About Our Practice

What is Reproductive Psychiatry?

Reproductive psychiatry is a subspecialty focused on how reproductive life stages (menstruation, fertility, pregnancy, postpartum, perimenopause and menopause) affect mental health. It combines psychiatric expertise with an understanding of hormonal and reproductive physiology.

Dr. Lindsay Standeven completed a two-year clinical, academic, and research fellowship in Reproductive Psychiatry at Johns Hopkins School of Medicine. View her publications. Samantha Meilman, LCSW, spent 10 years working and training at the Johns Hopkins Women’s Mood Disorders Center (now the Center for Reproductive Mental Health), where she was trained by leaders in reproductive psychiatry.

What makes our practice different?

Hormonal shifts across the reproductive lifespan can affect mood, anxiety, OCD, and other mental health symptoms. Yet most psychiatrists, OB/GYNs, and nurse practitioners receive limited training in how these changes influence symptoms, or in how to adapt therapy and medication accordingly.

Our providers have that specialized training. Dr. Standeven brings fellowship training in reproductive psychiatry and works with national leaders to establish standardized, evidence-based education in the field. Samantha Meilman, LCSW, brings nearly 15 years of experience in maternal mental health and specializes in Exposure and Response Prevention (ERP), the gold-standard treatment for OCD, and Inference-Based CBT (I-CBT). Because therapy and medication management happen within the same practice, your providers communicate closely and work toward shared goals.

Above all, we aim to create a space where you feel understood, supported, and empowered during some of life’s most sensitive transitions.

Who can benefit from our services?

We support adults (18+) experiencing mental health symptoms connected to reproductive health, including:

• Premenstrual mood symptoms and PMDD

• Mood symptoms and depression

• Anxiety and panic

• OCD and intrusive thoughts

• Trauma and stress-related symptoms

• Infertility, PCOS/MCOS, and other hormonal conditions

• Pregnancy and postpartum mood, anxiety, and OCD

• Pregnancy loss and perinatal grief

• Perimenopause and menopause-related changes

Will I see a psychiatrist?

For psychiatric care (medication evaluation and diagnosis), yes. Currently, psychiatric evaluations and medication management at our practice are provided by board-certified psychiatrists (MDs) with advanced training in reproductive mental health.

What’s the difference between psychiatrists, nurse practitioners, physician assistants, and therapists?

Many types of clinicians provide mental health care, and their titles can be confusing. The biggest differences are whether they prescribe medication and how much training they have in therapy.

Clinicians who can prescribe medication:

• Psychiatrist (MD or DO): a medical doctor who completed medical school and four years of residency training in psychiatry, which includes required training in psychotherapy. Psychiatrists diagnose mental health conditions, prescribe and manage medication, and can provide therapy. Their medical training is especially helpful for complex situations and for medication decisions during pregnancy and breastfeeding.

• Psychiatric nurse practitioner (PMHNP): a registered nurse with graduate training in psychiatric care. In Maryland, psychiatric NPs can diagnose and prescribe independently. Their programs include some psychotherapy coursework, but they are not required to complete supervised therapy hours, and most focus on medication management in practice.

• Physician assistant (PA): a clinician with master’s-level general medical training who diagnoses and prescribes in collaboration with a physician. PA programs cover all areas of medicine, with limited dedicated psychiatry training and generally little formal training in psychotherapy.

Clinicians who provide therapy (they don’t prescribe):

• Licensed clinical social worker (LCSW; in Maryland, LCSW-C): holds a master’s degree in social work and completed years of supervised clinical practice after graduating before practicing independently. LCSWs diagnose mental health conditions and provide therapy, often with a focus on the whole person and their circumstances.

• Licensed clinical professional counselor (LCPC): holds a master’s degree in counseling and completed years of supervised clinical practice after graduating. LCPCs diagnose and provide therapy.

• Licensed marriage and family therapist (MFT; in Maryland, LCMFT): holds a master’s degree in marriage and family therapy and completed supervised clinical practice after graduating. MFTs provide therapy with an emphasis on relationships and family dynamics, and also see individuals.

At our practice, psychiatric care is provided by board-certified psychiatrists, and therapy is provided by Samantha Meilman, a licensed clinical social worker with specialized training in reproductive mental health.

What training or credentials do your providers have?

Our psychiatrists are board-certified medical doctors trained at Johns Hopkins, with advanced training in reproductive mental health. Our therapist, Samantha Meilman, LCSW, MBA, is a licensed clinical social worker with nearly 15 years of experience in maternal mental health, including 10 years at the Johns Hopkins Women’s Mood Disorders Center. She specializes in Exposure and Response Prevention (ERP) and Inference-Based CBT (I-CBT) for OCD.

Dr. Lindsay Standeven and Samantha Meilman were trained at Johns Hopkins by Jennifer Payne, MD, and Lauren Osborne, MD, both leading researchers and clinicians in reproductive psychiatry.

All providers participate in ongoing continuing education and collaborative case consultation. Meet our team.

Do you see clients outside Maryland?

We can provide care only to clients who are physically located, at the time of each appointment, in a state where their provider is licensed:

• Dr. Lindsay Standeven: Maryland and Virginia

• Samantha Meilman, LCSW: Maryland and Indiana

• Dr. Sasha Narayan: Maryland

Do you coordinate care with my OB/GYN, fertility specialist, or other doctors?

Yes. With your written consent, we are happy to collaborate with your OB/GYN, fertility specialist, endocrinologist, or primary care provider, including before starting or changing medication, so your care is safe and consistent. We also advocate for you when recommendations conflict or misinformation comes up, which is especially common in perinatal and hormonal mental health.

Pregnancy, Postpartum, Fertility & Hormonal Transitions

Can I take psychiatric medication while pregnant or breastfeeding?

Often, yes. Many psychiatric medications have been well studied during pregnancy and breastfeeding, and untreated depression or anxiety also carries real risks for both parent and baby. Dr. Standeven reviews your options, explains the research on risks and benefits in plain language, and, if needed, coordinates with your OB/GYN so you can make the choice that feels right for you.

If you become pregnant, give birth, or begin breastfeeding while in treatment, we adjust your plan for each stage. For context on recent public discussion, read the National Curriculum in Reproductive Psychiatry’s response to the FDA panel on SSRIs in pregnancy.

I’m having scary or intrusive thoughts about my baby. Is that normal, and is it okay to tell you?

Unwanted, intrusive thoughts, such as sudden images of your baby being harmed, are very common during pregnancy and postpartum. They’re often a symptom of perinatal anxiety or OCD, and they feel so distressing precisely because they go against everything you want. These thoughts are treatable, and treating them is one of our specialties. Samantha Meilman, LCSW, provides Exposure and Response Prevention (ERP) and Inference-Based CBT (I-CBT), evidence-based therapies for OCD, and Dr. Standeven offers medication support when helpful.

Talking about these thoughts with us is welcome and expected. Sharing them helps us understand what you’re experiencing and get you the right care. If you ever feel you might act on thoughts of harm, or feel unsafe, call 911 or 988 right away.

What if I’m trying to conceive or going through fertility treatment?

Dr. Standeven offers preconception consultations to help you plan ahead. She reviews your current medications, discusses alternatives when needed, and helps you make a plan for pregnancy and postpartum. Samantha Meilman, LCSW, offers therapy and emotional support throughout fertility treatment.

Do you support people after pregnancy loss or infertility?

Yes. We offer compassionate, specialized care for miscarriage, stillbirth, pregnancy loss, infertility, and the grief that can come with them. Samantha Meilman, LCSW, offers therapy throughout the fertility journey and after loss, and Dr. Standeven can help when medication questions come up.

Do you treat PMDD or premenstrual mood symptoms?

Yes. Some people experience significant depression, anxiety, or irritability in the days before their period. This includes premenstrual dysphoric disorder (PMDD) and premenstrual worsening of an existing condition. We look at how your symptoms track with your cycle and offer evidence-based therapy and medication options.

Do you help with mood and anxiety changes during perimenopause and menopause?

Yes. Many people notice new or worsening depression, anxiety, irritability, sleep problems, or brain fog during perimenopause, which often begins in the 40s and sometimes earlier. This can happen even without any prior mental health history. These symptoms are real and treatable. We consider both psychiatric and hormonal factors, offer therapy and medication options, and coordinate with your gynecologist on options such as hormone therapy when appropriate.

How do you address PCOS, thyroid conditions, or other hormonal issues?

These conditions can influence mood, anxiety, and OCD symptoms. Dr. Standeven accounts for how they interact with your mental health, may request labs, and coordinates with your endocrinologist, OB/GYN, or primary care provider on your overall treatment.

Therapy, Medication & Treatment

What happens during the initial intake?

Our intake is thorough. We explore your medical, psychiatric, reproductive, and social history, review your current concerns, and understand your goals. We also discuss treatment options, confidentiality, and practice policies, and create an individualized care plan together. Psychiatric intakes with Dr. Standeven last about 90 - 120 minutes; therapy intakes with Samantha last 60–90 minutes.

What is therapy like at our practice?

Therapy with Samantha Meilman (Sam), LCSW, is warm, collaborative, and tailored to you. Whether you’re managing anxiety or OCD, coping with pregnancy and infant loss, navigating fertility treatment, or adjusting to life with a new baby, therapy offers a supportive space to gain insight, build practical coping tools, and feel more like yourself again. Sam uses evidence-based approaches, including Exposure and Response Prevention (ERP) and Inference-Based CBT (I-CBT) for OCD, and Acceptance and Commitment Therapy (ACT). ERP is typically time-limited, with length depending on symptom severity.

What’s the difference between therapy and medication management?

• Therapy supports emotional exploration, insight, coping skills, and meaningful behavioral change.

• Medication management involves evaluating symptoms, prescribing medication when appropriate, and monitoring your response and safety over time.

You can have therapy without medication, or medication management without therapy. When both are a good fit, many people do better with the combination, and having both in one practice means Dr. Standeven and Samantha coordinate closely on your care.

How often are sessions?

• Therapy: typically weekly or every other week, 45–60 minutes

• Medication management: every 4–12 weeks, but depending on your needs and how stable your symptoms are appointments may be more or less frequent.

Do I need lab tests or hormone panels?

Sometimes. We may request labs, such as thyroid or hormone levels, to understand how medical factors may be affecting your mood, anxiety, or OCD symptoms. When needed, we coordinate with your medical team.

How long does treatment usually last?

It varies. Some people benefit from brief therapy or short-term medication support; others prefer longer-term care. ERP for OCD is typically time-limited, with length depending on symptom severity. We review and adjust your plan regularly.

What if the first treatment doesn’t work?

Finding the right medication or therapy approach can take time. We work with you to adjust treatment, consider alternatives, and coordinate referrals when needed.

Virtual Care & Access

Do you offer virtual appointments?

Yes. We offer virtual appointments for both psychiatry and therapy, as well as in-person visits at our Baltimore office (600 Wyndhurst Ave., by appointment only). Virtual care can be especially helpful during pregnancy or with a new baby, and research shows it can be as effective as in-person care while reducing barriers like travel, scheduling, and childcare.

Is your telehealth/virtual platform secure?

Yes. We use a HIPAA-compliant, encrypted platform designed for healthcare.

Can I have a virtual session while traveling?

Only if you’re in a state where your provider is licensed. You must be physically located in one of those states during each session (see “Do you see clients outside Maryland?” above).

Can I bring my baby to appointments?

Yes, babies are welcome during virtual sessions. Feeding, rocking, or pausing when you need to is completely fine.

Getting Started, Policies & Emergencies

How do I get started?

1. Choose a provider on our homepage and fill out a short form.

2. We review your information to make sure we can meet your needs.

3. If it looks like a good fit, we’ll reach out to schedule a free 15-minute consultation call.

After your consultation, we schedule your first appointment with you directly; we don’t offer online self-booking. A credit card is required to reserve your session but isn’t charged until your appointment.

How soon can I be seen?

We review new requests weekly and will reach out sooner when we can. Availability varies by provider. If you need help right away, see “What should I do in an emergency?” below.

Do I need a referral?

No. You don’t need a referral to request a consultation. Some insurance plans require a referral for therapy coverage, so it’s worth checking with your plan.

What is your cancellation policy?

We require at least 24 hours’ notice to cancel or reschedule. To cancel or reschedule, email us more than 24 hours before your appointment and let us know your preferred new time. Late cancellations and no-shows may be charged the full session fee.

What should I do in an emergency?

We are not an emergency service. If you are in crisis:

• Call 911 or go to the nearest emergency department

• Call or text 988, the Suicide & Crisis Lifeline

• Call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262), free, confidential, and available 24/7 for pregnant and new parents

Fees, Insurance & Payment

What are your fees?

• 15-minute consultation: Free

• One-time consultation or second opinion with Dr. Standeven (records review, 90-minute evaluation, written report): $700

• Psychiatric intake evaluation with Dr. Standeven (90 min): $550

• Medication management follow-up (25 min): $220

• Extended medication management / psychotherapy (30–50 min): $320

• Therapy intake with Samantha Meilman, LCSW (60–90 min): $165

• Therapy session with Samantha Meilman, LCSW (45-60 min): $130

See our Services page for details on each service.

Please note prices will be updated in 2027.

Do you accept insurance?

• Dr. Standeven and Dr. Narayan do not accept insurance (out-of-network). We provide receipts and superbills you can submit for reimbursement.

• Samantha Meilman, LCSW, accepts United, Aetna, and Cigna.

It’s always a good idea to check with your insurance about your mental health coverage.

Why don’t the doctors accept insurance, and why don’t you take every plan?

We know cost is a real barrier to care, and we don’t take that lightly. Many of the people we see are already carrying a lot: a new baby, fertility treatment, loss, or a major life transition. Navigating insurance on top of that can feel overwhelming.

Our decision is about being able to provide the kind of care we believe you deserve. Insurance reimbursement for psychiatric care is often low, and it rarely reflects the time specialized care takes, such as a 90-minute evaluation, careful medication planning during pregnancy, or coordinating with your OB/GYN or fertility team. Insurance also comes with significant administrative work, including prior authorizations, claim denials, and appeals. That time would otherwise go to patient care. Staying out of network allows the psychiatrists to keep appointments unhurried, spend time on coordination that insurance often doesn’t cover, and tailor your care to what you need.

We also want care to be as accessible as possible:

• Therapy with Samantha Meilman, LCSW, is covered by United, Cigna, and Aetna and many of her clients have been able to get reimbursements through their Blue Cross Blue Shield plans.

• Superbills: we provide superbills you can submit for out-of-network reimbursement. Many plans with out-of-network benefits reimburse a portion of the cost. We can also submit the superbills for you.

• Help finding other options: if our fees aren’t workable for you, we’re glad to help you find in-network resources.

Tip: to check your out-of-network benefits, call the number on your insurance card and ask: “Do I have out-of-network benefits for outpatient mental health? What is my deductible, and what percentage is reimbursed?” It can help to ask about specific codes:

• Psychiatry: 90792 (psychiatric evaluation) and 99214 (medication follow-up)

• Therapy: 90791 (intake) and 90834 or 90837 (therapy sessions)

Do you provide superbills for reimbursement?

Yes. We provide superbills you can submit for out-of-network reimbursement. We also work with Mentaya, which can verify your out-of-network benefits and submit claims on your behalf.

Do you offer sliding-scale fees?

We occasionally offer reduced fees based on financial need and provider availability. Ask during your 15-minute consultation.

Will I receive a Good Faith Estimate?

Yes. In line with the No Surprises Act, we provide a Good Faith Estimate of expected costs. Learn about your rights.

Privacy & Confidentiality

How do you protect my privacy?

We follow HIPAA and all state and federal privacy regulations. Your information is stored securely and shared only with your providers unless you authorize additional sharing in writing.

When are you required to break confidentiality?

We are required to disclose information when:

• You are at serious risk of harming yourself or others

• Abuse of a child, elder, or dependent adult is suspected

• A court order requires disclosure

We also share information when you authorize it in writing, for example with your OB/GYN.

Does using insurance affect my privacy?

It can, and we want you to have the full picture so you can make the choice that’s right for you.

What insurance companies receive. To process a claim, your insurer receives a diagnosis code, the type of service, and dates of your sessions. Insurers may also request treatment records for reviews, authorizations, or audits. This information becomes part of your record with that insurance company.

What stays protected. Your employer does not see the details of your claims; HIPAA keeps them private. Under the Affordable Care Act, health insurers cannot deny you coverage or charge you more because of a mental health diagnosis. Psychotherapy notes, the personal notes a therapist may keep separately from your medical record, have extra protection under HIPAA, and insurers generally cannot require them.

Paying privately means no diagnosis or claim goes to an insurance company, which offers the highest level of privacy for your treatment records.

Most importantly, please don’t let these concerns keep you from getting care. Mental health conditions during pregnancy, postpartum, and other reproductive transitions are common and treatable, and getting support is a sign of strength. We’re happy to talk through these questions during your consultation.