Making the most of a visit to a psychiatrist

Psychiatrists are doctors with specialist training in mental health conditions that need secondary care inputs. You will usually have been referred to a psychiatrist by a GP from your local GP practice but it may have been by others such as counsellors or nurses working for the practice.

Psychiatrists are doctors with specialist training in mental health conditions that need secondary care inputs. You will usually have been referred to a psychiatrist by a GP from your local GP practice but it may have been by others such as counsellors or nurses working for the practice.

The Royal College of General Practitioners (RCGP) has put advice on web to help autistic people get the best help when visiting the GP practice (under drop down section – Resources and Guidance for patients and carers).

At present there is not a similar web resource for visiting mental health services including going to see a psychiatrist. This blog aims to give some general advice.

If you are referred to a psychiatrist it is worth checking if the service has its own webpage with more specific information about the service and what to expect.

If you are going to see a psychiatrist and have time to prepare in advance here are some things that you might find useful to know:

Psychiatrists will generally have a fixed amount of time for the appointment slot. They will use this to do an assessment with you and seek to agree next steps with you. They should be able to tell you how long the session will last at the beginning.

Depending on why you have been referred to a psychiatrist they will have often limited information about you and will need to ask a lot of questions about you.

At a first appointment these will usually cover your life story and your current circumstances in order to try to identify what is normal for you and what might be the issues that they can help with. 

Some/many may not be relevant to your life story but they don’t know that unless they ask. If a question doesn’t apply to you then say that. Similarly if you don’t know or can’t remember the answer to any question then say that. If you don’t understand a question ask them to explain it again or differently. The best way to help a psychiatrist to reach the best quality opinion on which to give advice is to be open and honest with them.

If the psychiatrist and the service know that you are autistic then they should try to make reasonable adjustments for you.

Reasonable adjustments differ from one autistic person to another and so it helps if any adjustments that you know help you are put into the referral to the psychiatrist. This gives them the best chance to see what can be done to help with your appointment.

People including Psychiatrists can generally read quicker than they can listen (especially if it is typed). As psychiatrists have to ask a lot of questions it can lead to information overload and processing issues for some autistic people. This can mean that key information can be accidentally  missed as well as additional stress and distress.

Many people find it useful to write down key information in advance. In general filling in the hospital passport can be useful especially if the clinic doesn’t use their own pre assessment questionnaire. This can be given to the psychiatrist to read at the start of the interview or you can use it to help you remember to say what is important for you.

The psychiatrist might be able to give you a clear opinion and advice/recommendations at that appointment. Sometimes they might need to consult with others in the service or get more information from other sources. In each appointment they should be able to at least explain to you their current opinion and discuss with you their proposed next steps.

You should receive a copy of any letter they write about you unless you choose to refuse to be sent a copy. The letter should confirm what has been discussed and next steps and gives you the chance to check that it is a reasonably accurate summary.

If you are unclear about any questions or about any advice or recommendations please ask them to explain it differently to you so that you can get best benefit from the appointment.
Sometimes you may not agree with their opinion or their advice or recommendations. If this is the case please say so at the time and see if agreement can be reached. Sometimes despite all best efforts agreement can’t be reached and if this is the case the disagreement and reasons for it should be recorded.

Many people can get anxious in case the psychiatrist recommends admission to hospital or recommends that people are detained against their will.  These are very rare events compared to the numbers seen in clinic and it is extremely rare that any psychiatrists can admit someone to hospital without having to gain agreement from other professionals.

The best way of avoiding being admitted to hospital is to address any issues before they reach that stage and that is what psychiatrists (and other health and social care  professionals) prefer to help people to do.