What happens when you go to see a Psychiatrist?!

What happens when you go to see a Psychiatrist?

I see a counsellor at the moment but my doctor wants me to see a psychiatrist, i don't want to but would like to know what they do particularly? I have had such bad experience with mental health workers and doctors from the NHS that i am scared to see them.

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As a psychiatrist in private practice, myself, I can briefly tell you what I do. I do an initial comprehensive psychiatric evaluation. This is generally a 90 minute eval. I spend the entire time with the patient asking many questions, as you could imagine. I don't do any complicated written tests or surveys. I go over the patient's complaint or "presenting illness", then ask many questions regarding the patient's history and family history, use of substances (drugs, alcohol, tobacco), criminal history, full medical history, the patient's own mental health history (hospitalizations, previous counseling and any psychiatric medicaitons you have been on), certainly want to know about any meds you are on currently. Then, after all of the history is obtained, I will then ask questions for an "affective screening" which consists of any symptoms you might be experiencing now in order to decipher if you meet criteria for any major psychiatric illness--(current mood, sleep pattern, concentration, motivation, isolation/withdrawas, irritability, anxieties, compusions/obsessions, and also ask about any defective thought processes like auditory or visuual hallucinations, paranoia's, etc.) Finally, the entire time, I am observing for any obvious signs of intellectual or cognitive delays as well as observing how one interacts with me and others. Plus so much more I would not be able to fully express in this forum.

I think the initial evaluation is also an important time to "get a feel" for whether or not the patient and myself could in fact work together. Since most patient/psychiatrist relationships are often long lasting, it is very important for both of us to feel a sense of trust and an ability to overall, tolerate one another. This is true especially if you intent to enter a psychotherapeutic relationship (or go into therapy) with this doctor.
I would estimate that for most of my initial 90 minute evals, I am able to "finish" in this amount of time. Meaning, I can obtain all the relavent information and usually formulate a diagnosis and a treatment plan in the one session. Often, if medication is required, I can also address this and sometimes even prescribe the medication in the first vistit. However, in about 25% of the cases, additional time is needed to accomplish all this and we simply book another "hour" for later in the week or for the following week to "finish" the initial evaluation.

Since I also see "children and adult's", if it is a child or adolescent, my formula is essentially the same. I see the child and parent or parents together for most of the information gathering and, time permitting, I will then see the child alone. Usually, these cases require the additional hour.

Realize too, the process of obtaining the initial information is forever ongoing. And, can sometimes take many sessions before it is adaquately completed.

I hope this helps. At least, this is my way of doing things and I know many of my colleagues do similar initial evals. Don't be "scared", because you are in the process of potentially "hiring" or entering a long term relationship with someone you intend to help you and treat you with success. Make sure you get all your questions and concerns addressed. And, realize, it may take more than one session before you feel this is the right Dr. for you. It is not uncommon to see a couple or a few psychiatrists before one decides they will continue with one Dr. or the other. By all means, if you feel uncomfortable with the Dr., this should be explored. I don't consider the person truly being "my patient", until it is mutually agreed that we can and will work together.

Sorry for the long rambling answer, but, I wanted to be complete. good luck and take care