Persons who undergo a psychiatric assessment are evaluated by a psychiatrist for their mental and physical condition. This usually involves interviewing the person and often obtaining information from other sources such as other health and social care professionals, relatives, associates and psychiatric rating scales.
A mental status examination is carried out, and a physical examination is usually performed to establish or exclude other illnesses that may be contributing to the alleged psychiatric problems. A physical examination may also serve to identify any signs of self-harm; blood tests and medical imaging are performed. Like most medications, psychiatric medications can cause adverse effects in patients, and some require ongoing therapeutic drug monitoring, for instance full blood counts serum drug levels, renal function, liver function, and/or thyroid function. Electroconvulsive therapy (ECT) is sometimes administered for serious and disabling conditions, such as those unresponsive to medication. The efficacy and adverse effects of psychiatric drugs may vary from patient to patient.
For many years, controversy has surrounded the use of involuntary treatment and use of the term “lack of insight” in describing patients. In many cases, involuntary psychiatric treatment is permitted when there is deemed to be a risk to the patient or others due to the patient’s illness. Involuntary treatment refers to treatment that occurs based on the treating physician’s recommendations without requiring consent from the patient.
Outpatient treatment involves periodic visits to a psychiatrist for consultation in his or her office. Initial appointments, at which the psychiatrist conducts a psychiatric assessment or evaluation of the patient, are typically 20 to 25 minutes in length. Follow-up appointments are generally shorter in duration, i.e., 5 to 30 minutes, with a focus on making medication adjustments, reviewing potential medication interactions, considering the impact of other medical disorders on the patient’s mental and emotional functioning, and counseling patients regarding changes they might make to facilitate healing and remission of symptoms (e.g., exercise, cognitive therapy techniques, sleep hygiene—to name just a few). The frequency with which a psychiatrist sees people in treatment varies widely, from once a week to twice a year, depending on the type, severity and stability of each person’s condition, and depending on what the clinician and patient decide would be best.