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Frequently Asked Questions - Psychiatric Assessment
FAQs - Psychiatric Assessment

 

A clinical interview by a trained psychiatrist can yield valuable information about a problem. Information obtained from other sources like family members and friends also helps in reaching a diagnosis. The Psychiatrist evaluates parameters like mood, thought and behaviour. These are compared with standardized criteria to arrive at a diagnosis.

 

Physical health is evaluated by the doctor by a clinical history and examination. Investigations are asked for, if necessary.

In mental illnesses multiple internal and external factors have influence on brain chemistry resulting into imbalances in brain functioning. These are not visible on brain scans. However, if the cause for symptoms is suspected to be gross brain pathology (stroke or tumor), then a CT or MRI scan can be useful.

These are standardized tests consisting of questions, pictures, images, puzzles, and skill evaluation. These are conducted by a qualified clinical psychologist. These are helpful in certain conditions.

It is necessary to evaluate the person in totality. Knowledge of the prior functioning of the individual, life history and the stresses contributing to the illness is vital. Family history is necessary to understand the social and inheritable aspects of the problem. Also important is the role of interpersonal conflicts and the personality structure of the individual.

 

Confidentiality is a professional ethic followed by all Psychiatrists. So, one should share as much information as possible without hesitation. It may be necessary to share some information with other doctors or psychologists from the management perspective.

 

Lot of relevant information can be obtained from people close to the patient. A highly distressed, confused, or violent patient is in no position to give accurate history. It is also important for family members to understand the illness, take appropriate decisions and supervise the treatment for best outcome.

You are correct! Each culture has a different approach, and hence the style of functioning is not comparable.

Some people still associate a Psychiatrist with the use of a “Couch”. This used to be a practice for “Psychoanalysis” which was a form of therapy. Psychoanalysis has a limited role in modern Psychiatry.

 

This is a challenge, and the best option is to discuss this with a Psychiatrist first who can guide you with respect to various options available in your setup.

This may involve help from a friend, family doctor, social agency, or some competent authority. Use of medication, home visit by a doctor, or direct hospitalization through emergency services are some options.

A severely depressed patient may be unmotivated to visit a Psychiatrist. Such patients will need to be handled tactfully. A recovered patient, or a neutral senior can help in this situation.

One should act as soon as possible in case of an uncooperative person or a patient who is non adherent to treatment so as to avoid unpleasant steps subsequently.

 

Short term hospitalization is considered for any psychiatric emergency for rapid control of symptoms. At times it is impossible to treat the patient at home due to various reasons and hence supervised care by skilled staff in a hospital setup is necessary. Treatment like ECT also needs medical facilities.

Long term hospitalization or institutional care is considered for severe, chronic, non remitting conditions, or in cases where adequate support system does not exist to manage the patient at home.

The available options can be broadly classified into following categories:

  1. Most Government and Municipal hospitals have a Psychiatrist and other Mental Health Professionals (MHPs) on staff. In big teaching hospitals, there are full-fledged Psychiatry departments with entire team of MHPs. These units also provide round the clock emergency services and have admission facilities. These hospitals also cater to patients from neighbouring districts and interior of the state.

  2. State run institutes (mental hospitals) have their outpatient departments and also receive patients through court orders. These hospitals have large admission facilities and are managed by teams of MHPs. These institutes are also considered for long term hospitalizations.

  3. Licensed Psychiatric Nursing Homes [private] or hospitals [private].

  4. Private General Hospitals may provide basic consultation and reference with MHPs. These hospitals may or may not have emergency or admission facilities.

  5. Private Practitioners: MHPs from different fields offer consultation and treatment in private capacity. Some of them work solo and others as team. They are often attached to some hospitals or NGOs.

  6. Charitable Clinics: These are trust run hospitals offering care at a subsidised rate. Fees charged fall between that of government and a private setup. The range of services offered depend on their size and setup.