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Choosing a Psychiatrist

Choosing a Psychiatrist

A psychiatrist is a medical physician who specializes in the diagnosis, treatment, and prevention of mental illnesses, including substance abuse and addiction. Psychiatrists are uniquely qualified to assess both the mental and physical aspects of psychological disturbance. Their medical education has given them a full working knowledge of the many causes for a patient’s feelings and symptoms. Armed with this understanding, psychiatrists can make a complete, accurate diagnosis and then recommend or provide treatment.

Warning Signs of Mental Illness

• Marked personality change
• Inability to cope with problems and daily activities
• Strange ideas or delusions
• Excessive anxiety
• Prolonged feelings of sadness
• Marked changes in eating or sleeping patterns
• Thinking or talking about suicide
• Extreme highs and lows
• Abuse of alcohol or drugs
• Excessive anger, hostility
• Violent behavior
• Irrational fears

If you notice any one of these symptoms, you should seek a psychiatric evaluation. If you need help right away, you should seek immediate treatment from a hospital emergency room. Also, many psychiatrists will make themselves available to handle emergency cases.

Where Do I Start?

You can begin with your own physician. Tell your doctor what you are feeling. If, after a thorough physical examination to check whether any other medical illnesses may be contributing to your symptoms, the doctor recommends psychiatric treatment, ask for the names of two or three psychiatrists. You should also request a copy of your medical records for the psychiatrist to examine. Your local medical or psychiatric society, community mental health center, and medical school are also good sources for referrals to psychiatrists. Of course, you might also seek the advice of family, friends, colleagues, or members of your church.

Will My Insurance Pay for Treatment?

Check your health insurance for its coverage of treatment for mental and emotional disorders. All health insurance policies should include nondiscriminatory coverage for mental illness treatment. Unfortunately, many do not. Some important questions to ask in evaluating your health plan include:

• Does it provide the same coverage for mental illnesses that it does for other medical illnesses?
• Does it pay for all medically necessary services and treatments?
• Does it permit you to appeal an insurance company’s decision that your treatment is not medically necessary?
• Can you see a psychiatrist of your choice without first seeing a general care "gatekeeper"?

Your health insurance plan should allow you to choose your own psychiatrist, even one who is "outside the plan" (although you probably will have to pay a larger portion of the cost yourself). Another option to consider, if your psychiatrist is not a participating physician in your health plan, is to ask whether he or she would be willing (or is allowed) to join your health plan’s panel of physicians. Finally, many employers offer several health care options, and you may be able to switch to coverage that allows for greater flexibility in psychiatric treatment.

What Treatments Do Psychiatrists Use?

Today psychiatrists can select from many effective treatments and will work with you to create an effective program. Psychotherapy is a systematic method of treatment in which you and the psychiatrist meet at regularly scheduled intervals to discuss troubling problems and feelings. Various forms of psychotherapy can help patients change behaviors or thought patterns, explore the effect of past relationships and experiences on present behaviors, or treat troubled relationships.

Because psychiatrists are medical doctors, they can also determine whether there is a need for medication to help restore imbalances in body chemistry that are often a large part of mental illnesses. Beware of any psychiatrist or other therapist who espouses one brand of treatment as the only one that works. As with any other physician, ask about the benefits and risks of the treatment program outlined by the psychiatrist.

The Initial Visit

When you visit the psychiatrist, the doctor will ask questions about your background, family, habits, and general health and will ask why you think you need treatment. The psychiatrist will want to know when you last had a complete physical examination, may ask to see your medical records, and may ask your permission to consult with your personal physician. The psychiatrist knows how to interpret laboratory results and other findings of the physical examination.

You should feel free to ask questions about fees, appointment flexibility, cancelation policy, and insurance form processing. When you’ve found a psychiatrist with whom you are comfortable, you’ve finished the first part of the treatment process. The second part—working together with your psychiatrist to understand and manage your illness—is about to begin.

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