Psychiatry Assessments / Medication
What can a Psychiatrist help with?
A Psychiatrist is a medical doctor who has additional expertise in mental health. Due to their training and qualifications, they have expert understanding of the interaction between physical and mental health. They are skilled in the assessment of both physical and mental symptoms, making diagnoses and formulating treatment and management plans. As part of their work, they can offer advice about the management of a mental health condition and prescribe medications (if indicated).
Our Psychiatrists can provide expert assessment for both children and adults, identifying and diagnosing the following difficulties (geographical variance in services may apply).
Mental health problems (e.g. depression, anxiety)
Autistic Spectrum Disorder (team diagnosis approach)
What does an assessment involve?
Assessments usually take up to 1.5 hours. The assessment will comprise of a combination of screening questionnaires and discussions with the client (parents will be involved in this process if the client is a child). The Psychiatrist will ask questions about the nature of the difficulties, the severity of difficulties and how they have developed over time. The Psychiatrist will also take a developmental history and explore the presence of any physical health difficulties. You will be provided feedback during the assessment and, following the assessment, you will receive a written summary report confirming the psychiatrist's professional opinion and recommendations.
How does the prescribing of medication work?
If medication is determined as an outcome of an assessment, it will usually be necessary for the client to be prescribed this privately as NHS services do not usually agree to take over prescribing in the first instance following a private assessment. In order to issue prescriptions, the Psychiatrist at Purple House will need to carry out medication review appointments to check the client’s progress (and for ADHD to measure height, weight and blood pressure). If there are no other issues, these appointments last no more than 30 minutes. The Psychiatrist will “titrate” the dose (gradually increase it depending on how it is helping and any side effects). Medication review appointments are usually every 4 weeks. Further to the cost of our appointments, you will need to pay for the cost of the medication at the chemist (approximately £25-30). You may also have to pay the chemist’s dispensing charges. If the client commences medication on a private prescription, the GP may agree to take over the prescribing under ‘shared care’ once the client is stabilised (or agree to make a referral to an NHS psychiatry service). ‘Shared care’ means that the GP would issue NHS prescriptions on repeat as long as the person continues to see a psychiatrist and being monitored. You may want to ask your GP about this possibility prior to commencing assessment/ treatment with Purple House if you are concerned about the cost of private prescribing.
When should I see a Psychiatrist rather than a Psychologist?
In most instances, we would recommend undergoing an assessment from one of our Psychologists first. Instances where we would recommend a psychiatry assessment is sought as the first point of contact with our service would include:-
ADHD assessments / medication- Psychiatrists have particular expertise in being able to consider physical conditions and symptoms alongside mental health presentations. They are also able to prescribe medications. Thus Psychiatrists are often the ideal choice of professional to assess, diagnose and provide treatment for ADHD. In some instances, we may recommend that one of our Clinical or Educational Psychologists be involved alongside the Psychiatrist, for example, if there were queries relating to the presence of other certain difficulties.
Mental health problems (certain instances) - when medication has already been identified as the preferred option for treatment or if a mental health assessment is required (for example, to confirm the absence of or the presence of a particular condition).
A Psychiatrist's assessment would comprise of a symptom-based/diagnostic approach and result in a mental health diagnosis with reference to recognised diagnostic criteria. A Psychiatrist's intervention would comprise medication and advice about management of the condition such as lifestyle changes.
In comparison, a Psychologist's assessment would identify the presenting issues, the severity of the difficulties and take in-depth consideration to the various factors contributing to the presentation (including life events). A Psychologist's course of treatment would comprise psychological therapy and/or other psycho-social interventions (e.g. parenting help for child clients). They would be able to identify when a pharmacological treatment might be helpful and be able to cross-refer to a psychiatrist.