These issues are hard enough without trying to figure out how to get into the doctor’s office. And then try to pay for the medications…

Our virtual mental health program is designed specifically to use medication to treat common mental health needs. Our program may not be the best fit for you. Many conditions can be treated by a counselor without the use of medications. Many patients need more advanced care from a psychiatrist.

However, for a majority of patients with the most common mental health needs, simple and cheap medications can make a world of difference.

And since over 95% of counties in Missouri don’t have adequate mental health providers, we think the below pathways can help thousands of people. At your first (free) visit, we will help you understand your mental health needs and which pathway is right for you. If you or someone you know is thinking about suicide, a suicide the national suicide helpline is available at 1-800-273-8255. Unfortunately, we are unable to treat ADD via this platform. In-person treatment can be obtained through our physical clinic at Big Tree Medical Home.  This pathway can also be used to treat chronic pain.  We do not prescribe opioids.


$20 / Month

Conditions treated at this level

depression, anxiety disorders, social phobia, anger/agitation, suicidal thoughts


one medication: typically an SSRI or SNRI such as generic versions of Lexapro, Zoloft or Effexor with free shipping to your home

Virtual Clinic Visits

all necessary doctor visits (video chat)

Cost estimate for similar service at a local health care organization


$20 / Month



$35 / Month

Conditions treated at this level

this level includes all of the conditions treated at level 1 that did not respond to level 1 medications, as well as, bipolar disorder and others.


two medications or a more advanced medication such as the generic version of Abilify, Lamictal or similar medications, with free shipping to your home.

Virtual Clinic Visits and Labs

all necessary doctor visits (video chat) and labs

Cost estimate for similar service at a local health care organization

$14,319/yr (unfortunately this is not a misprint, we often see patients that are quoted these prices)

$35 / Month


We may recommend patients also undergo counseling, which is not provided.


Is talking to your team as good as going to the Mayo Clinic or some other fancy health system?

Yes and no. In the end, everyone treats diabetes and depression with the same few medications. From a diagnostics perspective, I wish everyone could get care from the top internists at Mayo. Unfortunately, that is not possible. Countries must either ration health care by price or by making you stand in line (Uwe Reinhardt, if I remember right). Our country rations by price. The more you pay, the better your care, and, there are no cheaper options. We are just trying to leverage mobile technology, mid-level providers and generic medications to help lower the cost of care. If you are a multi-millionaire, then head up to Mayo and buy your medications at Walgreens. Or we can prescribe you the same exact medication for a much cheaper price. An insurance broker compares this to buying Busch beer at a Cardinals game or at a gas station across the street from the stadium. Same beer. Different price.

Are the medicines and supplies from foreign countries?

We use the same FDA approved suppliers as any use pharmacy would use. Though it is legal for individual patients to buy up to 90 days of medicine from out of the country (like you can do at, it is not legal for us to purchase medications that are not approved by the FDA. This is all legit.

Who are your doctors and nurses?

Adam Wheeler M.D. is the attending physician, who designs the programs and oversees several assistant physicians. Helena Galstian M.D., Megan Ellis R.N., and Noe Rusaya help patients apply the care pathways. Though this is a new idea, our team has coordinated care for thousands of people in many complex and diverse environments.

What if, after talking to the doctor and nurse, I don’t want to follow one of the care pathways? What if they don’t think they are appropriate for me?

There is no charge.

How long do I have to commit to the program?

We mail you a month of medication at a time. You can cancel any time.

What if I want to do other medications?

Our regular program, Big Tree Medical Home, has the ability to prescribe other medications. This program was designed to optimally integrate both state-of-the-art medical care and sensitivity to price. Other, newer medications have a role in the care of diabetes, especially if price is not an important consideration. For those patients for who price is keeping them from getting care, we believe this program is optimal.