceThe interface is easy, the basic anxiety and depression prescribing isn't crazy on its face, and if you know what you want it just works.
The catch
- A questionnaire has a ceilingNo real conversation, no nuanced history-taking, no way to catch the thing you'd have caught in person, because the model's built around speed and scale.
- You message a portalIf something goes sideways with your meds, you're not calling your prescriber, and the GLP-1 and ADHD-adjacent stuff has gotten them in trouble more than once.
What it does well
- AccessThe sheer number of therapists means you can usually find someone available within days, evenings and weekends included, which the brick and mortar world's been failing at for decades.
- A low front doorFor someone who put off therapy because of phone tag and a six week wait, BetterHelp removes that friction almost completely, and a lot of people get their first real exposure to therapy through it.
The catch
- Variable qualityThe only thing the platform verifies is a license. You might get a sharp clinician with years of CBT training, or someone fresh out of school burning through cases.
- Privacy track recordThe 2023 FTC settlement over sharing user health data with advertisers like Facebook and Snapchat was a real problem, not a minor PR hiccup.
BetterHelp
BetterHelp is a therapy marketplace owned by Teladoc, not a medical clinic. You fill out an intake, they match you to a licensed therapist on the platform, and you do sessions over video, voice, or chat on a weekly subscription. They don't prescribe medication and they don't employ psychiatrists. It's therapy, at scale, sold like a streaming service.
The platform also leans heavily on chat-based work that the research is much less convinced about than the marketing implies, and the sponsorship model that funded all those podcast ad reads bought a lot of soft coverage that papered over both issues. They also paid a $7.8 million FTC settlement in 2023 and got banned from doing it again, after the FTC found they fed users' email addresses and mental-health questionnaire answers to Facebook, Snapchat, and ad networks. BetterHelp fits someone who needs a place to talk, knows medication isn't the question, is willing to swap therapists a few times to find one that clicks, and has thought through the privacy tradeoff with their eyes open. It's not the call for someone who needs medication, needs a real psychiatric evaluation, or wants their data sitting outside an adtech pipeline.
Talkiatry
Talkiatry is an insurance-based telehealth psychiatry company. They employ actual psychiatrists, take a wide range of commercial insurance, and run the whole thing over telehealth, which is genuinely useful in a country where finding a psychiatrist who takes your plan can take months. They're venture funded and they've grown fast. They aren't spotless on billing, either. The ad watchdog Truth in Advertising flagged their "most visits cost $30 or less" marketing against a stack of consumer complaints about surprise bills that ran into the hundreds, sometimes near a thousand dollars, after the fact, and the company quietly dropped that pricing claim from its site in late 2024.
Talkiatry fits someone who wants a board-certified psychiatrist specifically, and is fine with shorter follow-ups and a bigger panel in exchange for that. If what you want is a longer visit with the same clinician every time, on insurance or cash, it's not the play.
What it does well
- Real psychiatristsCredentialed clinicians doing real evaluations on commercial insurance, which the system's been bad at for a long time.
- Longer first visitsThe initial evaluation runs longer than the legacy insurance model usually allows, and scheduling mostly gets you in inside a couple of weeks rather than three months out.
The catch
- The volume modelFollow-ups are short, often around twenty to thirty minutes, and panel sizes per provider are large because the unit economics demand it.
- TurnoverThe psychiatrist you started with might not be the one you've got a year in, and rebuilding that relationship from scratch takes a real toll on continuity.
What it does well
- Fast accessA service that says we'll see you this week and start a real workup, instead of putting you on a three month list, is doing something the rest of the field's failed at.
- For the long-overlookedReal ADHD goes undertreated in plenty of adult guys, sometimes a decade or more, and for people who genuinely have it that speed's meaningful.
The catch
- A legal cloudDone's prescribing practices drew a federal prosecution, and in November 2025 its founder and clinical president were convicted on drug distribution and health care fraud charges.
- Narrow scopeMostly stimulants, mostly ADHD. If what's going on is ADHD plus depression plus a sleep problem plus more, the model isn't built to see all of it at once.
Done
Done is an ADHD-focused subscription telepsych service. You sign up, get an evaluation, and if you're diagnosed you start a monthly subscription for ongoing prescribing, mostly stimulants. They've built the whole product around speed of access, on the bet that the existing system's so broken for ADHD that people'll pay a flat fee just to skip the waitlist and the bureaucracy.
The whole "ADHD pill mill" perception didn't come from nowhere, and the people who built the business haven't always done themselves favors with how they responded to it. Their founder and clinical president were federally convicted in a roughly $100 million case the DOJ said moved over 40 million Adderall and stimulant pills, plus health care fraud. Done fits a narrow case. Clean ADHD presentation, no significant co-occurring issues, you've done the homework on the company and made peace with the risk, and you want one specific thing fast. If your situation's more layered than that, or if the legal back and forth's a dealbreaker for you, it's not the move.
Where we sit
The fifteen-minute mill, and how we do it
We're LiveWell Psychiatry and Men's Health, a small PMHNP and DNP-run practice serving Oregon and Washington, in person and over telehealth. Initial evaluations run forty-five to sixty minutes because that's how long it actually takes to figure out what's going on, and follow-ups are thirty minutes for the same reason, not the seven to fifteen the volume clinics squeeze you into. We take most of the major insurance plans, and cash if you'd rather, the panel's kept small on purpose so a real clinician knows who you are, and you can do psych, basic men's health hormone stuff, and IV wellness through the same door without getting referred out for every single thing.
The volume model
The fifteen-minute mill
Seven to fifteen minutes a visit, a panel too big for anyone to know who you are, a questionnaire or a quick script standing in for an actual conversation, and a new clinician every time the venture math reshuffles the roster.
How we do it
Long enough to be a conversation
Forty-five to sixty minute evaluations, thirty minute follow-ups, the same clinician visit after visit so the longitudinal context's real, and scope broad enough to cover a tangled situation instead of one tidy diagnosis.
Where we beat all four
Depth and continuity
Hims won't give you a real evaluation, BetterHelp won't touch your medication, Talkiatry caps how deep the relationship gets, and Done only looks at one slice of you… we do the whole picture, with one clinician who actually remembers it.
Where we lose, plainly
A real visit costs more than a cheap DTC subscription, even on insurance, full stop. We only serve Oregon and Washington, the new patient wait can stretch a few weeks at busy points, and there's no app and no chat-bot intake. If those are your deciding factors, a national chain fits you better.
Pick the one that fits your actual situation, not the one with the biggest ad budget.
The honest one liner's this. If you want fast and DTC and a script in the mail, Hims wins, and we'll tell you so. If you want a real, long, ongoing conversation with the same clinician who actually remembers how you got here, treating the whole picture instead of one isolated slice, in Oregon or Washington, that's the call we're built for.
Want to know if we're actually the fit?
Drop a line. If one of the bigger national options serves you better, we'll tell you that honestly, no sales pitch. If we're the call, we'll say that too.
Sources
- BetterHelp $7.8M FTC privacy settlement (2023): www.ftc.gov
- Done indicted in $100M Adderall scheme (40M+ pills), DOJ: www.justice.gov
- Talkiatry surprise-billing complaints: truthinadvertising.org