Finding the Right Support Without Feeling Rushed or Dismissed
Deciding to explore medication for a mental health concern is rarely a simple decision. Many people spend months, or even years, trying to manage anxiety, depression, mood changes, or difficulty focusing on their own before reaching out for help. Once you do reach out, new worries can surface. It’s common to wonder whether needing medication means something is “wrong” with you, or to feel anxious about being pressured into taking something you are unsure about. Underneath those concerns is often a bigger question: will a provider actually take the time to understand what you are experiencing before recommending a treatment plan? These concerns are valid.
Many people come to us after feeling unheard by a previous provider, discouraged by the cost or complexity of accessing psychiatric care, or anxious about the idea that finding the right medication might take more than one try.
At Integrative Health Services, our medication management services are provided by Emily Trentacoste-Martin. She is a Psychiatric Mental Health Nurse Practitioner who serves children, adolescents, and adults. Our approach is built around collaboration, not quick fixes. We take the time to understand your history, your goals, and what has or has not worked for you before recommending any treatment plan. You deserve to be seen as a whole person, not a diagnosis or a prescription.
What Is Medication Management?
Medication management is more than simply being prescribed a psychiatric medication. It begins with a comprehensive psychiatric evaluation. This helps your provider understand your symptoms, mental health history, medical history, current and past medications, family history, and day-to-day functioning. From there, your provider works with you to determine whether medication may be appropriate. If so, the next step is finding the medication and dose that offers the greatest benefit with the fewest side effects.
Ongoing medication management does not stop after that first prescription. It includes monitoring your symptoms, side effects, sleep, mood, and overall response over time, along with lab work or other testing when appropriate. Adjustments are a normal part of the process, not a sign that something has gone wrong. One common misconception is that a psychiatric provider will prescribe medication, including controlled substances, at the very first appointment. That is not how thoughtful prescribing works, and it is not our approach.
A Common Misconception About Finding the Right Medication
Our goal is not to put you on as many medications as possible, but to use the lowest effective amount needed to help you feel and function well. Another misconception is that finding the right medication is usually straightforward. In reality, people can respond very differently to the same medication, and it sometimes takes more than one attempt to find the right fit. The National Institute of Mental Health notes that several medication trials may be necessary before finding the treatment that works best with the fewest side effects.
What Happens During a Psychiatric Evaluation?
Not knowing what to expect can make that first appointment feel more intimidating than it needs to be. During your evaluation, expect an unhurried conversation rather than a checklist. Your provider will want to understand your current symptoms, your history, and what has or has not worked for you before. They will also ask about how you are sleeping, functioning, and coping day to day. You do not need to arrive knowing exactly which medication you want, or even exactly what is wrong. What matters most is that you leave the appointment feeling heard, with a plan that reflects your actual goals, not just a diagnosis on paper.
What Can Medication Management Help You Achieve?
For many people, change starts small: a full night of sleep instead of hours spent staring at the ceiling, or a morning that doesn’t begin already exhausted. Over time, those small shifts tend to build into something larger. You may find yourself showing up at work or school without dreading the day, reconnecting with people you love, or finally able to concentrate on a task instead of feeling pulled in ten directions at once.
Panic attacks may become less frequent, and difficult emotions may feel more manageable rather than something that takes over the moment they arrive.For some, progress looks like simply getting out of bed, participating more fully in therapy, or feeling like themselves again after a long stretch of not recognizing who that was. Others experience progress differently. It shows up as enough relief to finally start making changes they have wanted to make for a long time.
Your Goals Guide the Treatment Plan
What “better” looks like is different for everyone, and that is why your goals matter. For someone with anxiety, that may mean it finally feels manageable after years of struggle. Someone with ADHD may want to focus at school or work without a constant fight to stay on task. For a person experiencing depression, it may simply mean having enough energy to participate in their own life again. Whatever improvement means to you, you should have an active voice in defining it, and in every decision that follows.
Meet Emily Trentacoste-Martin, CRNP, Psychiatric Mental Health Nurse Practitioner
Emily Trentacoste-Martin, CRNP, PMHNP-BC, is a Psychiatric Mental Health Nurse Practitioner who has worked in mental health care since 2015. She began her career as a registered nurse in inpatient and emergency mental health settings, and her experience gave her firsthand insight into what people need during their most difficult moments. She went on to earn her Master of Science in Nursing from the University of Alabama at Birmingham and began practicing as a Psychiatric Mental Health Nurse Practitioner in 2020.
She provides psychiatric evaluations and medication management for patients across the lifespan, including children, adolescents, and adults. Her areas of experience include:
- Depression and mood disorders
- Bipolar disorder
- Anxiety and panic disorders
- Trauma-related concerns
- Schizophrenia and schizoaffective disorder
- ADHD
- Autism and co-occurring mental health concerns
- OCD
- Women’s mental health, including concerns related to pregnancy, postpartum, and menopause
Emily’s background in inpatient and emergency mental health care shapes how she approaches every appointment. She takes the time to understand what each patient is experiencing before recommending a treatment plan, and she works with patients to find what genuinely helps, not simply what is easiest to prescribe.
Emily rotates between our Pelham and Gardendale offices. In Pelham, she offers psychiatry services for patients throughout Shelby County. In Gardendale, she provides psychiatric care for patients throughout Jefferson County, and telehealth appointments are also available for eligible patients throughout the rest of Alabama.
Do You Need Therapy Alongside Medication Management?
Not everyone needs to be in therapy to benefit from medication management, but in many cases, we do recommend it. Medication can help reduce symptoms such as anxiety, depression, mood instability, or intrusive thoughts. Therapy takes a different approach. It can help you or your loved one address the thoughts, behaviors, relationships, and life circumstances contributing to those symptoms in the first place. For many patients, using both together provides more complete support than either one alone.
We also want to acknowledge something that does not get talked about enough. If you or your child are already struggling, hearing that finding the right medication may take patience can feel discouraging, even when it is meant to be reassuring. We do not want you to feel dismissed or simply told to “give it time.” Instead, we want you to feel comfortable being honest with Emily about what is and is not working, so adjustments can be made along the way.
Continuing Support From Your Existing Therapist
This is one of the reasons therapy can be so valuable throughout the process. While medication adjustments are being made, counseling can offer additional support and healthier ways to cope in the meantime. If you or your loved one already has a therapist, there is no need to switch providers to work with Emily. We are happy to coordinate between your psychiatrist and therapist, with your authorization, so everyone involved in your or your child’s care is working from the same page.
How We Approach Medication Management and Ensuring Patients Get the Support They Need
At Integrative Health Services, we aim to provide evidence-based treatment at the least restrictive level of care possible. This means we want you to receive the support you need, yet not any more than necessary. Collaboration is at the center of how we practice. We want to prescribe the least amount of medication needed to help you function well, without over-medicating you. That starts with creating space for you to be honest with your provider about what is helping, what is not helping, and any side effects you notice along the way.
We also believe in interdisciplinary care as part of that same collaborative approach. Before starting a mental health evaluation, we want your primary care doctor to have the opportunity to rule out other medical issues. Things like low vitamin levels or other health conditions can affect mood and mental health. Medication is not the only piece of the puzzle either, which is why we encourage healthy habits like exercise and other preventative care alongside any treatment plan.
Responsible, Patient-Centered Prescribing
We want you to feel fully informed throughout your care. That is why we take the time to explain why a medication is being recommended, what benefits to expect, and what side effects to watch for. We will also walk you through what alternatives exist and what to do if your symptoms change. Responsible prescribing is also part of how we protect your wellbeing.
Decisions about controlled substances are made collaboratively and based on clinical judgment, not on request. If that approach does not feel like the right fit for what you are looking for, we want to be upfront with you so you can find the care that best matches your needs. Medication is only one part of mental health care. When appropriate, your provider will coordinate with your therapist, primary care provider, and any other healthcare professionals involved in your care to build a more complete treatment plan.
Our Commitment to Improving Mental Health Access in Alabama
Alabama consistently ranks among the states with the least access to mental health care, and we want to be part of changing that. Hiring Emily and expanding our psychiatric services is one part of that commitment, alongside our Ducks for Hope mental health initiative, which supports greater awareness and access to care across the state.
We want to make sure the right hand always knows what the left hand is doing, so that your care feels coordinated rather than fragmented. That might mean your therapist and psychiatric provider communicating with one another. It could also mean your psychiatric provider working alongside your primary care doctor.
Frequently Asked Questions About Medication Management in Alabama
Deciding whether medication management is the right next step often comes with practical questions, not just emotional ones. Here are some of the questions we hear most often from people considering psychiatry services in Alabama.
Medication management is commonly covered by health insurance, but coverage depends on your specific insurance company, plan, provider network, and diagnosis. We check your benefits before your first appointment and email you what your insurance reports you will owe. That said, insurance quotes are not always accurate. It is a good idea, prior to your appointment, to also call your insurance company directly to confirm your mental health benefits before your appointment.
We are paneled with most major insurances and will accept secondary insurance if we are already paneled with it. If we are not paneled with your insurance, we are still happy to file the claim on your behalf or provide you with a superbill so you can file for reimbursement yourself. Coverage for an appointment also does not guarantee that every medication prescribed will be covered. Especially, since some medications require prior authorization or use of a preferred alternative.
In most cases, you can contact us directly to request an appointment with Emily. That said, some insurance plans require a referral from a primary care provider before covering specialty mental health services. So, it is worth checking your plan’s specific requirements. Even when a referral is not required, records from a primary care physician, therapist, or previous psychiatric provider can be helpful during your evaluation.
Primary care physicians can treat many common mental health concerns and often prescribe medication for anxiety or depression. A psychiatric provider, however, has specialized training focused specifically on mental health diagnosis, psychiatric medications, medication interactions, and side effects.
Working with a psychiatric provider may be especially helpful when your symptoms are complex or severe, when multiple diagnoses seem to overlap, when previous medications have not worked, or when you simply want a specialist’s opinion about your mental health treatment. Ideally, your primary care doctor and psychiatric provider should work together rather than treating your physical and mental health as separate.
Controlled substances are medications regulated under federal and state law because they carry a greater potential for misuse, dependence, or diversion. In behavioral health, this can include certain medications used for ADHD, anxiety, and sleep, among other conditions. Whether a controlled substance is an appropriate option depends on each individual patient and is determined by the prescriber based on clinical judgment and practice policy. Emily is happy to walk you through what that process looks like and what to expect during your visit.
Yes. Children and adolescents can be prescribed psychiatric medications when a qualified provider determines that medication is appropriate. This decision is based on their diagnosis, symptoms, age, medical history, and individual needs. This may include medication management for ADHD, anxiety, depression, or other mood disorders.
Treatment for children and teens is individualized and closely monitored, since younger patients can respond differently to medication than adults. Care often includes collaboration with parents or guardians and may also involve psychotherapy, behavioral support, or school-based resources alongside medication.
There is no single medication that works best for every person with anxiety. The right choice depends on your specific symptoms, medical history, previous medication response, and personal goals. SSRIs and SNRIs are commonly used to treat anxiety because they tend to be effective with more manageable side-effect profiles than some older medications.
Other options may also be considered depending on your situation. Finding the right medication can involve some trial and adjustment. The goal is never to find the “strongest” medication, but the one that provides the most benefit with the fewest unwanted side effects for you specifically.
There is no single antidepressant that is most effective for every person with depression. Several classes of antidepressants, including SSRIs, SNRIs, and others, can be effective. The right choice depends on factors such as your symptoms, previous medication response, side-effect concerns, other health conditions, and personal preferences.
As with anxiety treatment, finding the right antidepressant sometimes takes trial and adjustment. The goal is not to find the medication with the strongest effect, but the one that provides the greatest improvement with the fewest side effects for you.
Pharmacogenomic testing, sometimes called psychiatric genetic testing, looks at certain genetic differences that may affect how your body processes particular medications. Results can give your provider additional information about how you may metabolize certain medications. They can also help identify whether specific genetic factors should be considered when selecting or dosing a medication.
This testing cannot tell us exactly which medication will work best for you.It is one additional tool to consider alongside your diagnosis, symptoms, previous medication response, and clinical evaluation. This testing may be worth discussing if you have experienced significant side effects or tried several medications without finding the right fit.
Other Counseling Services Available at Integrative Health Services
Medication management is not the only support we offer. Integrative Health Services provides comprehensive mental health counseling for children, teens, adults, couples, and families throughout Pelham, Alabaster, Gardendale, and the rest of Alabama. Our clinicians provide anxiety therapy, depression counseling, trauma therapy, EMDR therapy, and Brainspotting. Our team also offers play therapy, LGBTQIA+ affirming therapy, and pre-marital and marital counseling.
