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mental health

What happens at a first appointment for counseling or psychiatry?

By Brittainy | Mental Health Minute | 18 Jan 2020

Question: "I have never been to a psychiatrist.  I called and made an appointment for next week. The lady said I will have to fill out paperwork, and it’s an initial intake mental evaluation appointment. What does that mean? How long will it take and what should I bring? She said after that’s been assessed then she may refer me to therapy or the psychiatrist depending. Psychiatrist has a 3-4 month waiting list right now. Will they give me medication if they find something is wrong with me that requires it or will I have to wait 3-4 months?"


Answer: In most situations, an initial intake appointment is between 1-2 hours (usually on the longer side) and is with a master's level therapist. The only thing you really need to bring is your insurance card and maybe an I.D. If you have a list of past medication trials, that's helpful as well. You should find out in advance of your appointment if you are going to owe a co-pay or any other costs based on what your insurance does/does not cover. The intake therapist is going to do a psycho-social assessment, meaning they will ask you a LOT of questions about your history, your physical health, your family relationships, family history of mental health, your education, work history, substance use, etc. They will go over paperwork with you and explain the process. They should explain things like health information privacy laws and confidentiality. It may feel overwhelming but you should ask questions if you have any. It can be helpful to start thinking of any questions ahead of time and write them down so you don't forget to ask. The intake therapist is probably not going to be the one assigned to you for ongoing therapy. It's a bit clunky to have to meet your actual therapist at the next appointment, but that is how it's done in most places. This usually allows them to place you with a therapist who would be a good fit for your specific needs. As far as meds, only a psychiatrist (MD) or psychiatric nurse practitioner (NP or PMHNP) is able to prescribe medications to you, so unless you meet the doctor at your appointment you won't be getting any medications. If you feel 3-4 months is too long to wait, you could try to see your PCP (usually doable in a few weeks time or sooner) and ask if they would be willing to prescribe something in the interim while you wait. Some primary care physicians are more comfortable with psychiatric medications than others. If it's a complex issue, or they don't know you well, they may not feel comfortable prescribing and ask you to wait to see the psychiatrist. If you've never been in any mental health treatment before, what's typical is to start with therapy as a first line intervention to see if it can help alleviate your symptoms before trying medication. Be advised, there is no quick fix to our problems. Even if/when you are prescribed a medication, it will most likely not make your symptoms magically disappear. Like anything, it takes time and work to see improvement. Best of luck, and be PROUD of the fact that you are actively working towards getting the help you need.

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I'm a licensed mental health counselor in the U.S. seeking to enhance the public's understanding of various mental health topics and non-medication based strategies for achieving wellness like fitness and nutrition.

Mental Health Minute
Mental Health Minute

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