Psychiatric Care · Washington State
Psychiatric care for adults.
Honest. Unhurried.
Washington State.
Judgment-free psychiatric support for adults navigating anxiety, depression, grief, postpartum mental health, and identity-related struggles. In-person in Spokane. Telehealth statewide.
In-network with most major Washington insurance plans · 60-min evaluations · 25-min follow-ups
"You are not a problem to be solved. You are a person to be understood."— Michael Van Gelder, PMHNP-BC
What I Work With
Psychiatric care that meets you where you are.
You won't get five-minute med checks here. You'll get thoughtful care grounded in your values, insight, and lived experience.
Anxiety & Depression
For adults who are high-functioning on the outside but overwhelmed on the inside. We address root patterns, not just symptoms.
LGBTQ+ Affirming Care
Identity-affirming psychiatric support for anyone who has felt out of place in spaces that prioritize conformity over truth.
Postpartum Mental Health
Compassionate, responsive support for postpartum anxiety and depression with space to be honest about what you're experiencing.
Grief & Life Transitions
Support for navigating loss, major life changes, and the disorientation that comes when the path forward isn't clear.
Identity & Self-Understanding
For people who are thinkers and questioners, ready to understand themselves more honestly and stop performing "okay."
OCD
I work with adults with OCD, particularly those engaged in ERP therapy. If you're not yet working with an ERP therapist, I have a great referral.
Medication Management
Thoughtful prescribing that considers your full picture: sleep, relationships, work, identity. Not just a refill script.
ADHD (Established Diagnosis Only)
Ongoing medication management for adults who already have an established ADHD diagnosis with supporting records. I don't diagnose ADHD or perform evaluations — but if you're already diagnosed, I'm glad to continue or adjust your treatment.
Functional & Integrative Approach
Care that considers sleep, nutrition, hormones, and lifestyle alongside medication. Not a replacement for evidence-based treatment, but a fuller picture of what's actually driving how you feel.
How I Work
Direct access. No runaround.
I work with adults who think deeply, feel intensely, and are exhausted by systems that reward neither. I'm not here to med-check your symptoms and send you on your way.
My practice is built on clarity — not just around medication, but around what matters to you. We'll look at how your mental health intersects with work, sleep, relationships, and identity. I don't overpathologize. I don't sugarcoat.
My assistant Jesse handles all scheduling, billing, and coordination. Once you're a patient, you have direct access to me for medication questions via email.
60-Minute Evaluation
Initial appointments are unhurried. We cover history, current struggles, goals, and what's actually going on beneath the surface.
25-Minute Follow-Ups
Regular follow-ups with space to talk, reflect, and adjust. Not a five-minute refill appointment.
In-Person or Telehealth
In-person at our Spokane office, or telehealth anywhere in Washington state. Same care, your choice of format.
Insurance Accepted
In-network with most major Washington insurance plans including Premera, Regence, Asuris, First Choice Health, First Health Network, Kaiser, Aetna, Cigna, United Healthcare, and URM. We are not able to accept Medicaid or Apple Health, including as self-pay — this is a federal patient protection rule. Jesse will verify your benefits before your first appointment. This list is not exhaustive, so if you do not see your plan, ask anyway and Jesse will check. This list is not complete, so if you don’t see your plan, ask anyway and Jesse will check.
Michael Van Gelder
PMHNP-BC · 15+ Years Practice
About
Good care starts with honest conversation.
I'm a board-certified Psychiatric Nurse Practitioner with 15+ years of experience across community mental health and private practice. I built this practice from the ground up and I know what it looks like when someone has been rushed, misdiagnosed, or handed a prescription without a real conversation.
Many of my patients are high-functioning on the outside but overwhelmed on the inside. They're thinkers. Questioners. People who've tried to play the game but can't keep numbing what's real. I especially enjoy working with LGBTQ+ clients, and anyone who has felt out of place in spaces that prioritize conformity over truth.
I offer 60-minute evaluations and 25-minute follow-ups with space to talk, reflect, and adjust. You'll get direct access, same-day communication, and a partner who takes your values and insight seriously. More about my background and how I work.
"The curious paradox is that when I accept myself just as I am, then I can change." — Carl Rogers. That's the kind of work we'll do together — not rushing to a diagnosis, but understanding you well enough to make decisions that actually hold.
What I don't treat
I don't prescribe benzodiazepines or treat active crises, psychosis, personality disorders, or active substance use and abuse. If you're unsure whether we're a good fit, reach out and Jesse will help you figure it out.
Get in Touch
Ready to get started?
Jesse handles all scheduling, billing, and coordination. Reach out using the form or contact us directly. We'll confirm your insurance and get you scheduled.
Jesse answers Mon–Thurs, 10am–4pm Pacific
In person in Spokane or by telehealth
Spokane, WA 99218
Directions and office details
HIPAA-compliant platform
Request an Appointment
Jesse will follow up within one business day to confirm your insurance and schedule.
Please note: we do not perform ADHD evaluations or provide an ADHD diagnosis. Michael manages ADHD medication for adults who already have an established diagnosis with supporting records. If you're seeking an initial ADHD assessment or testing, we're not able to help — but Jesse is glad to point you toward providers who do. Once you have a diagnosis, feel free to come back here and Michael will manage it.
Please do not include detailed medical information in this form. For urgent mental health needs, please call 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room.
Common Questions
Before you reach out.
Think Beyond the Diagnosis
Perspectives on medication, diagnosis, identity, and what real healing actually asks of us. See all reflections.
What You Can Do to Heal
This work is for you. And only you can do it.
I can listen carefully. I can ask hard questions. I can suggest tools, strategies, even medication if appropriate. But here's the truth: I can't do the work for you.
Medication Isn't the Enemy. But It's Not the Whole Answer.
Relief matters. But so does what comes next.
Medication can be a doorway. But it's not the destination. It can stabilize, soften, support. But it can't substitute for the work of reflection, honesty, or growth.
Not Everything is a Disorder
And not every feeling needs a diagnosis.
We've made real progress in talking about mental health. But in that progress, something else has crept in: the idea that every emotional struggle must mean there's something wrong with you.
What Thoughtful Psychiatry Looks Like
Because your mind deserves more than checkboxes and quick fixes.
Psychiatry has a reputation problem. Too often it's reduced to rushed appointments, prescription refills, and symptom checklists. Instead of real conversation with real people.
Under the No Surprises Act, you have the right to receive a Good Faith Estimate of expected costs before receiving care.
If you are uninsured, or if you have insurance but choose not to use it for your care, you are entitled to a written cost estimate before your appointment.
If your final bill exceeds your Good Faith Estimate by $400 or more, you have the right to dispute the charge.
To request a Good Faith Estimate or for more information, contact Jesse at (509) 591-9007 or jesse@thinkbeyondpsych.com.
For general information about your rights, visit cms.gov/nosurprises or call 1-800-985-3059.