Board-Certified PMHNP SPRAVATO® Care in Tyler, TX

East Texas Psychiatry is staffed by three board-certified PMHNPs who collectively cover the full spectrum of adult and adolescent psychiatric conditions.

James Baughman, MSN APRN PMHNP-BC — Co-founder. More than 35 years of experience in psychiatric nursing, including service as a U.S. Navy veteran. His clinical background spans inpatient and outpatient psychiatric settings, medication-resistant conditions, and the full range of adult psychiatric presentations. He holds REMS certification for SPRAVATO® administration.

Antonio Brigham, MSN-Ed APRN PMHNP-BC PMHNP-C — Dual board-certified. Mr. Brigham holds both the PMHNP-BC credential from ANCC and the PMHNP-C credential from the American Association of Nurse Practitioners (AANP). Dual certification reflects demonstrated competency across two national credentialing frameworks. His approach integrates conventional psychiatric pharmacology with holistic perspectives on mental health.

Karen A. English, MSN PMHNP-BC — Child and adolescent specialist. Ms. English specializes in child and adolescent psychiatry — a population that requires specific expertise distinct from adult psychiatric care. Her presence on the team extends our clinical capacity to families and younger patients.

Together, this team provides a comprehensive psychiatric practice that serves patients from adolescence through older adulthood, across the full range of psychiatric conditions that commonly present alongside treatment-resistant depression.

Administering SPRAVATO® requires more than general psychiatric credentials — it requires specific REMS certification that covers esketamine pharmacology, acute effect monitoring, patient enrollment procedures, and facility compliance requirements.

East Texas Psychiatry's REMS-certified providers have completed the SPRAVATO® REMS training program as required by the FDA. This training covers the specific risks associated with esketamine administration — dissociation, sedation, cardiovascular effects — and the protocols for managing them during the mandatory two-hour monitoring period.

REMS certification is not a credential that can be assumed from general psychiatry training. It requires affirmative completion of the REMS-specific training program, enrollment in the REMS registry, and ongoing compliance with REMS requirements. Our practice maintains current certification and compliance.

This combination — board-certified PMHNP credentials, deep psychiatric clinical experience, and REMS certification — means that SPRAVATO® at East Texas Psychiatry is delivered by qualified, specifically trained providers within a compliant clinical framework.

The quality of your SPRAVATO® treatment depends significantly on the clinical judgment and expertise of the providers managing it. SPRAVATO® is not a simple infusion that requires only protocol adherence — it is a psychiatric treatment that requires sophisticated clinical judgment about candidacy, background medication management, response assessment, and long-term planning.

Evaluating SPRAVATO® candidacy requires a thorough psychiatric assessment that goes beyond confirming a TRD diagnosis. A skilled evaluator asks what is actually driving treatment resistance — is it pharmacogenomic variation, undiagnosed comorbidity, inadequate prior treatment, psychosocial factors, or genuine neurobiological non-response to monoamine-targeting medications? This diagnostic precision shapes the overall care plan, not just the decision to prescribe esketamine.

Managing response assessment requires clinical judgment about what constitutes meaningful improvement, how to integrate validated measures with patient-reported experience, when to adjust dose or frequency, and when to conclude that SPRAVATO® is not producing sufficient benefit and pivot to alternatives.

Long-term planning — deciding when to taper off maintenance, how to sustain gains, and what the ongoing medication regimen should look like as the patient's clinical status evolves — requires the continuity of care and clinical relationship that board-certified PMHNPs at a comprehensive psychiatric practice provide.

We accept Aetna, Ambetter, Blue Cross Blue Shield, Cigna/Evernorth, Medicare, Optum, UnitedHealthcare, and UMR.

One of the practical advantages of a multi-provider practice is the capacity for internal consultation and care coordination. When a patient's clinical presentation is complex — as is often the case with treatment-resistant depression — having three experienced PMHNPs on staff creates opportunities for collegial consultation.

Our providers consult with each other on complex cases, which brings multiple perspectives to difficult clinical decisions — dose adjustments, treatment alternatives, comorbidity management. This is not possible at single-provider practices, where the clinician manages every decision in isolation.

Internal coordination also supports continuity of care. If your primary SPRAVATO® provider is unavailable, another member of our team can provide coverage and maintain the continuity of your treatment — with full clinical context available through our shared records.

For patients whose care involves multiple providers — a primary care physician, a therapist, a specialist for a co-occurring medical condition — we coordinate with these providers with your consent, ensuring that your psychiatric care is coherent with your broader health management.

If you are considering SPRAVATO® in Tyler, TX, the first step is a comprehensive evaluation with one of our board-certified PMHNPs. This evaluation — 60 to 90 minutes — reviews your diagnosis, antidepressant history, current medications, and clinical goals, and determines whether SPRAVATO® is the appropriate next step in your care.

We accept Aetna, Ambetter, Blue Cross Blue Shield, Cigna/Evernorth, Medicare, Optum, UnitedHealthcare, and UMR. For patients with Medicare, we manage the prior authorization process — including documentation, submission, and any appeals needed — at no additional burden to you.

Call (430) 288-5800 or use the Schedule button to request a same-week consultation. Statewide telepsychiatry available for patients outside Tyler.

This page is educational and is not a substitute for personalized medical advice.