Irene Pastis, MD

Dr. Vargas is an adult psychiatrist who received her medical degree from the University of Texas Health Science Center of San Antonio. She subsequently completed her psychiatry residency training at UT Health San Antonio.

Dr. Vargas has a patient-centered and thorough approach to treatment. She has experience treating a broad spectrum of mental health disorders, with particular interest in depression, anxiety, and post-traumatic stress disorder. She has also worked in clinic with severely mentally ill patients at the South Texas VA in San Antonio.

Dr. Vargas's primary focus is medication management with an emphasis on shared decision-making; however, she frequently also utilizes supportive therapy, cognitive behavioral therapy, and psychodynamic therapy principles in her approach. She may refer patients to a therapist if further support would be beneficial.

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Dr. Seth Flesher is double board-certified in adult psychiatry and addiction medicine.  Dr. Flesher’s practice focuses on medication management of psychiatric illness without the use of controlled substances.  Typically, he offers this in conjunction with supportive or emotionally focused therapy in 30-minute follow-up visits. However, occasionally Dr. Flesher may believe that additional therapy is also needed and ask that you bring a therapist into your care team to provide the best outcome.

Before joining Talkiatry Dr. Flesher was Medical Director of Advanced Psychiatric Services [complex/high profile cases] at Kings County Hospital and Unit Chief of the Covid19 positive unit.  He was also a clinical professor at Downstate Medical College where he was voted educator of the year numerous times by psychiatric residents and medical students.  Dr. Flesher is a graduate of the prestigious combined 6-year BS/MD program at The Sophie Davis School of Biomedical Education.  He did research at the neuropsychiatric branch of the National Institute of Mental Health, completed his psychiatric residency at St. Lukes/Roosevelt Hospital, and he received his master’s degree in public health from Columbia University.

Dr. Flesher believes that psychiatry should start with a thorough assessment to arrive at an accurate diagnosis.  Then a discussion with the patient of the different evidence-based options available.  Followed by shared decision-making to arrive at an effective treatment plan to achieve the goals that the patient identifies as being important.  This should be done in an honest, open, non-judgmental, but realistic environment.  Understanding that the ultimate goal is to get the patient to a position where they will no longer need medication and/or therapy.

Dr. Robert Smeed, DO, is a board-certified psychiatrist with a passion for healing the human mind and consciousness. He earned his Doctor of Osteopathic Medicine from Lake Erie College of Osteopathic Medicine and completed his Psychiatry Residency at Wayne State University College of Medicine. Certified by the American Board of Psychiatry and Neurology (ABPN), Dr. Smeed served as an outpatient psychiatrist at Veterans Affairs for 11 years, honing his expertise in mental health care. Driven by a deep interest in consciousness and innovative treatments, he combines talking therapies, neuromodulation, and modern psychopharmacology to help patients achieve lasting wellness.

Dr. Smeed is proficient in treating a wide range of psychiatric conditions while specializing in treatment-resistant depression, neurodevelopmental disorders, anxiety and trauma disorders. His treatment style is empathic and collaborative, emphasizing family dynamics and relationships while integrating psychodynamic principles with biopsychosocial models. He approaches each patient with creativity, using open-ended discussions and innovative therapeutic and psychopharmacologic strategies to tailor care, ensuring a personalized and effective treatment experience.

Dr. Smeed begins with open-ended dialogue, allowing patients to develop their narrative, which is often therapeutic. Treatment plans are customized to patient needs and align with diagnostic standards of care. He incorporates medication reviews, mindfulness techniques, cognitive behavioral therapy (CBT), supportive therapy, and psychodynamic approaches. Dr. Smeed also educates patients on lifestyle factors, such as diet and exercise, to support mental health, fostering a holistic and individualized path to wellness.

Dr. Kyle Baird, DO, earned his medical degree from A.T. Still University – Kirksville College of Osteopathic Medicine and completed his psychiatry residency at the University of Colorado School of Medicine. He has practiced in diverse academic outpatient settings, using a multidisciplinary approach to understand clients and develop personalized treatment plans. He also served as medical director of a large academic outpatient clinic, overseeing psychiatrists, residents, psychology students, and advanced practitioners.

Dr. Baird values a holistic perspective in care, emphasizing empathy, understanding, and patient-centered treatment. He fosters open, clear communication and collaborates with clients to explore the causes of symptoms, as well as the strengths and behaviors that support resiliency and well-being. He also considers daily routines and life contexts that influence mental health.

During the initial appointment, Dr. Baird conducts a thorough evaluation of concerns, history, and functioning, completing any necessary screenings. He then develops a personalized treatment plan collaboratively, reviewing potential therapeutic interventions. Follow-up visits typically combine medication management, if appropriate, with brief psychotherapeutic support, adjusting intervals based on client needs, monitoring, and treatment progress.

Justin Stone is a board-certified Psychiatric-Mental Health Nurse Practitioner (PMHNP) with experience in both outpatient and inpatient psychiatric settings, including in-person and telehealth care. He completed his undergraduate and master’s programs at Southern Adventist University in Collegedale, Tennessee. Justin is committed to providing compassionate, patient-centered care that addresses the whole person—mind, body, and environment.

Justin works collaboratively with patients to reach personal goals and support a more fulfilled life. He strives to create an open, judgment-free relationship where patients can be completely themselves. His aim is to provide a safe space for vulnerability without fear of judgment, fostering trust and partnership in the therapeutic process.

Patients can expect a thorough initial evaluation to ensure the correct diagnosis is addressed from the start. Justin prioritizes safety and evidence-based best practices while tailoring treatment plans to individual goals. His approach is focused on developing personalized strategies that help patients achieve meaningful improvements in mental health and overall well-being.

Dr. Shaily C. Desai, MD is a board-certified psychiatrist who treats adults. She graduated Magna Cum Laude and with General Honors from University of Miami. She completed medical school at the University of Miami Miller School of Medicine in the prestigious Honors Program in Medicine. She continued her medical education at Jackson Memorial Hospital & University of Miami Hospital for her 4-year psychiatry residency training program. After completing her training, Dr. Desai held an academic appointment at the University of Miami while working at the Miami Veterans Affairs Hospital initially as a behavioral health consultant in the Primary Care Mental Health Integration (PCMHI) model and later as a Behavioral Health Interdisciplinary Program (BHIP) psychiatrist in the Mental Health Treatment Coordinator (MHTC) role.

Dr. Desai’s background spans clinical care, academic research, and community service, giving a comprehensive understanding of mental healthcare delivery across different settings. Dr. Desai developed expertise in quickly building rapport with patients, conducting medication management assessments, and implementing effective interventions. These experiences taught Dr. Desai how to maintain clinical excellence while showing patience and respect for each patient's unique circumstances. She understands the delicate balance of providing thorough care within the constraints of virtual sessions and she has developed strategies to ensure patients feel supported and understood, even though a screen.

By combining clinical expertise with genuine empathy and persistence, Dr. Desai helps her patients navigate their treatment journey with confidence and hope. Dr. Desai’s practice focuses on medication management and supportive psychotherapy in typically 30-minute follow up visits. At times, additional psychotherapy is needed, and a therapist may be added to provide the best outcome.