What is a Psychiatrist?
A psychiatrist is a licensed medical doctor, who has not only earned a medical degree (MD), but has further specialized in the field of psychiatry, which emphasizes the care and treatment of people with mental illness. Specialization takes three to four years after obtaining a medical license, and involves treating people with mental illness in a variety of settings. Most people who specialize in this field then take examinations given by the American Board of Psychiatry and Neurology to receive board certification. For the patient evaluating psychiatrists, board certification is a good thing to look for because it presupposes the doctor in question has demonstrated sufficient knowledge in his/her profession.
Sometimes people confuse psychiatrists with other therapists. Only medical doctors can be psychiatrists, and only psychiatrists (not counselors, social workers, or psychologists) can prescribe medications or other medical therapies for the treatment of mental disorders. Many of these specialists work in conjunction with therapists, and may provide therapy or counseling only as it relates to medication issues, while a main therapist provides the majority of actual counseling to augment cure or management of mental illness. This is not always the case.
Other psychiatrists not only prescribe medication but also offer therapy, since they are trained to do so, much as any other therapist would be. In the US, it can sometimes be worthwhile to find a psychiatrist who also maintains a therapy practice, as most health insurance companies treat visits to the psychiatrist as normal doctor’s visits. Visits to a therapist may be limited in certain states, and in many states, health insurance only allows people a maximum of 20 visits to a therapist a year, which may not be sufficient to address a chronic mental illness.
A psychiatrist can work in numerous settings. Some work in hospitals, mental health facilities or institutions for the criminally insane. Others maintain a private practice, and yet others consult with mental health facilities and maintain private practices. Psychiatrists can also work in research facilities, for pharmaceutical companies, or they may be part of investigative organizations like the police force.
Some psychiatrists specialize in criminal psychiatry and examine people accused of a crime to testify as to their fitness to stand trial or their mental health status during the commission of a crime. In criminal trials, you’ll also see private psychiatrists who testify for the defense, suggesting that a person cannot be held legally responsible for a crime because of mental illness. As part of criminal investigation, psychiatrists may also create profiles to help police narrow their field of suspects.
One of the principal jobs of this medical doctor in therapeutic settings is the diagnosis of mental illness and determining course of treatment. In other words, typically the psychiatrist diagnoses mental illness and prescribes drugs and/or other medical therapies thought most efficacious in treatment. Since certain medications may have unwanted side effects, and it can take a while to find the right treatment for each individual patient, psychiatrists continue to evaluate the patient until they are considered stabilized through medical therapies.
If you do have both a psychiatrist and a talk therapist, one of the most important things to look for is the willingness of both parties to communicate with each other. You should sign whatever medical releases are necessary so these two clinicians can work in concert with each other. Since many treatments for mental illness are primarily addressed by both talk or cognitive behavioral therapy and medication, clinicians with opposing opinions on treatment may create problems for the patient. It’s often beneficial to ask either your therapist or your psychiatrist for recommendations as to psychiatrists or therapists with whom they work frequently. Some therapy practices employ psychiatrists and therapists of different types, which can make communication between these practitioners easier to achieve.
When a psychiatrist actually utilizes talk therapy, it’s important to remember that there are many different philosophical approaches to the treatment of mental illness. Psychiatrists can be Jungians, Freudians, behaviorists, humanists, Gestalt therapists or fall into a category more loosely defined. You may want to ask your clinician what his/her approach to therapy is prior to beginning treatment to see if this is compatible with your own philosophies on achieving good mental health.
Written by Tricia Ellis-Christensen
