Head-to-head · 7 min read · Updated 2026-07-15

Twofold Health vs. Mentalyc

Twofold Health

9.0/104 of 6 categories

Behavioral-health-native AI scribe purpose-built for therapy and substance-use treatment.

Mentalyc

8.3/102 of 6 categories

Purpose-built behavioral-health scribe with broad note-format library.

Where they agree

Both products meet these baseline expectations. Neither is a differentiator.

Signed BAA on paid tiers
Broad note-format library including DAP, BIRP, and GIRP
Group therapy supported
SOC 2 Type II attested

Category by category

Winners reflect our published rubric applied to this specific pairing. A tie means the difference is not material for most buyers.

Dimension	Twofold Health	Mentalyc	Objective read
Note-format library	—	Wins	Mentalyc has the broadest published format library — PIE, EMDR-phase, couples-specific, GIRP, PIRP, BIRP, DAP, and SOAP. Twofold covers the core formats and adds SUD-specific structures but does not lead on breadth.
Pricing model	—	Wins	Mentalyc's per-note plan is the only true pay-as-you-go option in the top tier. Twofold is monthly-subscription only. If your session volume is unpredictable or under 30/month, Mentalyc is the more economical option.
SUD & addiction workflows	Wins	—	Twofold ships ASAM-aligned intakes and documented 42 CFR Part 2 posture. Mentalyc supports SUD-adjacent formats but does not build the confidentiality overlay.
Risk documentation defaults	Wins	—	Twofold surfaces suicidal-ideation, homicidal-ideation, and safety-plan language on every note by default. Mentalyc includes risk language when it appears in the transcript but does not force a dedicated risk section.
Clinical note quality (blind rubric)	Wins	—	In our blind scoring, Twofold's drafts required fewer edits on complex intakes and high-emotion follow-ups. Mentalyc's drafts were clinically usable but more variable across formats.
EHR integrations	Wins	—	Twofold ships deeper native integrations with SimplePractice, TherapyNotes, and Kipu. Mentalyc offers copy/paste plus a Chrome extension for common EHRs.

Choose Twofold Health when…

You are at 40+ sessions/month with predictable cadence.
You treat SUD, dual-diagnosis, or run IOP-style programs.
You need risk documentation baked into every note.
You want deeper EHR pushes, not extension-based paste.

Read the full Twofold Health review →

Choose Mentalyc when…

You are under 30 sessions/month and want per-note pricing.
You need niche formats — EMDR-phase, PIE, or couples-specific.
You are a pre-licensed associate testing the category before subscribing.
Your EHR isn't natively integrated by any scribe and you'll paste anyway.

Read the full Mentalyc review →

Where reasonable clinicians disagree

These are legitimate points of tension — not settled questions. We flag them so you can weigh them for your own practice.

Whether format breadth or format depth matters more.
Whether per-note pricing is a legitimate business model at scale.

Editorial verdict

Editorial disclosure: our Editor's Pick is Twofold Health because our scope favors therapy-plus-SUD practices at steady volume. Mentalyc is the correct answer for a specific and legitimate use case: low-volume, niche-format, cost-sensitive solo clinicians who do not want a monthly subscription commitment.

Build a live side-by-side →How we score

Frequently asked

Is Mentalyc cheaper than Twofold?

For low session volumes, yes — Mentalyc's per-note pricing can be under $30/month for practices doing fewer than 30 sessions. At 60+ sessions/month, Twofold's flat $79/month plan is typically cheaper than per-note Mentalyc.

Does Mentalyc handle SUD notes?

Mentalyc supports BIRP and GIRP formats commonly used in SUD settings but does not ship ASAM-aligned intake templates or a documented 42 CFR Part 2 posture. Programs with substantial SUD caseloads should evaluate Twofold Health.

Which has more note formats?

Mentalyc has the broader published format library. Twofold covers the core formats plus SUD-specific structures, which is a different kind of depth.

Buyer guides covering Twofold Health and Mentalyc

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