5 Ways To Know If Your Psychiatrist Is A Good Match

Millions of Americans seek treatment for mental health conditions from a psychiatrist, a physician who specializes in the treatment of psychiatric illnesses such as depressive, anxiety, mood, and substance abuse disorders. Receiving high-quality psychiatric care can have a massive beneficial impact on one's symptoms, quality of life, and overall prognosis.

What does high-quality psychiatric care look like? If you are seeking help for yourself or for a loved one, how can you tell you are getting the best care? What qualities should you look for to know you've really found a psychiatrist that will be able to help you with your mental health?

It is not unusual, when I first meet a patient, for them to minimize their distress. They try to present their best self and often talk themselves out of the need to see me. It's tempting to collude with my patients, but then I remind myself to honor their story and their journey to my office and the fact that by this point they have often hit their version of rock bottom.

The onus is on me, as the psychiatrist, to create a safe space that encourages them to shed this façade of normalcy and be authentic about their thoughts and feelings in their visits with me.

This process starts with a thorough evaluation, which typically takes the form of me asking several questions. This fundamental principle of "taking a patient history" can get shortchanged in large health care organizations where dozens of professionals are asking patients a variety of questions and documenting all the answers in one electronic medical record.

Though it's true that it does not make sense to repeatedly ask the same questions of my patients, I find that the act of my engaging them in providing this personal data builds their trust in me. Furthermore, this one-on-one, live, real-time conversation leaves an imprint of their life story in my mind that reading an electronic medical record will never do.

Often a big part of the care provided by a psychiatrist is that of prescribing psychotropic medications for the treatment of mental illness. But high-quality medication management visits are much, much more than the simple act of "pushing pills."

All psychiatrists receive extensive training in therapy and should feel comfortable switching into therapist mode as needed. Moreover, high-quality psychiatry pays close attention to the psychology surrounding decisions about medications—both a clinician's instinct to prescribe them and the patients' decisions whether to take them.

Not a month goes by without my meeting a patient who has decided to stop taking a medication or never filled the prescription in the first place. Patients' stopping medication prematurely is a fact of life in psychiatry.

Why do people suddenly stop taking their prescription medication? Some feel better and so assume they no longer need medication; some view having to take medication as a personal failure, and taking the pill every day reminds them of this. Others can't afford their copay or are frustrated by their lack of progress or side effects, and a few have a change of heart after talking to friends or reading something unfavorable about their medicine on the Internet.

Paying careful attention to the ambivalence and resistance that often accompany prescription medications is a crucial part of delivering high-quality psychiatric care. If physicians don't openly talk about the obstacles that are contributing to a patient's treatment adherence, then patients are erroneously labeled as "treatment-resistant" and prescribed more medications under the false assumption that the original medications did not work.

U.S. health care is famous for being fragmented. With so many different medical specialties, multidisciplinary teams, health care systems, and insurance providers involved, the simple task of talking to one another becomes daunting and thus a low priority for busy clinicians. This lack of communication can have disastrous consequences for patients.

At minimum, before prescribing you a medication, your psychiatrist should know the results of your last physical examination, what your vital signs are, and the results of your most recent laboratory tests. Access to an up-to-date list of your medications is vital to avoiding bad reactions between the pills you are already taking and the ones your psychiatrist is prescribing. And if you are seeing a therapist for talk therapies in parallel to seeing a psychiatrist for medication management, it's important that both mental health professionals communicate about you, their mutual patient.

Mental illness affects many spheres of a person's life, including work, school, family, and social relationships. Having stable housing, employment, and financial security is crucial for many sufferers.

Your psychiatrist should know when to put the prescription pad aside and, instead, take the time to advocate for you by making phone calls, writing letters, nudging colleagues, or helping you access needed programs or services.

Integral to having a good match with your psychiatrist is a relationship that has healthy boundaries. One must never feel coerced or forced into a decision about treatment. Nothing about treatment should leave you feeling exploited or shamed.

This said, having a warm and fuzzy relationship with one's psychiatrist is also problematic. As I often tell my patients, "My job is not to be your friend, but it is my job to be your well-wisher, and sometimes that involves my saying things you might not want to hear."

To effectively treat the symptoms of mental illness and aid someone in moving forward in their life and achieving their personal goals requires the psychiatrist to touch on uncomfortable areas, hold their patient accountable, and sometimes speak ugly truths.