For Retreats, Healing Centers, and Integration Programs
Psychiatric Care, In Support of the Work You Do.
A consulting psychiatrist working alongside retreats, healing centers, and integration programs.
Where I Can Be Useful
Most retreats and healing centers are built around the work itself, not around medical infrastructure, and that's how it should be. The thing is, the people coming to you are usually carrying a long history with psychiatric medications, and questions come up around those medications, before, during, and after, that don't have a clear place to land.
Can this person stay on their SSRI through the work, or does something need to change first. What do we do about the client who had a hypomanic episode two months ago. Is somebody on lithium safe to work with, and under what conditions. And it isn't only psych meds. Blood pressure medications, thyroid management, supplements people are stacking, and other prescriptions can interact with the medicine itself in ways that benefit from a physician's read. These aren't really facilitation or therapy questions, and they're easier to hold when somebody whose whole job is thinking about medications is on the team, even at a distance.
One thing worth saying about how I approach this work. I don't believe in one-size-fits-all. Some clients can stay on their SSRIs and other psychiatric medications through the work, given the right plan around it. Others benefit from adjustments. The right answer depends on the person, the medication, the diagnosis, and the specific medicine they're about to take. I work that out case by case, with the team running the work.
In most of the practices I've talked to, the medication questions end up getting answered by whoever happens to be available, usually somebody doing their best with information they weren't trained to weigh. That isn't anybody's fault. There hasn't been an obvious place to send them. That's the part I'd like to support.
Retreats & Integration Programs
Your team handles the work itself: facilitators, integration coaches, therapists, sometimes practitioners holding their own traditions. I support the medical side, before, during, and after. That includes screening clients with complex medication histories, working through the questions that come up around SSRIs, mood stabilizers, blood pressure medications, thyroid issues, and other prescriptions that interact with the medicine itself, and being available when something on an intake form or in an integration session calls for a physician's read.
Healing Centers
Healing centers run on facilitators, ceremonial frames, and integration support, and the medical-side questions often fall outside what your team is set up to weigh. A client arrives on three psychiatric medications. A diagnosis comes up that hasn't been pinned down. An intake form flags something nobody on staff is comfortable holding. Sometimes it's a non-psych medical issue, like blood pressure or thyroid management, that has direct bearing on whether and how the work moves forward. That's the role I fill, alongside what your facilitators are already doing.
Ketamine & Spravato Clinics
If your clinic has anesthesia or NP coverage but no psychiatrist on the team, the gap is narrower than it is for a retreat, but it isn't zero. There are still screening edge cases, antidepressant decisions that should probably have a psychiatrist's input, and treatment-resistant cases where a second opinion makes things easier on everybody. I'm happy to cover those too, on a smaller engagement if that's what fits.
What I Cover
One monthly fee, four things you actually need a psychiatrist for. No recruiting, no W-2, no equity ask.
Protocols
This is mostly one-time work, and it holds up better when it's done thoughtfully. We sit down with what your practice has now: intake forms, exclusion criteria, anything you've written down about screening, medication management, and emergency response. Then we build the version that holds under stress. Who's screened in or out and why. How psychiatric medications are handled for clients preparing for the work, on a case-by-case basis rather than a single template. How non-psych medications and medical conditions get factored in. What your team does in the next ten minutes when an intake form flags suicidal ideation. The goal is to have these things on paper, written with a psychiatrist's input, in a form your malpractice carrier and your attorney are both comfortable with, before you actually need them.
Monthly Caseload Review
Once a month, your active panel goes on a shared registry and we walk through where each client is, before, during, and after the work. Validated measures tracked over time, like PHQ-9 for depression, GAD-7 for anxiety, and PCL-5 for trauma, give us something concrete to talk against. Most clients are doing well and the numbers reflect that, which is useful in its own right. The clients who aren't are the ones we spend real time on: what's stuck, what's worth trying next, and when it makes sense to bring me in for a direct evaluation rather than handle it through review. After a few months, you have something most practices in this space simply don't have yet: actual outcomes data, on your population, that you can show.
On-Call
This is the catchall, and it's probably what your team uses most. When something comes up that nobody on staff is comfortable weighing, like a medication on an intake form nobody recognizes, a screening question without an obvious answer, or something a client said in an integration session that's sitting wrong, they can call or text me directly. I respond same day for routine things, sooner if it's urgent. Everything I tell them gets documented in writing, both for your records and because curbside guidance lands better on paper than in someone's head three weeks later.
Direct Patient Consults
Sometimes the right answer is for a client to actually see a psychiatrist rather than have their case reviewed at a distance. We agree on a number of consults per month upfront, based on your volume and what your team expects to need. I see those clients myself, by telehealth in the states I'm licensed for or in person in NYC if that's easier, and I send back a written eval that gives your team a clear medical picture: what to keep in mind going in, what I'd recommend ahead of the work, and any considerations worth holding alongside it.
Why the Collaborative Care Model
The collaborative care model isn't new, isn't branded, and isn't mine. It's the system that primary care medicine settled on for behavioral health over the last twenty years or so, after a fair amount of trial and error and somewhere north of ninety randomized controlled trials behind it.
The reason I keep coming back to it is that I do this work every week at NYC Health + Hospitals, which is the largest public hospital system in the country. The patient population there is about as medication-complex as you'll find anywhere outside an inpatient unit, so I've had to learn how to make this model work in genuinely messy conditions, not just on a slide. That matters here for a specific reason: most of the retreats and healing centers I've talked to are working with clients who are more medication-complex than the average primary care patient, not less, and the windows where things tend to go wrong (preparation and integration, mostly) are exactly the windows that benefit from having a psychiatrist watching the case. So this isn't really a new idea. It's an existing model that's been working in harder conditions, applied honestly to the population you're already treating.
In practice, the model has five working parts that hold it together: every active client is on a shared registry so nobody quietly falls off the radar, validated measures get tracked at the visits that actually matter so we know whether treatment is working or just feels like it is, there's a clear stepped-care logic for when a case needs to come in for direct psychiatric evaluation rather than indirect review, my time gets used at the panel level (which is what makes one psychiatrist useful across many clients instead of just a handful), and the whole thing gets judged on what the scores do over time rather than on how good the protocol sounded when we wrote it.
How It Works
First Call
Twenty minutes on the phone, sometimes a bit longer if there's a lot to talk through. You walk me through how your practice runs and where you're feeling exposed, and I'll be honest with you about whether I can actually help and what kind of engagement would make sense if I can.
Written Scope
If we both think it's a fit, I'll send you a one-page document covering exactly what I'm delivering, how fast I respond, how many consults per month, and a flat monthly fee. Cancellable any month, no minimum term, no equity ask.
First 30 Days
The first month is a bit heavier than steady-state. Protocol audit, registry setup, going through your intake forms, and training your team on when to bring me in versus when to handle something themselves. By the end of it your team should know exactly where I fit, and you should have written documentation for the things that didn't have any.
Ongoing
After onboarding the rhythm gets pretty steady. Caseload review once a month, on-call coverage during the hours we agreed on, the consults we scoped, and a quarterly outcomes report you can show your board, your insurer, or anyone else who'd like to know how things are actually going.
One thing I want to be clear about up front: I don't run infusions, I don't administer psilocybin, and I don't sit in on journey sessions. My role is medical oversight, medication decisions, and the clinical scaffolding around the work your therapy team is already doing. I cover multiple states through the IMLC where it applies, and any controlled-substance prescribing I do follows the current DEA rules around telemedicine.
About Dr. Vijal Parikh
I'm a board-certified psychiatrist in private practice in Manhattan. My background is Cornell for neurobiology, the New York College of Osteopathic Medicine for medical school, and Columbia for a Public Psychiatry fellowship after four years of adult residency. The work I do is trauma-informed, integrative, and above all careful about what medication can and can't do.
Most weeks, my time is split between a private practice that focuses on treatment-resistant depression and complex psychopharmacology, and ongoing collaborative care work at NYC Health + Hospitals. The patient population at H+H is genuinely complex (multiple medications, longstanding conditions, real comorbidity), and that work is what taught me how to do this kind of consulting in real-world conditions rather than tidy ones. Before this I spent several years with the NYC Mental Health Service Corps, working with severely mentally ill, homeless, and LGBTQ+ at-risk populations across the five boroughs.
My honest reason for building this practice: I believe psychedelic-assisted therapy needs a psychiatric model that meets these practices where they are, rather than asking them to become medical practices to get medical support. The therapy side is real. The demand is real. The piece that's missing is a way to fold psychiatric oversight into the work without changing what the work is. Collaborative care turned out to be a workable answer for primary care, and I think a version of it works here, alongside the practitioners already doing the harder part.
Frequently Asked Questions
Reviewed by Vijal Parikh, D.O., Board-Certified Psychiatrist Last reviewed May 2026
Are you serving as Medical Director?
The role is structured as consulting psychiatrist, not Medical Director. Medical Director carries specific licensing, regulatory, and operational responsibilities that vary by state and by the type of facility. The arrangement here is bounded clinical consulting (written protocols, monthly caseload review, on-call clinical questions, and direct patient consults) within a defined scope of work. If you need a Medical Director of record, that's a different conversation worth having upfront.
Do you take patients from the retreat or center directly into your private practice?
Sometimes, when it's clinically the right move and there's no conflict with the consulting relationship. The default is to refer back to the patient's existing prescriber or to an outside psychiatrist. Anything that crosses that line is discussed with the team running the work, in writing, before it happens. For reference, the private patient practice is at 201 E 16th St in Union Square.
Do you support ketamine and Spravato clinics, not just psychedelic retreats?
Yes. Ketamine and Spravato clinics, IV ketamine practices, and integration-only programs all fit. The questions are similar (eligibility screening, medication interactions, post-treatment psychiatric care) even when the medicine and the regulatory environment differ.
What does the engagement look like in the first 30 days?
A 20-minute call to see if it's a fit, then a written scope covering protocols, on-call coverage, caseload review cadence, and direct-consult availability. The first 30 days are spent learning your population, your existing intake process, and the gaps you've been working around. Nothing is changed unilaterally.
Are you affiliated with a specific medicine, lineage, or protocol?
No. The work is medication-agnostic and lineage-agnostic. The job is to support whatever you're running with sound psychiatric thinking, not to push a particular framework, supplement stack, or treatment style. The patient-side practice does include adjacent work in metabolic psychiatry (GLP-1 medications, peptides, lab-guided psychopharmacology), but that's a separate offering and not pushed onto consulting clients.
Do you work with practices outside of New York?
Consulting work that doesn't involve direct patient care or prescribing is straightforward across state lines. Anything involving direct patient consults or prescribing is limited to states where licensure is in place. Both can be sorted out on the first call.
How is this billed: retainer, hourly, or per-patient?
Most engagements are structured as a monthly retainer scoped to the volume and intensity of clinical questions you expect, with direct patient consults billed separately. The exact structure is part of the written scope after the first call.
What is the Collaborative Care Model and why does it matter here?
Collaborative Care (CoCM) is an evidence-based framework for embedding psychiatric expertise into care that's primarily delivered by another clinician. Originally built around primary care, it's now adapted to settings like retreats, integration programs, and specialty clinics. It's the model behind this consulting work: the psychiatrist supports the team without replacing the relationships your clients already have.
Get in Touch
If anything on this page sounds like your practice, send me a note and we'll set up a call. The first conversation is around twenty minutes, and there's no expectation that it goes anywhere. I'd rather find out we're not a good fit on a phone call than waste each other's time later. No deck, no pitch, just a real conversation about whether what I do is what you actually need.