What is it like to attend a psychiatry appointment?
Psychiatry gets a bad rap in our culture. If you've spent any amount of time watching TV shows or movies you've likely seen psychiatry in a negative light. Psychiatrists are portrayed as being evil, incompetent, paternalistic, or at the very least, are typically committing serious boundary violations. How many scenes have we watched of a patient taking a small cups worth of mysterious pills? Given our culture, it's no wonder that many are apprehensive about seeking out mental health care. So what is seeing a psychiatric provider really like? Let's break down common questions.
What are all of these letters after people's names? Who can provide medications? Who can I go see for therapy?
Something that can be tough in the mental health field is simply knowing who is who! Very broadly we could break up the list into providers who do solely therapy and providers who prescribe medication. However, providers who prescribe also may do therapy.
Providers who are able to prescribe medications
Physician Assistants (PA)
Nurse Practitioners (NP)
Certified Nurse Specialists (CNS)
Providers who provide therapy
Psychologists (PsyD, PhD)
Counselors and Therapists (LPC, LMFT, LADC)
Clinical Social Workers (LCSW, ASCW)
Okay, I scheduled an appointment with a psychiatric provider. What should I expect?
You might hear your first appointment referred to as an "Intake" appointment or as a "Diagnostic assessment". Both of these refer to the first visit you will have with your provider. The first visit with a psychiatric provider is typically 60-90 minutes in length and is a comprehensive appointment that goes over your concerns and history.
Every provider is a bit different in their approach but typically you will fill out new patient paperwork prior to your visit which will help inform your provider of your history and symptoms before you meet.
During the appointment, the psychiatric provider often will lead the appointment with asking you different questions about your life. Though the provider usually leads the conversation, you should feel that you have the space to explain what you need.
Usually psychiatric providers have a few areas that they like to know about. This includes:
Your daily life. We like to get to know you, know about where you live, your supports in life, your work, your education, and your stresses.
Your medical history. Medical history is extremely important to know as some conditions can contribute to mental health concerns. It is also important to know for your provider to pick out the right medication for you.
Your mental health history. Knowing if you have done any previous treatments for mental health conditions is also very important to help plan the right treatment for you.
Your family history. Family histories are helpful to know, both your family's history of medical and mental health concerns
Your use of substances. This typically gets quite detailed as any substance (even caffeine or nicotine) can impact your mental health symptoms and the medications we use. You should never feel that you are being judged when discussing your substance use history, this is simply something that your provider needs to know to safely prescribe you medications.
Your trauma and abuse history. This is an area that is important to discuss but individuals often don't feel ready to discuss this on the first visit. That is okay. Just let your provider know and you can come back to it when you feel ready.
What you are experiencing: Of course your provider will also want to know what is bringing you in! You will talk through your symptoms at length and also screen for other psychiatric illnesses.
That seems like an overwhelming amount of information to go over! What happens if we don't get through it all?
Although it seems like a lot, your provider is a pro and knows how to navigate the visit so in most cases, you will be able to get through all of the information with no problems. Occasionally, more time is needed to really make sure that the provider knows your whole history. That is just fine! Usually your provider will then schedule a follow up to finish your intake.
I'm nervous about starting a medication. Will that be talked about in my first appointment?
It's completely normal to be nervous about starting medications, most people are! After you go over your history with your provider, typically they will spend the last part of your appointment explaining their impression of your symptoms and medication options (if that is an appropriate treatment).
You should have the benefits, risks, and side effects of the medication options reviewed with you and have plenty of time to ask questions of your provider.
What happens after the first visit?
After your initial visit, you will start doing follow up visits with your provider. These are shorter visits (usually 15-30 minutes in length) where you go over how your symptoms are, your thoughts on the medication, and any side effects or concerns. Depending on your needs, these visits typically occur every 1-3 months.
What if I didn't feel comfortable with the provider?
As human beings, we don't always mesh well with every other person in the world. Mental health providers are no different and that is okay. If something felt off with your visit, you can certainly seek out care elsewhere. However, if you felt that things went okay for the most part, it can be helpful to have a few sessions with a provider to really see how things feel. Often what is called the "therapeutic relationship" takes time to build. At the end of the day, you are in charge of your care and should do what is best for you.
Anything else I should know?
Even though psychiatry can seem daunting, it doesn't have to be. Working with a psychiatric provider should be a partnership and you should feel involved in your care. You should feel encouraged to bring questions and concerns to your provider and feel heard in your sessions. Treating mental health concerns is a team effort, don't feel you need to do it alone.
Feeling ready to explore medication management? Request a consult from Northern Oak Wellness today