Psychiatric Assessment- Initial Psychiatric Assessment

This Tuesday coming up I have my Initial Psychiatric Assessment with a Psychiatrist, not a Community Mental Health Nurse, I believe. I've always asked to see a psychiatrist and have been on the waiting list for ages for this so it's even more of a really big deal. One of the things that I have is clinical depression- really severe. I have taken time out from studying so as to get treatment for my mental health illnesses so the time is ticking on this. I'm really scared though and don't respond well to interacting with people- I also have social anxiety disorder and sociophobia. I don't trust easily and I tend to keep myself to myself. I really don't know what to expect from this assessment or what is going to be asked etc, which is making me even more anxious because that's something I don't have any control over.

So has anyone here had any psychiatric assessments before with either a psychiatrist, community mental health nurse or similar other? I would be really grateful if people could share their experiences with me for this. What happened? What was the format like? Did you get asked loads of questions or did you have to fill out questionaires about your mental health or was there silence and you were expected to talk on your own accord? Was it recorded? Was there a tense beginning of a dreaded open-ended or really personal question at the beginning? Was there also a physical examination? How long did it last? I think that my assessment will last an hour but it could be 2 hours or more :s-smilie:

, I don't know. Were there any tears and tantrums?

How do you be open and let it all out without clamming up or under-estimating everything or shutting off and down from it? Because I don't want to muck this up. I really need to be able to get treatment for all of this and get healthy again. I need for understanding and support. I don't want to get fobbed off or disregarded or pushed to one side again. Because I don't know how much longer I can go on like this. :frown:

Reply 1

River85

First of all, don't worry, please don't worry.

A psychiatrist is a well trained professional. They should be aware and sensitive to your troubles. It should take place in a clean and comfortable room.

The psychiatrist will ask you questions relating to your mental health obviously.

First though you may need to give them a medical history, just a very brief one, of any chronic heath conditions you have. To know this information is very important for the diagnosis and treatment of your depression. I you don't have other chronic health conditios thn don't worry about it. You should also be asked what medicatons you take, when you started taking them etc.

If done correctly it should be a relatively lengthy discussion (it's hard to put a time frame on it, but at least 30 minutes). You shouldn't need to fill in any questionnaires as such, everything will be kept verbal. There may be exceptions to this though.

Edit no 2 - If you do clam up then the psychiatrist should give you some time to collect your thoughts. If you still can't answer then just let them know. They really will understand. Just be honet.

You will be asked a lot of questions. Don't get too hung up on the detail, just give as much informatio as you can. Always be honest though. These questions will usually revolve aroun your mental state. Obviouslly the doctor will need to know when you started getting depessed, were there any reasons for the depression (was it reactive - caused by an event). You'll be asked how severe your problems are and possibly if you have any suicidal thoughts. You'll also be asked if there's a history of mental illness in your familyand whether you abuse drugs or self harm.

At the end of the appoitment the psychiatirst will give you a diagnosis or, if there are complicating factors, ask you to come back for another appointment. A care/treatment plan can be offered depending on the severity of your illness, this will usually new or a change of medication, cognitive behavioural therapy, counselling and continued appoitnment with a psychiatrist and, eventually, if you start to revocer, close monitoring by your GP.

Don't get too worried. The psychiatrist will be sensitive to the fact that you're very nervous about his, particularly if you have social anxiety (as I do). THey should make every effort to make sure you are kept comfortable.

Take care.

Edit: - I can't say whether or not the assesmnt will be recorded or not. It shouldn't be, the psychiatrist will write donanything that he or she needs to. If it does get recorded, or somebody else need to be present during the assemsement,they will ask for your permission. This shouldn't happen though, so don't worry. If yo do feel s if you are being fobbed off or ignored (I know the feeling) you are entitled to ask for second opinion.

Reply 2

Prince Rhyus

It's a little bit like a counselling session more than anything else.

I've had a couple of these in the past with psychiatrists (medical doctors who specialise in psychiatric illnesses) and on both occasions it's an hour long conversation trying to examine both causes and symptoms of your condition before trying to find the most appropriate form of treatment - as well as some recommendations for lifestyle changes.

No physical examinations, no tape recordings, no questionnaires in my experience. They should have received all the information they needed from your GP who referred you to them.

All the best
PR

Reply 3

River85

Mind have a series of leaflets and brochures which may be of benefit to you, these leaflets concern community care

http://www.mind.org.uk/Information/Factsheets/#Community_care

This is a list of likely questions and issues that may be raised in your assement. Please don't get too worried by it though.

http://www.patient.co.uk/showdoc/40000061/

You have a right to have someone with you, a friend or relative, if that would make you more comfortable. I don't think many psychiatrists will disagree with that.

Edit: - The Royal College of Psychiatrists also has some information that may be useful to you

http://www.rcpsych.ac.uk/mentalhealthinformation/thementalhealthteam.aspx

I must stress what it says at the bottom though, each community mental heath team is different and have their own different resources. Still, that's something that we can come to later as it concerns treatment more than the assesment.

Also, to give you an idea about assesment time. My initial appointment with my psychiatrist was 30 minutes. This should be the minimum time it will last. For me, it wasn't long enough and I don't think my problems were properly highlighted. I was then able to get an assesment with a consultant psychiatrist and that lasted an hour. I've also had a psychological assesment done privately, with a clinical psychologist. That lasted two full half days! It really can vary.

The length of time will be proportionate to your problem, a doctor should never rush you.

Reply 4

Anonymous #2

Just ask you how you're feeling now, how long you've felt like that, if anything started it, can you sleep, eating habits, family background/health, questions basically about everything in your life. I was terrified the first time too but they know you're probably pretty scared and the psych will probably be able to tell you're not great at talking (I have social anxiety too) so will help you along when you get stuck or whatever. They're not too scary they're just trying to help you.

Reply 5

Anonymous #1

Has anyone here had to do an Initial Psychiatric/Mental Health Assessment twice because one was on the NHS but they couldn't help you so you had to have it down again privately, or for another reason? Because if so, how did you cope with it? I've got to go through it again- how exhausting/emotionally draining. :frown:

Reply 6

icedsarcasm

I've done the 'first appointment' a few times in my time (once privately, first, and then the NHS), and both were fairly similar. S/he'll probably ask you lots of questions and keep it very structured - they're not just going to go "talk about yourself", so you don't need to worry about not knowing what to say next. There will be questions about your physical health and any problems you've had or have with that, as well as your emotional health. Basically they'll want to take a very detailed history of you up to the point you walked into the room. Timing wise, the first time it lasted 2 hours, the second 1 hour, so plan for around that kind of time. Don't be disconcerted by the amount of notes they take.

And it's ok to cry, they always have tissues!

Reply 7

herbal bug

I did one, and they basically just talked to me to see what had happened.
it has to be detailed as they want to consider all the facts, which a GP doesnt necessairly have time for.

PM if you need anymore help love.

hope it goes well.
xxx

Reply 8

Laura25

Hi there, sorry you've got to have another one. I hate those things - I've lost count of the number of times I've had them, often with new people. I find the best way is to distance myself so I kinda dissocciate in order not to get too distressed, however I know that's probably not ideal! Take your time and try to remember that by getting through it you'll be able to get the help you need. I've had assessments both on the NHS and privately and I've usually found that the outcome of the private ones are best because they've got more resources. I wish you luck with it and PM me if you want to talk more about it. Take care x

Reply 9

kiddranc

They'll just tell you stuff that isn't even medically documented, and push their own personal beliefs as objective medical judgements.

And don't mind me, I've just had too many bad experiences with psychiatric practitioners.

Reply 10

Custer

kiddranc

They'll just tell you stuff that isn't even medically documented, and push their own personal beliefs as objective medical judgements.

Yes, psychiatry is a joke, they'll pump you with drugs that don't really work, numbing your entire existence, turning you into a glorified zombie. It is also likely, they'll tell you need medication for the rest of your life, so OP enjoy your existence as a prisoner, bound by the shackles of pseudo-science. :smile:

Reply 11

Laura25

Psychiatrists aren't that bad. Yeah sure there's some bad ones out there but some do help. Not all think drugs are the answer and there'll work with you to find out the best solution for you.

Reply 12

InnocentEyes

River85 gave you some seriously good advice OP.

I can give you a summary of my last psych assessment if it helps you. (this is with the CMHT)
It was about 50mins I think, there were two people in the room (the psychiatrist and another doctor taking notes) and they basically sat me down and offered tea and coffee :wink:

.
The questions basically involved a) a chronological story of my life including schooling, health, previous mental health problems and treatment, symptoms etc and b) similar but less in depth questions about my family.
There will probably be quite a few 'screening' questions which you really don't feel apply to you but don't worry they just need to cover all bases. It's not necessary to 'open up' as much as say in therapy because a lot of things have factual answers, but if you do clam up they'll rephrase or give you time.
At the end of the assessment they should give you their opinion on your current problems and needs, and begin to decide on what they can offer you to help.
Hope it goes ok.
xx

Reply 13

Maaudd

Write stuff down that you want help with and take any medication vitamins anything you take at the moment if they offer you a cpn day yes cos you can ask them for a social worker soooo hard to get one! They are not the police you aren't going to be sectioned unless you say your a danger to others look at this as a gift it gets you into the system a cushion in ten twenty yrs time I don'tThink it will be around keep all letters etc in folder and apply for benifits once your on the regester you can go to mind to get extra support it's a good thing relax they want to help if you got weight issues tell them you don't want medication that puts on weight singer Robbie Williams take a anti debredsant called brittox I can't remember correct spelling google Robbie Williams finds antidepressant no weight gain changed his life so you get correct spelling ps after 46 yrs going to mental health ppl take tissues cos when you realise they want to help you it all comes out just be happy we got this help nhs bloody marvellous x from a old gal