The Mental Health Puzzle – Making Sense of Who to See and Why!

It’s important to make sense of who all our very important players are when it comes to mental health.

Psychologists, Psychotherapists, Psychiatrists and Nurse Practitioners.

Many people are confused about the different mental health providers and their roles. Some make the error of thinking that one type of provider is “better” than another. The reality is that mental health is a puzzle and the solution is different for different people. In some situations it may be best to work with a psychotherapist, in others a psychiatrist may be better, in another it may be a nurse practioner and psychotherapist team, etc.

But first some definitions:

PSYCHOLOGIST – is someone with a degree in psychology, this degree can be a bachelors, masters, or doctorate level. Sometimes a psychologist with a PhD will use the title “doctor” to emphasize they have completed the highest level of education for this work.

PSYCHOTHERAPIST – this can encompass many different types of degrees, but is typically used by people with a master’s level degree in social work or counseling. A PhD psychologist or a psychiatrist may also refer to themselves as a psychotherapist.

PSYCHIATRIST – is someone who has completed 4 years of medical school and 4 years of residency in adult psychiatry. They can prescribe medications and offer psychotherapy. Many psychiatrists are “board-certified” meaning that they have completed a high level of examination by the American Board of Neurology and Psychiatry.

NURSE PRACTITIONER – more and more often NPs are providing mental health care, often prescribing medications when a psychiatrist is not available. An NP is largely independent, but will have a supervising MD who helps supervise her clinical work. Some NPs undergo specialty training in psychiatry.

How do you know which provider(s) are best for you?

This is a difficult question because it is different for everyone. If you need medication, you will need a psychiatrist or an NP. If you want therapy, there are many different options. Sometimes it makes sense to do therapy with your psychiatrist, especially if your medications are complicated. In other cases, you may want to see a therapist that has specialty training in your issue. You may want to work with a psychologist if you need certain kinds of assessment or testing that only psychologists are certified to perform. If cost is an issue, you may want to find a therapist that is in your insurance network or who has sliding scale fees.

So how do I figure out the pieces of the puzzle?

The first step is to have a consultation visit with either a psychiatrist or a psychotherapist. They are BOTH skilled in assessment and if they think you need a service they do not provide, they will refer you to the appropriate provider. If you are already taking medication, you may want to start with a psychiatrist assessment since they will be able to prescribe for you.

What happens if I need or want more than one type of provider?

This is very common and sometimes the TEAM approach is a very powerful tool for your mental health. Make sure that your providers have a good communication system to discuss your care, and make sure you sign release forms for each of them to talk with each other.

The key here is to understand that all of these professions are very important and they all play a very important role solving our mental health issues.

Do you have a question about one of these professions or who you feel you should see first?

Here’s to Your Mental Health,
Dr. Jennie Byrne

Author
Dr. Jennie Byrne, M.D., PhD. With over 15 years of medical expertise, Jennie Byrne, MD, PhD, is a board-certified psychiatrist with experience treating mental health conditions in adults, including dementia, attention-deficit hyperactivity disorder, anxiety, and depression. After practicing in New York City for 12 years, Dr. Byrne relocated to North Carolina in 2008; she currently cares for patients in Chapel Hill, North Carolina, at Cognitive Psychiatry of Chapel Hill. Dr. Byrne earned her bachelor’s degree at the University of Pennsylvania in Philadelphia. She then received her doctorate from New York University Department of Neurophysiology. She also has a doctorate of medicine from New York University School of Medicine. Dr. Byrne went on to complete a psychiatry residency at Mt. Sinai School of Medicine in New York. In addition to her work as a psychiatrist, Dr. Byrne has performed extensive research on attention, memory, and depression. As a board-certified adult psychiatrist, Dr. Byrne focuses on the needs of each patient to pro

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