We care about your safety.
If you are in a mental health crisis or having suicidal thoughts, call the Suicide Prevention Lifeline (800-273-8255) or text HOME to the Crisis Text Line at 741741. These services are free and confidential.
At Circle Medical, our providers are board-certified in primary care and may not always be equipped to manage certain medical histories or mental health conditions. To ensure your safety and the best possible care, your provider may recommend establishing care with a local mental health specialist.
Patients who are ineligible for specific mental health treatments at Circle Medical can still receive primary care services from our providers.
Limitations with Current Medications & Treatments
Patients are typically ineligible for mental healthcare services at Circle Medical, including treatment for ADHD, anxiety, or depression, if they are actively engaged in certain treatments or have recently been on them. Providers have the right to use clinical judgment and discretion to determine eligibility.
Examples of treatments that may make you ineligible for mental health care:
Chronic Daily Opioids: Patients taking opioids every day as prescribed by a primary care provider are not eligible for ADHD care. We don't prescribe narcotics or opioid medications. If you have a history of chronic opioid use, you must be abstinent for at least one year to be considered for ADHD treatment.
Buprenorphine and Chronic Pain: If you are stable on buprenorphine treatment for over a year (managed by an outside provider) or have a stable chronic pain plan managed by a specialist, you may be eligible for mental health services.
Chronic Daily Benzodiazepines or Sedatives: We do not prescribe benzodiazepines (e.g., Alprazolam, Lorazepam) or sleep aids (e.g., Zolpidem, Dayvigo) for daily, long-term use. If you've been taking these medications daily, you must be abstinent for 3-4 months to be considered for ADHD treatment. Providers use their clinical judgment and discretion to determine eligibility.
Methadone Treatment Program: For your safety and care coordination, we can't offer behavioral healthcare if you are currently in a methadone treatment program.
Kratom: We are unable to provide care for depression, anxiety, or ADHD if you are currently using Kratom.
Stimulants Above FDA Doses: If your current ADHD treatment plan requires stimulants at doses higher than what the FDA has approved, you are not eligible for mental health care with us. A provider may offer a bridge prescription to prevent an immediate disruption in your care and refer you to an outside specialist.
Prescription Monitoring
Circle Medical providers use your state’s Prescription Drug Monitoring Program (PDMP) to review compliant management of controlled substance prescriptions. This is a standard safety measure to ensure compliant management of your medications and to adhere to our clinical policies.
Current & Prior Psychiatric History
To provide safe, effective care, we may advise patients with certain psychiatric histories to seek specialized behavioral healthcare outside of our primary care practice. Your provider will communicate this guidance during your appointment and may also send a message after your appointment via your Secure Care Inbox.
Examples include:
Multiple Psychiatric Medications: If you have tried multiple psychiatric medications without relief, we may recommend that you consult a psychiatrist who specializes in complex medication management.
Specific Psychiatric Diagnoses: Patients diagnosed with bipolar disorder, schizophrenia, mania, paranoia, or C-PTSD will need to establish care with a psychiatrist to meet the needs of these conditions.
History of Substance Use or Alcohol Use Disorder: A history of substance use alone does not disqualify you. However, if you have a formal Substance Use Disorder (SUD), you must have been abstinent for a specific period to be considered for mental health treatment. This includes at least 12 months of abstinence for a history of addiction to opioids or illicit drugs. Your provider may order a urine drug screen as part of our safety protocol.
Suicidal Thoughts or Self-Harm: If you are having active suicidal thoughts or thoughts of self-harm, we will refer you to your local emergency room for immediate care.
Important Requirements for Mental Health Care
Annual Wellness Exam (AWE): An Annual Wellness Exam is a mandatory requirement for patients receiving care for ADHD, anxiety, or depression. This is to ensure we consider all aspects of your health.
For ADHD care involving stimulant medication, the AWE must be on file before the first prescription.
For anxiety and depression, it is generally required by the second or third visit. A grace period may be provided if your AWE has recently expired, but chronic non-compliance may result in a discharge from our practice.
Follow-Up Visits: A video follow-up appointment is required for each controlled substance prescription, including monthly visits for stable ADHD patients on stimulants.
Prescription Monitoring: Our providers review your state's Prescription Drug Monitoring Program (PDMP) to ensure the safe and compliant management of controlled substances.