About OCD
OCD (obsessive-compulsive disorder) involves intrusive thoughts that cause distress and repetitive behaviours or mental rituals to reduce it. Cognitive-behavioural therapy with exposure and response prevention is the first-line psychological treatment.
Psychiatrists are medical doctors specialised in mental health. They diagnose, prescribe and monitor medication and may also provide psychotherapy. They are usually the first choice when medication may be needed or symptoms are severe.
Getting mental health care in the United States
Public health system · No single public system (Medicaid, Medicare, community mental health centers)
There is no universal public mental health service. People with low incomes may be covered by Medicaid, older adults by Medicare, and publicly funded community mental health centers and treatment facilities can be located through the federal SAMHSA locator. More information
How to check that a professional is licensed
- State medical boards (umbrella body: Federation of State Medical Boards). Psychiatrists are physicians licensed by each state medical board. The FSMB DocInfo service lets you look up a physician's license and disciplinary history. Search the official register
Insurance and coverage
Federal parity law (MHPAEA) requires most group health plans that cover mental health to do so on terms no more restrictive than for physical health; deductibles, copays and in-network rules still apply.
Online therapy in the United States
The clinician must normally be licensed in the state where the patient is located. Psychologists in PSYPACT member states may practice telepsychology across those states.
Urgent help in the United States
If your life or someone else's is in danger, call the emergency number now. These services can help at any time:
- 911 · Emergency (911)
- 988 · 988 Suicide & Crisis Lifeline
Information reviewed in November 2026 · Sources: findtreatment.gov, docinfo.org
Signs to look out for
Many people have occasional intrusive thoughts or like things a certain way. OCD may be involved when unwanted thoughts, images or urges cause intense distress, and you feel driven to perform rituals, such as checking, washing, counting, seeking reassurance or mentally neutralising, to reduce the anxiety. These rituals take a lot of time, feel hard to resist and interfere with daily life.
What helps: treatments and professionals
Cognitive-behavioural therapy with exposure and response prevention (ERP) is the psychological treatment with the strongest evidence for OCD. It involves gradually facing feared thoughts or situations without performing rituals, at a pace agreed with the therapist. Clinical psychologists and psychologists trained in ERP usually lead treatment. A psychiatrist can assess whether medication may help, particularly when symptoms are severe.
When to seek urgent help
Having an intrusive thought about harm does not mean you want to act on it; this is common in OCD. However, if you feel hopeless, have thoughts of ending your life, or rituals prevent you from eating, drinking or caring for yourself, contact your local emergency services or go to the nearest emergency department. Sudden onset of OCD symptoms in a child should be checked by a doctor.
What you can do in the meantime
Learn from reliable sources how OCD works: trying to push thoughts away or seeking reassurance usually makes them stronger. Try to delay a ritual by a few minutes, or shorten it slightly, and notice that anxiety tends to fall on its own. Ask family members to support you without joining in rituals. Look after sleep and stress, which can intensify symptoms.
What does a psychiatrist do?
A psychiatrist is a medical doctor who assesses mental health problems from a medical point of view. Day to day they carry out diagnostic interviews, rule out physical causes, decide whether medication could help, prescribe it and monitor its effects and side effects. Many also offer psychotherapy or work alongside psychologists. They see adults, older people and, if specialised, children and adolescents.
When to see a psychiatrist
Consider a psychiatrist when symptoms are intense or long-lasting, when therapy alone has not been enough, when you are already taking psychiatric medication, or when there are experiences such as severe mood swings, hearing or seeing things others do not, or very disturbed sleep. If what you mainly need is talking therapy for everyday difficulties, a psychologist or psychotherapist may fit better.
How to choose
When choosing, check the licence and training, the approach they use and whether they have experience with what you need. Consider practical aspects too: language, price, location or online sessions and availability. The relationship with the professional matters a great deal; if after a few sessions it does not feel right, it is fine to change.
Frequently asked questions
Does the public health system in the United States cover psychological care?
There is no universal public mental health service. People with low incomes may be covered by Medicaid, older adults by Medicare, and publicly funded community mental health centers and treatment facilities can be located through the federal SAMHSA locator.
How do I check that a psychiatrist is licensed in the United States?
State medical boards (umbrella body: Federation of State Medical Boards): Psychiatrists are physicians licensed by each state medical board. The FSMB DocInfo service lets you look up a physician's license and disciplinary history.
Can I have online therapy in the United States?
The clinician must normally be licensed in the state where the patient is located. Psychologists in PSYPACT member states may practice telepsychology across those states.