What is a psychiatric evaluation and what should I expect?
Discover the purpose, process, and types of psychiatric assessments, as well as how they can aid in mental health diagnosis and treatment.
Key takeaways
“Psychiatric evaluation” might sound like a scary term, but in reality, it’s a mental health assessment that’s generally a lot less intimidating than you’ve imagined.
This evaluation isn’t a rigid, stressful test like you take in school––rather, it’s more of an assessment or screening that occurs during your first appointment with a psychiatrist so they can assess your current symptoms, psychiatric history, and medical history.
Here’s what you need to know about why people get psychiatric evaluations, what actually happens at one, and what comes next.
Why would someone get a psychiatric evaluation?
People get psychiatric evaluations for all sorts of reasons. Generally speaking, someone who is struggling with their mental health may seek out care from a psychiatrist, a medical doctor who is licensed expert on such things. A psychiatrist will conduct a psychiatric evaluation during the first intake appointment to get a comprehensive view of someone’s symptoms.
A psychiatric evaluation is especially helpful if someone’s symptoms are interfering with their daily functioning or quality of life for an extended period of time, and they’re hoping to get answers and treatment.
Someone with the following conditions (whether previously diagnosed or undiagnosed) might get a psychiatric evaluation:
- Personality disorders
- Substance use disorder
- Eating disorders
- Schizophrenia
- And more
To learn more, check out our guide on when to see a psychiatrist.
What are the types of psychiatric evaluations?
Psychiatric evaluation is a broad term. There are a few different types of them including:
- Comprehensive psychiatric evaluation: The most common type, usually performed in an outpatient setting, like a psychiatrist's office, this evaluation can determine if someone has a mental health condition, and if so what treatment options exist
- Emergency psychiatric evaluation: This evaluation is made in an emergency setting, such as the emergency room or urgent care facility, when an individual is in danger of harming themselves or others. An emergency evaluation may involve getting information from a variety of sources, like family members, nursing home, or police, so the doctor can piece the patient’s medical history together. fy. This will include a mental status examination to fully assess someone’s mood, behavior, body movements, and appearance. The goal is to get acute symptoms under control and determine what type of care is necessary (such as if they should be admitted to the hospital or not).
- Court-ordered psychiatric evaluation: This is when someone is legally required to get evaluated, such as to determine their mental health during the time of a crime, or whether they’re fit to stand trial, for child custody, for example.
What actually happens at psychiatric evaluation?
You can think of a comprehensive psychiatric evaluation as a mental health check-up. Just like how your primary care doctor asks you all sorts of questions about your well-being at a physical examination, you can expect something similar for an evaluation with a psychiatrist.
When you go into your intake appointment, anticipate a lot of questions. Through this clinical interview, your psychiatrist is just trying to get all the details they need, so they can diagnose you and ultimately help you. Most of this will be spoken out loud, but there may also be some questionnaires or rating scales for you to complete on paper or electronically.
According to the American Psychiatric Association, the main guidelines for adult psychiatric evaluations are:
- Review symptoms, trauma history, and treatment history: This is how the psychiatrist learns about what’s bothering you now, if you’ve experienced any trauma, and if you’ve been diagnosed and/or treated for mental health struggles before in an inpatient or outpatient setting.
- Evaluate substance use: Your psychiatrist will ask if you smoke, drink, or do any other drugs. This isn’t to get you in trouble––it’s to figure out if the substance use could be contributing to your symptoms or if you may have a substance use disorder.
- Assess risk of suicide: For your safety, your psychiatrist will ask you if you’re having any thoughts about dying and, if so, if you have a suicide plan in place. They will also want to know if you’ve had suicidal thoughts in the past or ever attempted suicide before.
- Assess risk of aggressive behaviors: The psychiatrist will ask if you have any violent thoughts about harming others, including whether you’ve ever acted on these thoughts or struggle with impulsivity.
- Evaluate cultural factors: Cultural differences can affect how people view mental health struggles and even how they interact with healthcare professionals. Your psychiatrist will assess whether cultural factors are impacting you.
- Assess medical health: Physical health can impact mental health, so it’s important for your psychiatrist to understand your medical health status. They may also check to see if you’re currently under the care of a primary care physician and want to know their name. Psychiatrists often order baseline lab tests to assess certain medical conditions, like hypothyroidism which can cause depression.
- Use quantitative tools: On top of having a conversation with you, the provider may use tools like questionnaires or rating scales to have some hard data about how you’re feeling. For example, they may have you rate how strongly you relate to a certain statement on a scale of 1-5.
- Involve the patient in decision-making: Although the psychiatrist is the professional doctor here, that doesn't mean they call 100% of the shots. They will explain diagnosis and treatment options with you, explaining benefits and risks, allowing you to give your input into treatment. Most doctors will give you options, and let you make the decision you feel most comfortable with based on the information they provide.
- Document the psychiatric evaluation: Your psychiatrist will likely take notes throughout the evaluation and ultimately complete a report for your records about their findings and your diagnoses.
17 questions your psychiatrist might ask you throughout the evaluation process
- What are your current symptoms, and how long have you been experiencing them?
- How severe are your symptoms?
- Do your symptoms interfere with your quality of life or functioning at school, work, or home?
- Do you have a family history of mental illness, especially among immediate family members?
- What is your medical history? Do you currently have any physical health conditions?
- Have you previously been diagnosed with any mental health condition?
- Do you currently take any medications?
- What was your childhood like?
- Have you ever been abused?
- Have you experienced any traumatic events?
- Do you have any thoughts about harming yourself or others?
- Do you have any thoughts of suicide?
- Do you ever see or hear things that aren’t really there?
- Do you ever believe someone is out to get you?
- What is your sleep schedule like?
- Do you drink alcohol or use any drugs? If so, which ones and how often?
- Do you have a history of substance abuse?
The conversation that you have based on all these questions will help paint a picture of your overall well-being and mental health. Your psychiatrist is simply trying to get to know you so they can come up with the correct diagnosis and the best treatment to help you feel better.
You should expect to be at your first psychiatrist appointment for around an hour to an hour and a half. Don’t worry, though––follow-up appointments will be much shorter, generally about 30 minutes.
What shouldn’t you say at a psych evaluation?
Although it can feel scary to be so vulnerable with someone new, it’s crucial to answer your psychiatrist’s questions honestly. Your psychiatrist isn’t here to judge you––they want to help you. Withholding information or lying can ultimately backfire since it could result in inaccurate diagnosis and treatment. Don’t be embarrassed to talk about how you feel and what you’re experiencing. Your psychiatrist has already heard it all.
If you’re worried about confidentiality, know that your psychiatrist legally cannot share any information that you tell them. The only time they need to report something is if you are truly a danger to yourself or others. Psychiatrists are also required to report any concerns of child or elderly abuse. This is called “duty to warn.” Otherwise, your secrets are safe with them.
What happens after?
Once your initial psychiatric evaluation is complete, your psychiatrist should have enough information to diagnose you. In some cases, they might want you to get some lab tests done (such as bloodwork) to see if there are any physical health issues that may be an underlying cause for your psychiatric symptoms. If a physical condition is found, treating that might treat the mental health symptoms.
Treatment
Next, your psychiatrist will explain your diagnosis and develop a psychiatric treatment plan, along with your input. They may recommend a specific medication or combination of medications, explaining the benefits and risks of treatment. They might also suggest going to a psychologist, therapist, or social worker for ongoing psychotherapy (AKA talk therapy) if you aren’t already seeing one. For many people, a combination of medication and therapy is the most effective way to manage mental health conditions and ensure the most symptom relief.
Follow-ups
In cases where a psychiatrist prescribes medications, there will be regular follow-up appointments to assess how you’re responding to the medication, such as if the meds are effectively relieving symptoms or if you’re having any bothersome side effects. Once you’ve reached an optimal dose and the medication is helping, you’ll still have regular follow-up appointments to get refills and check-in. This is known as medication management.
If you’re looking for a psychiatrist to conduct a comprehensive psychiatric evaluation and help you with treatment options, consider Talkiatry. We’re a national psychiatry practice that treats a wide variety of mental health conditions. We provide virtual, in-network services so you can get the care you need from the comfort of your home. To get started, complete our free online assessment to get matched with a psychiatrist.
FAQs
Still have more questions? Here’s what else to know about psych evals.
What can a psychiatric evaluation diagnose?
A comprehensive psychiatric evaluation can diagnose all psychiatric disorders, whether they are less common psychotic disorders or more common mental health conditions. They can also help diagnose neuro-developmental disorders such as ADHD and autism spectrum disorder. (Some psychiatrists have extra training or expertise to diagnose these conditions.)
Should you prepare for a psych eval?
Although you don’t need to study up for this type of “test,” it is helpful to prepare a bit for your evaluation. You might want to make a list of any important talking points or questions you don’t want to forget. For example, you might want to write down the following to bring with you:
- Information about your medical history
- Information about past psychiatric diagnoses and medications
- A list of your current medications
- Any questions you have for your psychiatrist
How do you know if you need one?
If you are struggling with your mental health –– especially if your symptoms are interfering with your functioning and quality of life –– it’s a good idea to see a professional for a psychiatric evaluation.
The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.
