What Is A Psychiatrist: Definition And Specializations
The field of mental health care relies on a range of different professionals with widely varying skills and areas of expertise. One such mental health provider is a psychiatrist, a medical doctor responsible for directing the treatment plans of individuals seeking care by providing diagnoses, prescribing medication, and performing other functions. To understand the job of psychiatrists, it may be helpful to look at what they do, where they work, and the different fields in which they specialize.
What is a psychiatrist?
Psychiatrists are medical doctors whose practice generally centers around the treatment of mental health disorders. As one of the few types of mental health professionals able to prescribe medication and diagnose mental health disorders, psychiatrists can play a key role in developing treatment plans for people seeking care. Below are some of the roles psychiatrists can take.
Psychiatrist definition: The different roles of psychiatrists
Psychiatrists may work in a variety of settings such as hospitals, community clinics, academic institutions, and research facilities, each providing unique opportunities to address mental health needs.
Primary mental health care provider who completed medical school and is seeing patients
In a clinical setting, psychiatrists can serve as the first point of contact for individuals seeking care for mental health concerns. Typically, a psychiatrist is consulted when a client has reason to believe they’re living with a mental health condition. Often, the individual has been referred to a psychiatrist by a primary care provider, their insurance company, or another healthcare professional. However, some clients may seek care from psychiatrists on their own.
When a client comes in for a consultation, the psychiatrist can provide screenings and assessments to evaluate them and determine whether a diagnosis is necessary. From there, they may direct the individual’s treatment plan, which might include medication, psychotherapy, and other modalities.
Medical doctors providing treatment for mental health conditions, like bipolar disorder
Medication management is often a modality used to treat mental disorders. After initially prescribing medication for an individual (if necessary), the psychiatrist may focus on evaluating its efficacy. This process often involves setting regular appointments to evaluate the individual’s progress and adjust the dosage or prescribe different psychiatric medications, if necessary. For individuals living with treatment-resistant conditions, psychiatrists may use other medical treatments, such as brain stimulation therapy, to alleviate symptoms.
The ability to prescribe medication is often cited as one of the significant differences between a psychiatrist and a psychologist. Psychologists typically cannot prescribe medications and must refer clients they believe would benefit from a prescription for a mental or behavioral issue to a psychiatrist. Some states give psychologists the authority to prescribe certain medications. However, not all psychologists in these states are licensed to do so. Conversely, while they can conduct talk therapy, psychiatrists may refer clients to psychologists or other therapists for that form of treatment.
In clinical practice, routine parts of the psychiatrist's job include gathering client details and keeping updated records of their medical history. These professionals can also help clients and their families cope with stress and crises, which may be directly related to the mental concern the individual is living with.
Researchers studying mental and behavioral disorders
The field of mental health relies on a thorough understanding of the symptoms, causes, and treatment of psychiatric disorders. Psychiatrists can utilize the expertise gained from their medical education and psychiatric training to facilitate this research. For example, professionals who conduct psychiatric research may evaluate the efficacy of medical treatments for behavioral disorders, study brain scans of people with depression, or identify links between sleep disruptions and anxiety.
What is a psychiatrist? Other roles which fall under the psychiatrist definition
Psychiatry career path: Medical school and training
According to the American Psychiatric Association, to become a psychiatrist, one must first complete medical school. A medical education separates psychiatrists from other types of mental health professionals, such as psychologists, who typically earn a PhD in clinical psychology. Doctors who decide to pursue psychiatry then typically spend at least four years in a residency training program. At the end of their psychiatry residency, they can apply to the American Board of Psychiatry and Neurology for certification as a psychiatrist. A few more years of subspecialty training may be required to specialize in a particular area of psychiatry.
Which mental health conditions and behavioral disorders can psychiatrists diagnose and provide treatment for? Bipolar disorder, anxiety, and more
Psychiatrists can treat a range of mental health-related challenges, including but not limited to the following:
- Anxiety
- Depression
- Bipolar disorder
- Neurodevelopmental disorders
- Personality disorders
- Sexual dysfunction
- Phobias
- Post-traumatic stress disorder (PTSD)
- Dementia and Alzheimer's disease
- Eating disorders, such as anorexia and bulimia
- Sleep disorders, such as insomnia
- Substance use disorders
- Psychotic disorders
- Dissociative disorders
- Elimination disorders
- Sleep-wake disorders
- Gender dysphoria
- Paraphilic disorders
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Psychiatry work environments and interacting with patients
Psychiatrists can work in the public sector, delivering psychiatric services to individuals, couples, families, and groups in face-to-face or remote formats. Examples of settings in which psychiatrists commonly work include:
- Psychiatric hospitals
- Clinics
- Non-public practice
- Businesses
- Justice systems
- Nursing homes
- General hospitals
- Emergency rooms
- Military settings
Areas of specialization within psychiatry
Following general psychiatry training, psychiatrists can pursue further training and certification in a particular area of research or clinical practice. The following are specializations that psychiatrists may pursue.
Addiction and substance use psychiatry
Addiction psychiatry helps individuals manage addiction-related mental health concerns, such as substance use disorders and behavioral addictions. An addiction psychiatrist may treat clients individually or in groups. They may also work with the individual's family to come up with a supportive rehabilitation framework. Addiction psychiatrists often work in rehabilitation facilities, though they may provide care in various other public settings.
Child and adolescent psychiatry
Also called pediatric psychiatry, child and adolescent psychiatry is a branch of medicine focused on treating children and teenagers with mental health concerns. Common challenges child and adolescent psychiatrists address include learning disabilities, changing moods, anxiety disorders, eating disorders, substance use disorders, and neurodevelopmental disorders.
Consultation-liaison psychiatry
Providers who treat physical illnesses may not address potential comorbid mental health concerns. Because psychiatrists are trained to address mental and medical illnesses, they can work with care teams to provide more comprehensive treatment. Specialists in consultation-liaison psychiatry can help providers in various contexts, including primary care, emergency departments, or clinics. For example, a psychiatrist may be consulted to alleviate depression symptoms in individuals recovering from heart surgery.
Geriatric psychiatry
A professional who specializes in geriatric psychiatry treats mental health concerns that can arise as a result of aging. Among these complications may be sleep disorders, depression, late-onset substance use disorder, and dementia. A geriatric psychiatrist may also address the emotional challenges that can accompany aging, which may be related to loneliness, physical health concerns, or cognitive impairment.
Improvements in life expectancy mean developing countries may now have larger aging populations than in past generations. This change has led to the projection of a vast increase in the demand for geriatric psychiatrists in the future. Already, numerous job opportunities are available for geriatric psychiatrists in assisted living facilities, nursing homes, and personal practices.
Forensic (legal) psychiatry
Forensic psychiatry involves working within the court system and with government agencies to evaluate the mental health of witnesses, suspects, and inmates. Forensic psychiatrists are often called upon to conduct assessments of inmates seeking probation and help determine whether their release is prudent.
Forensic psychiatrists are also often used as expert witnesses in criminal cases, responsible for helping decide whether someone is competent to stand trial or provide evidence. They may also help describe a suspect's mental state when they committed an offense.
In civil cases, the forensic psychiatrist's job may involve assessing the extent of medical health injuries and deciding on mental competency for guardianship. The field of forensic psychiatry has led to the development of further specializations, including:
Adolescent forensic psychiatry
Forensic learning disability psychiatry
Forensic psychotherapy
Biological psychiatry
Biological psychiatry, or biopsychiatry, deals with the physical basis of mental disorders, focusing on the nervous system and brain chemistry. As such, these psychologists may not use psychotherapy, instead addressing a client's mental disorder with medical treatment or physical approaches, such as light therapy, electrical brain stimulation, exercise, and nutritional counseling. Conditions that biological psychiatrists treat can include psychotic disorders, such as schizophrenia, bipolar disorder, depression, attention-deficit hyperactivity disorder (ADHD), eating disorders, and substance use disorders.
Organizational and occupational psychiatrists
This form of psychiatry is typically concerned with the mental state an individual brings to the workplace—and the effect the workplace has on the individual’s mental health. Organizational and occupational psychiatrists may assess and treat employees for work-related stress and its manifestations, such as hypertension. These professionals may also be asked to determine the mental health of a potential hire or an employee in line for a promotion. Other responsibilities may include performing assessments for disability insurance benefits and contributing to company policy and procedure development.
Sleep medicine psychiatry
Sleep medicine has evolved as an area of specialization within several branches of medicine, including psychiatry. This form involves diagnosing and treating sleep disorders like insomnia, restless leg syndrome, narcolepsy, and obstructive sleep apnea. Psychiatrists who practice sleep medicine may look at the amount and quality of a client's sleep and how this amount affects their mental health and ability to function in daily life.
Emergency psychiatry
This area of specialization involves psychiatrists working in various settings, including the emergency rooms of hospitals. One challenge for emergency psychiatrists is working with clients in immediate and severe danger due to their mental state.
Emergency psychiatrists are often called upon in cases of acute withdrawal symptoms in someone with an addiction. They may also address situations in which an individual is experiencing extreme intoxication or medical complications due to their mental health. Unlike some other psychiatrists, who can build relationships with their clients over time, emergency psychiatrists may always be treating new clients with acute mental health episodes.
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