What Does a Psychiatrist Do?
What is a psychiatrist?
A psychiatrist is a medical doctor, either an MD or a DO, who specializes in diagnosing and treating mental illness, evaluating symptoms, prescribing medication when it is clinically appropriate, and following treatment over time.
The U.S. Bureau of Labor Statistics describes psychiatrists as primary mental health physicians who diagnose and treat mental illnesses. A psychiatrist may provide psychotherapy and may prescribe medication. The National Institute of Mental Health says treatment for mental illnesses usually includes therapy, medication, or a combination of the two.
What does a psychiatrist do on the first visit?
On the first visit a psychiatrist does a full psychiatric evaluation, which is a structured conversation about what brought you in, your history and your safety.
At PsychBright the first psychiatric evaluation typically takes 45 to 60 minutes. It covers what brought you in and how it affects your work, relationships and daily life, your mental health history and past diagnoses, your current symptoms and how long you have had them, your medical history and medications now and before, previous treatment and what helped, family history, alcohol, tobacco and drug use, your work, relationships and living situation, and safety.
The first psychiatry appointment covers the whole history for a reason. The Merck Manual notes that focusing only on presenting symptoms can lead to an incorrect diagnosis and the wrong treatment, and gives the example that a past manic episode changes the diagnosis in someone who comes in with depression.
The evaluation also includes a mental status exam, which looks at appearance, speech, mood, thinking, attention and memory through observation and questions. At PsychBright, where care is by video, it is done through conversation, not a physical examination. In general, tests are sometimes ordered, depending on the person.
What does a psychiatrist do after the first visit?
After the first visit, a psychiatrist may continue care through medication management, which means prescribing a medication, checking whether it is working, watching for side effects and adjusting it over time.
At PsychBright, medication management follow-up appointments are usually 15 to 30 minutes. The National Institute of Mental Health says medications affect people in different ways and it may take several tries to find the one that works best with the fewest side effects, and that antidepressants usually take 4 to 8 weeks to work.
At PsychBright, nothing is prescribed automatically. Medication is part of a plan only if it is clinically appropriate after the full evaluation. The National Institute of Mental Health says not to stop a prescribed medication without the help of a health care provider, even if you are feeling better.
Can a psychiatrist prescribe medication?
Yes, a psychiatrist can prescribe medication, because a psychiatrist is a licensed physician and physicians prescribe.
The National Institute of Mental Health covers several classes of mental health medication, including antidepressants, anti-anxiety medications, antipsychotics and mood stabilizers.
Not every mental health professional can prescribe. The California Board of Psychology states that California psychologists cannot prescribe medication under Section 2904 of the Business and Professions Code. Psychiatric nurse practitioners can prescribe. In California, according to the California Board of Registered Nursing, nurse practitioners traditionally prescribe under standardized procedures with physician supervision, and two newer optional categories, 103 and 104 NPs, may practice without them.
Do psychiatrists go to medical school?
Yes, a psychiatrist is a physician who has finished medical school, and in the United States that degree is an MD or a DO.
According to the U.S. Bureau of Labor Statistics, the usual path is a bachelor’s degree, then four years of medical school. After that comes a psychiatry residency, which the Accreditation Council for Graduate Medical Education requires to be 48 months long. The Bureau of Labor Statistics notes that every state requires physicians to be licensed. The Medical Board of California says physicians who treat patients located in California by telehealth must be licensed in California.
The Bureau of Labor Statistics says board certification is not required. It means completing an approved training program and passing an evaluation from a specialty board, such as the American Board of Psychiatry and Neurology or the American Osteopathic Board of Neurology and Psychiatry.
What is the difference between a psychiatrist and a psychologist?
A psychiatrist is a medical doctor who can prescribe medication, while a California psychologist is licensed on a doctoral degree in psychology or a related field, not a medical degree, and cannot prescribe, according to the California Board of Psychology.
| Psychiatrist | Psychologist | Psychiatric nurse practitioner | |
|---|---|---|---|
| Medical degree | Yes (MD or DO) | No; a doctoral degree in psychology or a related field (California Board of Psychology) | No; a registered nurse with a graduate psychiatric nurse practitioner degree |
| Can prescribe in California | Yes | No (California Board of Psychology) | Yes; traditionally under standardized procedures with physician supervision, while 103 and 104 NPs may practice without them (Board of Registered Nursing) |
| California licensing body | Medical Board of California (Osteopathic Medical Board of California for DOs) | California Board of Psychology | California Board of Registered Nursing |
For a fuller comparison, read the difference between a psychiatrist, psychologist and therapist.
When should you see a psychiatrist?
A psychiatrist is one option when symptoms are affecting your daily life, and the National Institute of Mental Health says to seek professional help when severe symptoms have lasted two weeks or more.
The National Institute of Mental Health frames the decision by impact and duration. For mild symptoms lasting less than two weeks it suggests self-care, and a health care provider if that does not help or symptoms worsen. Severe symptoms for two weeks or more include feeling sad, tearful or hopeless, irritable, worthless or guilty, or tired or low on energy, losing interest, having difficulty concentrating or making simple decisions, having trouble completing tasks, and changes in appetite, weight, sleep or sex drive. For those, it says to seek professional help. This is a framing, not a checklist, and it cannot tell you what you have.
A primary care provider can screen you and refer you to a mental health professional. At PsychBright you can also book directly, and the intake team checks whether your plan needs a referral.
If you are having thoughts of suicide or urges to hurt yourself, call or text 988. In a life-threatening situation, call 911.
How do you check a psychiatrist’s license in California?
You can check a California physician’s license on the Department of Consumer Affairs License Search at search.dca.ca.gov.
The Medical Board of California publishes physician profiles there, and a profile may include administrative actions the Board has posted. If your physician is an osteopathic doctor (DO), contact the Osteopathic Medical Board of California.
Who will I see at PsychBright?
At PsychBright you see a member of a psychiatrist-led team that includes board-certified psychiatrists and experienced psychiatric mental health nurse practitioners who provide care with ongoing psychiatrist supervision and clinical oversight.
You are told who you are booked with before the appointment. Care is by secure video, anywhere in California, for adults 18 and older, through telepsychiatry. New patients are usually seen within five business days (same-week availability). Insurance is verified before the first visit, and Medicare and Medicare Advantage are accepted (see insurance). Several clinicians are bilingual.
The practice treats adults for conditions including anxiety disorders, depressive disorders and ADHD, as well as OCD, PTSD, bipolar disorder and sleep disorders. To get started, call (213) 584-2331.
Frequently asked questions
What can a psychiatrist do that a psychologist cannot?
A psychiatrist can prescribe medication. In California, psychologists cannot prescribe, according to the California Board of Psychology.
In what states can psychologists prescribe medication?
Not in California. The California Board of Psychology states that California psychologists cannot prescribe medication under Section 2904 of the Business and Professions Code. This page does not cover other states.
What questions does a psychiatrist ask on the first visit?
The Merck Manual describes the interview as starting with what prompted the visit and how far your symptoms interfere with your work, relationships and social life. After that comes your history, including past psychiatric history, medical history, current and past medications, previous treatment, family history, and safety.
How long is a typical session with a psychiatrist?
At PsychBright, the first evaluation typically takes 45 to 60 minutes, and follow-up appointments are usually 15 to 30 minutes. Other practices may differ.
How do I prepare for seeing a psychiatrist?
Bring a list of your current medications, including over-the-counter products and supplements, and the issues you want to discuss.
What are good questions to ask a psychiatrist?
The National Institute of Mental Health suggests asking: What experience do you have treating someone with my issue? How do you usually treat someone with my issue? How long do you expect treatment to last? Do you accept my insurance? How much will treatment cost?
What should I do in a mental health crisis?
Call or text 988, the Suicide and Crisis Lifeline, which is 24-hour and confidential. In a life-threatening situation, call 911.