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Guest Article

What to expect in a psychiatric evaluation?

By: Vanessa Padilla, MD and Lujain Alhajji, MD

UM Department of Clinical Psychiatry and Behavioral Sciences

Psychiatrists are medical doctors trained and equipped to assess the physical and mental health effects of psychological problems that may affect daily life functioning. Psychiatrists specialize in treating mental, emotional, and behavioral health conditions, including depression, anxiety, obsessive-compulsive disorder, post-traumatic stress disorder, schizophrenia, bipolar disorder, and substance use disorders. Psychiatrists provide psychological support and, when indicated, prescribe medications for any temporary or chronic mental health problem, which may be caused or precipitated by relationship, financial, or medical hardships.  

The first step in booking the appointment can be the most challenging, as it takes strength and courage. It is not uncommon to experience fear, anxiety, awkwardness, or apprehension before the first psychiatry appointment. It is helpful to remember that the psychiatrist is there to listen and help you. 

To receive the most benefit from the evaluation, you must arrive on time for the appointment. It is essential to clarify the appointment details in advance, such as date, time, length of appointment, location, and payment or insurance details. Nowadays, the appointment can be conducted either in person at a behavioral health clinic or via telemedicine. If your appointment is via telehealth, you may need to download an application on your phone or computer and check in online. It is vital to connect from a safe, private space and keep your video and audio on during the complete evaluation. Do not connect to a remote medical visit while driving or if you are busy.  

It is helpful to bring a list of your medications, supplements, vitamins (doses, periods, side effects), and any relevant past medical and psychiatric records during your psychiatry appointments. If you feel that you may forget to mention an ongoing issue or symptom, you may consider writing down your concerns on a list to show to your psychiatrist.  

In the initial appointment, the psychiatrist will greet you, build rapport, and ask you about the circumstances leading to the referral. This appointment can last from 30-90 minutes. The focus of the evaluation will be to inquire about your thoughts, feelings, behaviors, and physical health. The psychiatrist will obtain a detailed history by asking you questions about your past medical, psychiatric, family, and social histories. These questions help the psychiatrist obtain a wholesome "biopsychosocial" understanding of your past life experiences, family dynamics, relationships, medical issues, and culture. It is okay to cry or express any emotions felt when discussing difficult or complex topics. The information shared during the psychiatry appointment is confidential and protected under federal law, unless there is an imminent serious risk of harm to yourself or others. 

Sometimes patients are asked to complete questionnaires before the appointment or during the check-in process to screen for common mental health symptoms. The results of the questionnaires are discussed with you during the appointment. Some of these questionnaires may need to be completed again during follow-up appointments to monitor and track your symptoms.  

Collaborative shared decision-making is encouraged for you to be actively involved in the treatment goals. Towards the end of the evaluation, the psychiatrist will collaborate with you to create an individualized treatment plan. The treatment plan frequently includes ordering laboratory tests or brain imaging and providing a referral to social and other medical services, psychotherapy (talk therapy), or medication management.  

At the end of the initial evaluation, the psychiatrist in communication with you will determine further follow-up based on your condition. The follow-up appointments are usually shorter at 15-35 minutes. With your permission, the psychiatrist may be interested in contacting a member of your family, loved ones, or social worker to gain a different perspective and provide information for support and coordination of care.  

In a transparent, safe environment and with a non-judgmental approach, psychiatrists can help with any inquiries related to your mental health needs. You are encouraged to ask your psychiatrist questions about your mental health, including diagnosis (if any), treatment plan, educational information, self-care tips, and what to do in an emergency.  

Emotional healing takes time, and it is essential to feel comfortable and trusting in your psychiatrist. Being honest and open, being prepared for realistic expectations, and developing professional rapport with your psychiatrist, can be the start of the rewarding journey of your recovery. 

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