Depression

Psychiatrists and other mental health professionals

Psychiatrists

People can get to see a psychiatrist through a referral from their GP, or if they are in hospital. Common complaints about getting a psychiatrist were that GPs were reluctant to refer and people had to wait too long to see a psychiatrist when distressed. One woman said she felt fortunate that her GP knew his limitations and so referred her to a psychiatrist. People who are thought to be a danger to themselves or others should be able to get an urgent referral to psychiatric care.

All psychiatrists can make diagnoses about mental health conditions and prescribe medication. A number of people felt that psychiatrists were very good at selecting and adjusting medication. For example, one man believed that he would not have got through his severe depression without a psychiatrist who had the skill and authority to prescribe the right 'mind bending drugs.' However, another was convinced that her psychiatrists only prescribed drugs that were heavily promoted by drug companies.

Experiences of psychiatrists were mixed. Some were anxious about the referral, but were relieved when the psychiatrist turned out to be human and took their problem seriously. Many psychiatrists were described in positive terms e.g. 'eminent', 'very down to earth… so it was easy to be real', 'we get on like a house on fire', or 'very gentle, very sympathetic'. And an advantage of the authority of psychiatrists was that they had the clout to rule-out conditions that people did not have, or classify a condition as due to a chemical imbalance, meaning the patient did not feel they were at fault.

Some psychiatrists are helpful in allowing people to talk through issues. One man in his 70s was relieved when his psychiatrist showed a real understanding of how he felt.

 

A number of psychiatrists are also trained to provide talking therapies. Those who found a psychiatrist they liked in the NHS were sometimes frustrated that they seemed to see a different psychiatrist every time. They emphasised the need to build up rapport and trust over time with psychiatrists. One woman managed to convince her mental health team that because her condition was severe and ongoing, she should have only one psychiatrist.

A number of psychiatrists were described as aloof, pompous and judgemental, and people felt they had to fight to be heard. The advice for those with such doctors was to write down things you want to say, take a friend along, argue your case if you can, and/or keep diaries of medication and suspected effects.

Criticisms of psychiatrists also included that they jumped to inappropriate conclusions, or gave advice based on non-therapy training and 'homespun wisdom.' One organised and rational woman (who had experience of running a large department at work) said her mental health team were disorganised and her psychiatrist “wet”. She reported obtaining her medical notes after she had made complaints about her hospital treatment (which the NHS later apologised for). She found that a psychiatrist had labelled her as having a personality disorder because 'she thinks the NHS is against her.' Another person said his 'faith in psychiatrists went zooming out the window' when one told him his hair loss was due to stress, when in actual fact it was due to the lithium he was on. Some people did not want to talk about uncomfortable issues with psychiatrists: for example one woman acknowledged that she had been reluctant to admit how her childhood had affected her life.

Other professionals & mental health teams

A range of non-medical professionals are involved in mental health care. For instance, clinical psychologists, community psychiatric nurses (CPNs), occupational therapists and social workers. Some of these professionals can help support people in the community, particularly through difficult periods of their illness when problems might occur. Some people have a community mental health team supporting them, and if so, they will have a key worker (any member of the team) who coordinates the services they need (for more information see Mind's factsheet - Community-based mental health and social care in England). The help of mental health professionals and teams was invaluable to some, particularly those with less social support.

Mental health professionals help people to complete tasks, act as go-betweens with psychiatrists, help with medication, talk through problems with clients, educate clients and carers, and help sort out practical issues. One woman had a CPN who helped her when she developed panic attacks after leaving hospital and had to live in the community again. However, a few were dissatisfied at times when the services of professionals did not meet their needs.

Last reviewed April 2015.

Last updated October 2012.

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