FAQs for Referring Providers
Who should I refer?
People who are interested in collaborative care, and are willing to take an active role in their healing process. People who could use a less formal, perhaps less intimidating approach. People who are looking for a provider who has lived experience with marginalized identities.
And more concretely:
18 years & older.
Inside of Washington State.
No more than 2 psychiatric-related ER visits in the last 5 years, unless people are being discharged from treatment for substance use disorder.
No psychiatric hospitalization within the last 5 years, unless you feel they are stable enough to be cared for in a solo telehealth practice.
Able to be safely cared for by a solo telehealth practice.
If you’re not sure whether to refer someone, please send an email to jo@steelandflora.com.
How exactly do I refer?
Send people to the website, and ask them to push the schedule online button. They can self-schedule a free 15 minute consult.
Can you do letters for gender affirming surgery?
Many insurances require specific credentials to write mental health letters. As an FNP, it’s likely my qualifications don’t count. However, if there is no such requirement, then yes. For existing clients, that is a normal part of mental health treatment. For clients that only need a letter, the cost is the same as for any other intake. The two circumstances under which someone would get a letter saying that they are a work in progress are: Unable to provide informed consent, and illness so severe that it will affect the surgical outcome. In those cases, I am happy to follow the client until they are stable enough to proceed.
How can I communicate with you about a client?
I am happy to communicate securely, providing the requisite releases have been signed. You can message me directly on Spruce Health, which has a web version if you don’t want to download any more apps. You can use regular email, phone, or text for anything without PHI.
About Me
I started studying psychiatry early in my family practice career. As you know, access to mental health resources is limited. I always believed it was my responsibility as a PCP to manage mental health meds for my patients instead of referring into a void. Over time, much of my practice became psychiatry because you can’t talk about uncontrolled hypertension or chronic pain without addressing mental health. Trauma informed care also quickly became a practice mainstay. When you work in community health generally, and HIV and gender affirming care specifically, an understanding of trauma responses is essential.
I believe in compassionate, creative, low-barrier health care. Evidence is critical to my practice, as is an understanding of its limitations. I attend CME regularly including the weekly University of Washington Psychiatry and Addiction Case Conference.
It can be helpful for some clients to know I am gay and a person of color. That said, everyone’s identity experience and social location is unique so I don’t assume to know what a person is going through.
I am happy to answer any questions about my background, approach, or experience. Just use the contact us page to easily send an email.