- Ongoing, active suicidal ideation, or homicidal ideation

- Ongoing, high risk self-harm behavior

- Recent involuntary hospitalization for psychiatric reasons

- Recent Suicide attempt (within past 2 years)

- Primary diagnosis of substance use disorder or moderate to severe substance abuse

- Active eating disorders with high risk symptoms

- Ongoing grave disability

- Bipolar disorder with psychotic features

- Medical complex patients, including those with liver disease, kidney disease, seizures, long QT, or any other medical complex scenario that makes remote depression treatment inappropriate.

- Borderline personality disorder

- Complex polypharmacy (>4 psychiatric medications)

- Multiple providers in the past

- Inability to accurately provide history and the need for higher level of care.



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