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.

Request an Appointment About Michael →

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
In-network with
Premera Blue Cross · Regence BlueShield · First Choice Health · Kaiser · Aetna · Cigna · United Healthcare · Most major WA plans

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.

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.

01

60-Minute Evaluation

Initial appointments are unhurried. We cover history, current struggles, goals, and what's actually going on beneath the surface.

02

25-Minute Follow-Ups

Regular follow-ups with space to talk, reflect, and adjust. Not a five-minute refill appointment.

03

In-Person or Telehealth

In-person at our Spokane office, or telehealth anywhere in Washington state. Same care, your choice of format.

04

Insurance Accepted

In-network with most major Washington insurance plans. Jesse will verify your benefits before your first appointment.

Michael Van Gelder, PMHNP-BC

Michael Van Gelder

PMHNP-BC · 13+ Years Practice

M.S. Clinical Psychology, Eastern Washington University
M.N. Nursing, Oregon Health & Science University
Board-Certified Psychiatric Nurse Practitioner
8 years community mental health · 7 years private practice

About

Good care starts with honest conversation.

I'm a board-certified Psychiatric Nurse Practitioner with over 13 years of practice, including eight years in community mental health and seven in solo 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.

"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.

Phone (509) 591-9007
Mon–Thurs, 10am–4pm Pacific
Email Jesse@thinkbeyondpsych.com
Office 9631 N Nevada St, Suite 209
Spokane, WA 99218
Telehealth Available statewide in Washington
HIPAA-compliant platform
Current patients Medication questions: michael@thinkbeyondpsych.com

Request an Appointment

Jesse will follow up within one business day to confirm your insurance and schedule.

For urgent mental health needs, please call 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room.

Common Questions

Before you reach out.

Yes. We are in-network with most major Washington state insurance plans including Premera Blue Cross, Regence BlueShield, First Choice Health, Kaiser, Aetna, Cigna, and United Healthcare. Jesse will verify your specific benefits before your first appointment so you know exactly what to expect.
Yes. Telehealth psychiatric care is available to adults anywhere in Washington state, including Spokane, Seattle, Tacoma, Bellevue, Olympia, Vancouver, Yakima, Kennewick, Bellingham, and all other Washington communities. In-person appointments are available at our Spokane office at 9631 N Nevada St, Suite 209. Both options use the same 60-minute evaluation and 25-minute follow-up format.
Anxiety, depression, grief, postpartum mental health, and identity-related struggles. I offer LGBTQ+ affirming care and work with adults who often feel misunderstood or rushed in traditional systems. I do not prescribe benzodiazepines or treat active crises, psychosis, or personality disorders. If you're unsure whether we're a fit, reach out and Jesse can help you figure it out.
Initial evaluations are 60 minutes. That's time to understand your history, your current struggles, and what you're hoping for, not a rushed intake. Follow-up appointments are 25 minutes with space to adjust as we go.
Fill out the contact form above or call Jesse at (509) 591-9007 (Mon–Thurs, 10am–4pm Pacific). Jesse handles all scheduling, insurance verification, and intake coordination. You'll hear back within one business day.
Current patients can reach Michael directly at michael@thinkbeyondpsych.com for medication questions or refill needs. For scheduling and billing, contact Jesse. Most questions get a same-day response.
Think Beyond Psych does not prescribe benzodiazepines. Stimulant medications for ADHD may be prescribed for patients who have an existing diagnosis with supporting records. Michael does not perform initial ADHD diagnostic evaluations but will manage treatment once a diagnosis has been established by another provider.
Yes. Think Beyond Psych treats ADHD in adults who already have an established diagnosis with supporting documentation. If you have been diagnosed by another provider and can provide records, Michael will manage your treatment including medication. If you need a diagnosis first, he can help connect you with a provider who does evaluations, and then manage your treatment once the diagnosis is established.
Yes. Michael treats OCD with medication management and works collaboratively with ERP (Exposure and Response Prevention) therapists. If you don't currently have an ERP therapist, he can provide a referral. The combination of medication and ERP therapy is the gold standard for OCD treatment.
Yes. Michael specializes in working with LGBTQ+ adults navigating anxiety, internal conflict, religious trauma, and major life transitions. Whether you're questioning, coming out, or working through identity-related stress, care is provided without judgment and grounded in your lived experience.
Reflections

Think Beyond the Diagnosis

Perspectives on medication, diagnosis, identity, and what real healing actually asks of us.

Healing & Responsibility

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.

Michael Van Gelder Michael Van Gelder, PMHNP-BC
Read →
Medication

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.

Michael Van Gelder Michael Van Gelder, PMHNP-BC
Read →
Diagnosis

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.

Michael Van Gelder Michael Van Gelder, PMHNP-BC
Read →
Care Philosophy

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.

Michael Van Gelder Michael Van Gelder, PMHNP-BC
Read →

What You Can Do to Heal

This work is for you. And only you can do it.

There's a lot I can offer you. I can listen carefully. I can ask hard questions and hold space for honest answers. I can suggest tools, strategies, even medication if it's appropriate. But here's the truth: I can't do the work for you. And I won't pretend otherwise.

If you're here just for a prescription, hoping medication will fix everything without any effort, reflection, or change, then I'm not the right provider for you. Medication can help. But healing takes more than a pill. It takes honesty. Willingness. And the courage to engage with what's actually going on, even when it's hard to face.

What I can offer, and what I can't

I can offer insight. I can ask the kinds of questions that move things forward, not just soothe the moment. I can challenge you when you're avoiding something important. I can affirm you when you forget your own strength. But I can't force honesty. I can't untangle patterns you're unwilling to look at. I can't change your life from the outside in.

I won't sit in judgment. But I also won't sit in silence while something important goes unacknowledged, especially if it's holding you back. This work only works if you're willing to show up. Not just to appointments, but to yourself.

Facing what gets in the way

Everyone has barriers to growth. Old habits. Protective stories. Avoidance. Fear. Sometimes it's just the pace of life. Sometimes it's survival mode. But sometimes it's something more direct, like substance use. If you're using something to numb, escape, or get through the day, I won't shame you for it. But I also won't pretend it doesn't matter.

Substance use can cloud the picture. It makes it harder to know what's symptom, what's circumstance, and what's chemistry. I don't treat active substance use in my practice. But I do believe in your ability to face hard truths and grow from them.

The other things that matter

Healing isn't about being perfect. But it is about being engaged. It's about showing up curious, even when you feel stuck. It's about offering yourself patience, especially when progress is slow. It's about practicing self-compassion, even as you take responsibility for your choices. And it's about doing the work between sessions.

My role is to offer a space that's open, honest, and free of judgment. Your role is to step into that space and do something with it. You don't need to get it right every time. You just need to stay in the process.

This work is hard. But it's also yours. No one else can do it for you. But you don't have to do it alone. The growth, the change, the healing: that's in your hands. Not because it's your fault, but because it's your life. And you deserve to live it fully, not just survive it.

Michael Van Gelder
Michael Van Gelder, PMHNP-BC
Psychiatric Nurse Practitioner · Think Beyond Psych

Medication Isn't the Enemy. But It's Not the Whole Answer.

Relief matters. But so does what comes next.

Some people are afraid to take medication. Others expect it to fix everything. And somewhere in between are the rest, unsure what to think, just hoping for something that helps. There's a lot of noise about psych meds. Some of it's stigma. Some of it's false hope. But beneath all of it is a simple truth: medication can help. But it can't do all the work for you. And it was never meant to.

What medication can do, and do well

It can bring relief. It can lift the weight just enough for you to stand up again. It can ease the storm so you can think clearly, breathe fully, or begin therapy that used to feel impossible. Sometimes that relief is life-saving. And dismissing it because "you should just tough it out" isn't strength. It's cruelty dressed up as self-reliance. Medication can be a doorway. But it's not the destination.

What medication can't do

It can't process your grief. It can't teach you boundaries. It won't help you find meaning, confront trauma, or change a toxic relationship. Medication doesn't ask the deeper questions. It quiets the noise so you can start listening, but it can't tell you what to hear. It can stabilize, soften, support. But it can't substitute for the work of reflection, honesty, or growth. Sometimes the most powerful shift isn't chemical. It's personal.

The risk of over-reliance

When we expect medication to do all the work, we set people up to fail. We start chasing dosage changes instead of life changes. We treat the symptom like the root. We confuse "feeling better" with getting better and stop asking what better actually means. Sometimes the system reinforces that: fifteen-minute med checks, no room for therapy, no time for context. Just symptom, prescription, repeat. That's not care. That's maintenance.

Medication isn't the enemy. It's also not the cure. You can take the medication and ask the deeper questions. You can seek relief and seek meaning. You can feel better and still want something more. Because you deserve more than just symptom control. You deserve to become who you were always meant to be.

Michael Van Gelder
Michael Van Gelder, PMHNP-BC
Psychiatric Nurse Practitioner · Think Beyond Psych

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, sadness, fear, frustration, exhaustion, must mean there's something wrong with you. Sometimes that's true. But not always. And if we're not careful, we start confusing being human with being unwell.

Diagnosis can help, but it's not the whole picture

A diagnosis can bring clarity. It can help name patterns, guide treatment, and connect people to care. It can offer relief: "Oh. That's what this is." But it's not a verdict. It's not an identity. And it's not always the first, or most helpful, step. Not every low mood is clinical depression. Not every worry is an anxiety disorder. Not every reaction needs a label. Sometimes we're just going through something hard.

When naming helps, and when it doesn't

Labels can bring relief. They can explain what once felt unexplainable. They can make someone feel seen, validated, and less alone. But sometimes the label becomes the lens. Instead of offering insight, it becomes identity: "This is who I am." "This is all I'll ever be." We stop asking why we feel what we feel. We stop exploring the context. And we start organizing our lives around a diagnosis that was meant to describe us, not define us.

The danger of turning emotions into disorders

It's okay to feel overwhelmed by stress. It's okay to grieve, to panic in a crisis, to freeze in uncertainty. That doesn't always mean you're disordered. It means you're alive, responding to something real. Pathologizing everything doesn't lead to more care. Sometimes it leads to more fear, or more medications. Sometimes it leads to avoidance, escape, or a quiet pressure to "fix" what might not actually be broken.

This isn't a rejection of diagnosis. It's a call for discernment, and for deeper care. Not every answer comes with a label. But every person deserves to be seen clearly, not just categorized, but understood.

Michael Van Gelder
Michael Van Gelder, PMHNP-BC
Psychiatric Nurse Practitioner · Think Beyond Psych

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. But thoughtful psychiatry isn't fast. It's not mechanical. And it's definitely not one-size-fits-all.

It starts with listening

Not just to what's wrong, but to what matters. To the questions under the surface. To the patterns, the pain, the possibilities, even if they're hard to name. If we're not listening, we're not understanding.

It honors complexity

You're not a diagnosis. You're a human being with a story. Medication might be part of that story. So might trauma. Or stress. Or grief. Thoughtful psychiatry doesn't flatten those into a label. It works with them. You are so much more than a label, and your care should reflect that.

It's grounded in both science and self-awareness

I believe in evidence. I also believe in context. Some people need structure. Some need space. Some need to feel seen before they can feel safe. There's no algorithm for healing. But there is relationship, reflection, and respect. That's what makes thoughtful psychiatric treatment different. It adapts to who you are.

It's not about fixing people

You're not a problem to be solved. You're a person yearning for something deeper: for clarity, connection, and peace. It's about supporting growth, integrity, and the return to yourself, on your terms, in your time. Real mental health care means honoring your experience, not overriding it.

If you've ever felt dismissed, rushed, or reduced in your search for care, you're not alone. And you're not asking too much. Because you're not a diagnosis. You're a whole person. And that matters.

Michael Van Gelder
Michael Van Gelder, PMHNP-BC
Psychiatric Nurse Practitioner · Think Beyond Psych
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Your Rights Under Federal Law
Right to a Good Faith Estimate

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.