Zachary Mooney

I am a board-certified psychiatric mental health nurse practitioner with extensive experience working in high-acuity crisis settings across both North Carolina and Delaware. My clinical background spans inpatient crisis stabilization, detoxification, involuntary psychiatric evaluations, and medication management for individuals navigating complex psychiatric, substance use, and trauma-related conditions. I have worked with some of the most underserved and underrepresented populations in mental health care, including individuals experiencing homelessness, chronic substance use disorders, and severe and persistent mental illness. I bring a direct, nonjudgmental, and clinically grounded approach to every encounter, and I believe that people are more than their diagnoses or their worst moments.

My practice is centered on the treatment of serious mental illness, including bipolar disorder, schizophrenia and schizoaffective disorder, and major depressive disorder. I approach medication management conservatively: my philosophy is to treat with the fewest medications necessary at the lowest effective dose, prioritizing stabilization and long-term safety. Given this focus and the population I've built my practice around, I do not prescribe benzodiazepines or stimulants. If ongoing management of these medication classes is central to what you're seeking, I likely won't be the right fit. What I can offer is thoughtful, evidence-based care for individuals managing complex or severe psychiatric conditions who are looking for a provider invested in long-term stability.

My approach is collaborative, trauma-informed, and grounded in years of high-acuity crisis work. I believe accurate diagnosis and honest, direct conversation are the foundation of good psychiatric care, especially for individuals managing serious mental illness who may have had past experiences of feeling dismissed or over-medicated. I prioritize stabilization first, then work with each person to find the most conservative medication regimen that keeps them well, adjusting only when clinically necessary rather than defaulting to more or stronger medications. I take complexity seriously, whether that means co-occurring substance use, trauma history, or a diagnosis that's been missed or mislabeled elsewhere, and I don't shy away from the harder clinical conversations. My goal in every relationship is sustainable stability.

In our first session, expect a thorough psychiatric evaluation: a detailed review of your history, current symptoms, past medication trials, and what has and hasn't worked for you before. I ask direct questions because getting an accurate picture matters more to me than moving quickly, and I want you to leave that first visit with a clear, honest sense of what I think is going on and what a reasonable treatment plan looks like. If medication is part of that plan, I'll walk you through my reasoning, including why I'm recommending a particular option over another, and what the lowest effective approach looks like for your situation. You can expect me to be straightforward about what I can and can't offer, including that I don't prescribe benzodiazepines or stimulants, so there are no surprises later in our work together.