A Comprehensive Guide to Psychiatric Evaluations
Discover the significance of psychiatric evaluations in mental health treatment. Learn about types of assessment, their importance, and how to prepare.
Table of Contents
What is Psychiatric Evaluation?
What Happens In a Psychiatric Evaluation?
During a psychiatric evaluation, the clinician gathers information through various methods, such as interviews, questionnaires, and standardized assessments. They explore the individual’s personal history, family history, current symptoms, and relevant life events.
The evaluation may also involve collaborating with other healthcare professionals, family members, or caregivers to gain a broader perspective on the person’s mental health.
Purpose of a Psychiatric Evaluation
A psychiatric evaluation aims to:
- Assess a person’s mental health status
- Rule out other physical conditions that might be causing the symptoms
- Diagnose a mental disorder and confirm if the individual needs psychiatric treatment
- Develop a treatment plan for a mental disorder
- Make changes in the previous treatment plan (in case of past evaluations)
- Identify long-term problems that might emerge in the future
- Determine whether a person is competent to make decisions about their care
- Assess a person’s risk of harm to themselves or others
- Provide expert testimony in a legal matter
The Growing Need for Psychiatric Evaluation in the United States
- In 2020, 21% of U.S. adults experienced a mental health condition, with 5.6% having a serious mental health condition.
- 32.1% of U.S. adults in 2020 experienced both a mental health condition and substance use disorder.
- Young adults aged 18 to 25 in the U.S. have the highest rate of experiencing any mental health concerns (30.6%).
- Anxiety and depression are the most commonly diagnosed mental health conditions in the U.S.
- PTSD affects 12 million U.S. adults, while bipolar disorder affects 3.3 million adults, and schizophrenia affects approximately 1.5 million adults.
- Despite an increase in the percentage of U.S. adults receiving mental health treatment, affordability remains a barrier, with 42% reporting they cannot afford necessary treatment.
Types of Psychiatric Evaluations
General Psychiatric Evaluation
General psychiatric evaluations are comprehensive assessments performed by mental health professionals to understand a patient’s mental health status, symptoms, and overall functioning. It is the foundation for establishing a diagnosis and creating a treatment plan.
During a general psychiatric evaluation, the clinician gathers information through interviews with the patient, reviewing their medical and psychiatric history, and may use standardized psychological tests or questionnaires to assess specific symptoms or conditions.
The evaluation aims to identify any psychiatric disorders, psychological distress, or other mental health issues the patient may be experiencing. This comprehensive approach helps the clinician understand the individual holistically and design a tailored treatment plan.
An emergency psychiatric evaluation is performed when an individual:
- Is agitated and uncooperative
- Shows violent or self-injurious behaviors
- Poses a threat to self or other people
- Is markedly confused or hallucinating
Most people who receive emergency evaluations have recent trauma or drug use. The primary goal of an emergency evaluation is to assess the person’s immediate safety and determine the level of care needed to address the crisis.
Based on the assessment, the clinician may recommend inpatient hospitalization, outpatient treatment, or refer the individual to community resources for ongoing support and intervention.
This helps with diagnosis if people are suspected of having problems with behavior or thinking. Clinical consultations are valuable for complex cases, treatment-resistant conditions, or situations where the primary care provider seeks a second opinion to enhance patient care outcomes.
Each type of clinical psychiatric evaluation serves a specific purpose and helps mental health professionals make informed decisions about diagnosis, treatment planning, and interventions to effectively support individuals with mental health concerns.
Other Types of Evaluations
Other types of psychiatric evaluations include:
- Neuropsychological Evaluation: This evaluation focuses on assessing cognitive abilities, memory, attention, and other neurological aspects to identify brain-related conditions.
- Child and Adolescent Psychiatric Evaluation: Geared toward young individuals, this evaluation considers developmental factors and specific issues related to children and teenagers.
- Forensic Psychiatric Evaluation: This evaluation is conducted in legal contexts to assess mental health issues relevant to legal cases, such as competency to stand trial or mental state during an offense.
Where Do Psychiatric Evaluations Take Place?
These evaluations can occur in various settings, including:
Inpatient settings refer to hospitals or psychiatric facilities where individuals receive intensive mental health care. Clinical evaluations in these settings are typically conducted when patients require immediate or extensive treatment due to severe mental health issues, crises, or safety concerns.
Outpatient settings encompass clinics or private offices where individuals receive mental health care without hospitalization.
Clinical evaluations in these settings are suitable for individuals with less severe mental health issues who can manage their symptoms and daily life while attending regular appointments.
General Medical Settings
Clinical evaluations in general medical settings occur within primary care or medical offices. Here, mental health concerns are addressed alongside physical health issues. These evaluations facilitate an integrated healthcare approach. This helps consider the patient’s mental and physical well-being.
These may include schools, community centers, specialized mental health facilities, or prisons, homes. The choice of the setting depends on the patient’s needs, convenience, and accessibility to mental health services.
Who Can Conduct Psychiatric Evaluations?
Psychiatric evaluations require specialized training and expertise and, as such, are typically performed by qualified mental health professionals.
The following are some of the professionals who can perform psychiatric evaluations:
Psychiatrists are medical doctors or doctors of osteopathic medicine who have completed specialized training in psychiatry.
They are the most qualified professionals to perform psychiatric evaluations, as they comprehensively understand the medical and psychological aspects of mental health.
Psychiatrists can conduct thorough evaluations, provide diagnoses, prescribe medications, and offer various forms of treatment.
Types of Specialized Psychiatric Training
A psychiatrist may choose to enroll in specialized training to become a specialist in:
- Child and adolescent psychiatry
- Geriatric psychiatry
- Forensic psychiatry
- Addiction psychiatry
- Pain medicine
- Psychosomatic (mind and body) medicine
- Sleep medicine
Clinical psychologists hold doctoral degrees in psychology and specialize in diagnosing and treating mental health conditions.
They are trained in conducting psychological assessments and utilizing various testing instruments to evaluate cognitive, emotional, and behavioral functioning.
Clinical Social Workers
Licensed clinical social workers (LCSWs) have advanced training in providing mental health services. They can perform psychiatric evaluations, offer counseling, and provide therapy.
Psychiatric Physician Assistants
Psychiatric physician assistants (PAs) are healthcare professionals who work under the supervision of psychiatrists.
Licensed Professional Counselors and Licensed Marriage and Family Therapists
Licensed professional counselors and licensed marriage and family therapists are mental health professionals trained to provide counseling and therapy services.
While they may not typically diagnose mental health disorders, they can conduct assessments to understand patients’ concerns and help determine appropriate treatment approaches.
How Does a Psychiatrist Perform an Evaluation?
Performing psychiatric evaluations is a comprehensive process that requires skill, sensitivity, and expertise.
The evaluation process typically involves the following steps:
The psychiatrist begins by conducting a detailed clinical interview with the patient. During this interview, the psychiatrist establishes rapport, gains the patient’s trust, and creates a safe environment for open communication.
They ask specific questions about the patient’s presenting concerns, medical and psychiatric history, family history, current symptoms, and relevant life events.
Mental Status Examination (MSE)
The psychiatrist performs a mental status examination, which involves assessing the patient’s cognitive, emotional, and behavioral functioning at the time of the evaluation. This examination helps identify abnormal thought processes, mood disturbances, or cognitive deficits.
Based on the information gathered from the clinical interview and mental status examination, the psychiatrist considers various possible diagnoses.
These adhere to the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD). The goal is to determine the most accurate diagnosis that aligns with the patient’s symptoms and experiences.
In some cases, psychiatrists may use standardized assessment tools, questionnaires, or rating scales to obtain a more objective measurement of the patient’s symptoms and level of functioning. These tools can provide valuable insights into the severity of the patient’s condition and track changes over time.
To gain a comprehensive understanding of the patient’s situation, psychiatrists may also gather information from collateral sources, such as family members, close friends, or other healthcare professionals involved in the patient’s care. This information can help validate the patient’s report and provide additional context.
Medical and Neurological Assessment
Psychiatrists assess the patient’s physical health and may order laboratory tests or other medical examinations to rule out any underlying medical conditions that could contribute to mental health symptoms. They also consider the impact of medications the patient may take on their mental health.
The examiner may order blood and urine tests. These tests help determine the levels of hormones, vitamins, and electrolytes in the body. A brain scan may be needed if the doctor suspects a neurological problem.
Examples of a Brain Scan
Examples of a brain scan include:
- Magnetic resonance imaging (MRI)
- Electroencephalogram (EEG)
- Computed tomography (CT) scan
Formulation and Treatment Planning
After completing the evaluation, the psychiatrist synthesizes all the gathered information and formulates a comprehensive understanding of the patient’s mental health.
They use this formulation to develop an individualized treatment plan, including psychotherapy, medication management, lifestyle changes, or referrals to other specialists as needed.
Follow-Up and Monitoring
Throughout the treatment process, psychiatrists maintain ongoing communication with the patient to monitor progress, adjust treatment as necessary, and address emerging concerns.
Regular follow-up psychiatric evaluations are essential to ensure the effectiveness of the treatment plan and provide ongoing support to the patient.
More About Psychiatric Evaluations
Multiple aspects often come into play when you’re answering questions during psychiatric evaluations.
While you are answering the questions, the examiner will be thoroughly observing:9
- Attitude (whether or not you are actively participating in the conversation)
- General appearance
- Hygiene and grooming
- Mood and emotional expression
- Speech (tone, volume, choice of words)
- Thinking and perception
- Awareness (if you are aware of their mental status)
It’s important to answer the questions accurately and truthfully for an accurate diagnosis. Some mental illnesses are hard to diagnose. In such cases, additional tests may be needed.
What Questions Are Asked During Psychiatric Evaluations?
The questions can include:
- Have you experienced anxiety, unreasonable fear, or restlessness in the last six months?
- Do you have problems falling or staying asleep?
- Have you had a panic attack recently?
- Do you have problems falling or staying asleep?
- Have you been a victim or a witness to a traumatic event?
- Do you have nightmares or flashbacks of the traumatic event?
- Have you ever been treated for a mental illness? If so, what medications did you take? What other treatments did you receive?
- Do you deliberately avoid situations that might cause panic?
- Do you hear or see things that others do not?
- Is anyone trying to hurt you?
- When did you first start drinking or using drugs?
- Do you drink alcohol or use drugs?
- Has anyone in your family committed suicide, used drugs, or had a mental disorder?
- Are you married?
- Have you ever attempted suicide? If so, how many times? What were the reasons?
- What is your highest level of education?
- Have you ever been arrested?
- Do you believe in God or follow any particular religion?
- Are you sexually active?
- Do you use any method of contraception?
- Have you ever been hospitalized for a serious condition, such as a head injury or major surgery?
- Do you have a current or past history of seizures?
Interview Involving a Family Member
People with loved ones undergoing psychiatric evaluations may ask questions about their loved one or the treatment process as well.
Below are some questions that are commonly asked:
- What is the problem with my loved one?
- Are they normal?
- Is my behavior responsible for the current situation?
- Should they be hospitalized?
- What are the treatment options?
- What can I do to help?
- What is the cost of the treatment?
Preparing for a Psychiatric Evaluation
Before visiting a psychiatrist, patients should prepare a list of things to ask, including:
- Is it normal to feel the way I do?
- Do I have a mental health disorder?
- How much does the treatment cost?
- How long will the treatment last?
- What are my treatment options?
- What are my treatment options?
- What factors can trigger my illness?
- Will my children have a similar illness in the future?
Questions and Answers to Bring in Preparation
Moreover, it’s helpful to answer the following questions in writing and bring them to the evaluation:
- What are my symptoms? How long do they last?
- What do I do to control the symptoms?
- How do I feel, think, and behave?
- Did the symptoms appear after a major life event, such as the death of a loved one?
It is best to start writing the answers at least one week before the appointment. A patient may take a friend or family member with them.
Patients who take any medications or supplements should inform their doctors. Some drugs (prescription or OTC) can change how people think and behave.
Importance of Psychiatric Evaluations in Mental Health Treatment
Psychiatric evaluations play a crucial role in mental health treatment. They can help individuals get the care they need and can also help provide:
- Accurate Diagnosis: A comprehensive evaluation helps in accurately diagnosing psychiatric disorders. Proper diagnosis is essential for providing effective and targeted treatment interventions.
- Treatment Planning: After psychiatric evaluations, the clinician can create a personalized treatment plan tailored to the individual’s needs, symptoms, and challenges. This might include medication management, psychotherapy, or a combination of approaches.
- Early Intervention: Early identification of mental health issues through psychiatric evaluations allows for timely intervention, potentially preventing the progression of symptoms and improving the overall prognosis.
- Differential Diagnosis: Some mental health conditions may present with similar symptoms. An evaluation helps to differentiate between different disorders and ensures appropriate treatment.
- Monitoring Progress: Psychiatric evaluations are not limited to the initial assessment. They can be conducted periodically to assess treatment progress and adjust the plan if necessary.
Discover Optimal Psychiatric Evaluations at J. Flowers Health Institute
At J. Flower Health Institute, we are committed to providing you with expert psychiatric evaluations that can bring clarity and understanding to your mental health concerns.
Our experienced team of psychiatric professionals utilizes a comprehensive approach, combining in-depth interviews, standardized assessments, and clinical judgment to deliver accurate diagnoses and personalized treatment plans.
How Can We Help?
We ensure a safe and confidential environment for all of our patients. Our “Living MRI” encapsulates multiple aspects of your health as we’re evaluating your health.
This often includes psychiatric evaluations, as well as:
We will work with you to create an individualized treatment plan that helps address any substance use disorder, mental health disorder, or other medical symptoms you may have.