What to Expect from a Psychiatric Evaluation

Going into a psychiatric evaluation can feel overwhelming. You might worry about the results or how you’ll feel after talking about potentially triggering topics. Others may be looking forward to the appointment to have answers and to start treatment, but still feel a little anxious about the unknown. Knowing what to expect from a psychiatric evaluation can help to calm some of these nerves.

In this article, we’ll go over what happens during a psychiatric evaluation, how long a psychiatric evaluation takes, and what to expect during your first psychiatrist appointment. We’ll also cover what questions you might be asked and what comes next. 

What is a psychiatric evaluation?

A psychiatric evaluation, also known as a psychiatric assessment, is a comprehensive assessment of your mental health conducted by a qualified mental health professional. Depending on the setting, a psychiatrist or another qualified clinician, such as a physician assistant or psychiatric nurse practitioner, will typically conduct this. A psychiatric evaluation can help your clinician better understand your symptoms, consider whether a mental health condition may be contributing to them, and identify whether additional medical evaluation may be needed. 

If this is your first psychiatry appointment, it’s common to have questions about what will happen. Your psychiatrist or other provider will generally guide the conversation and ask questions to better understand what you’re experiencing. You do not need to know exactly what to say or have all the answers prepared beforehand. 

How long does a psychiatric evaluation take?

An initial psychiatric evaluation usually takes between 45 and 90 minutes. The time it takes depends on the complexity of your symptoms, your mental health history, and whether more assessments are needed. 

What happens during a psychiatric evaluation?

During a psychiatric evaluation, you will discuss symptoms and history, medical and medication history, family and social history, and safety. Your clinician may also assess aspects of your mental status, such as your appearance, behavior, mood, speech, thought process, and memory.

Your symptoms and history

Usually, a psychiatric evaluation starts with asking ‌why you’re seeking an evaluation. You’ll go over your symptoms, including how they are affecting your daily life, such as your ability to work, attend school, maintain relationships, or manage everyday responsibilities. From here, your mental health professional might ask you questions to learn more about your symptoms. Potential topics include mood changes, anxiety levels, changes in sleeping and eating habits, ability to focus, and shifts in relationships. 

You might also answer questions about your mental health history. This includes whether you’ve previously been diagnosed with a mental health condition and which treatments have or haven’t helped in the past. Your clinician may ask you to fill out a rating scale about your symptoms and mood. This could include the Patient Health Questionnaire-9 (PHQ-9) or the Generalized Anxiety Disorder-7 (GAD-7). These tools not only provide more information about your current experience, but can also serve as a baseline to monitor how treatment is working.

Medical and medication history

Because physical health issues can cause mental health symptoms, your mental health professional will ask about your medical background, such as if you have any chronic illnesses, if you’ve had surgery, or if you’ve been hospitalized. They may also ask about significant life events or traumas, as these can impact your well-being. 

You’ll also be asked about any medications you currently take, including medications for both physical and mental health conditions. In addition, your mental health professional may review your family medical history, including any history of mental health conditions. 

Family and social history

Your mental health practitioner will ask questions to learn more about your support system and relationships. This includes your current living situation, such as if you live with anyone and what your relationship with them is. They might also ask you about your work and education experience and how you get along with other people, including family and friends.

They’ll also ask you about your past experiences. This includes questions about your childhood, including your living situation growing up and the quality of relationships with friends and family members. 

Questions about safety

Safety questions that a mental health professional may ask include whether you’re having or have had thoughts of harming yourself or others. They may also ask if you’ve thought about ending your life, including if you’ve done any planning. We know that simply thinking about this can be activating. If you are currently feeling unsafe or think you might be experiencing a mental health crisis, call or text the Suicide & Crisis Lifeline at 988.

What questions will a psychiatrist ask?

Common psychiatric evaluation questions include:

• What brings you in today?
• How long have you been feeling this way?
• Have you noticed any patterns or triggers?
• How is your daily life being affected by your symptoms?
• Have you noticed any changes in your sleep, eating habits, or energy levels?
• Do you have trouble concentrating, focusing on tasks, or making decisions?
• Have you been diagnosed with a mental health condition before?
• Are you taking any prescription medication, either for a mental health condition or a physical health condition?
• What is your current living situation and support system like?
• Do you use alcohol, cannabis, or other recreational drugs?
• How do you usually cope with stress?
• Have you had any thoughts of harming yourself or others?

How to prepare for a psychiatric evaluation

If you’re worried about how to prepare for a psychiatric evaluation, the most important thing to know is that there is nothing that is necessary for you to prepare. Your clinician will guide the session, and your only responsibility is to be honest. However, there are some things that you can do to make the experience feel less stressful and overwhelming.

During a mental health evaluation, you’ll be answering several questions, and it can be easy to forget things if you’re feeling nervous or overwhelmed. For that reason, it can help l to write down a list of your symptoms and concerns. You might include whether you’ve noticed any triggers for these symptoms and whether you’ve tried anything to help them. If you’re taking medication for any condition, or have taken psychiatric medication previously, it’s helpful to bring a list of these medications so you don’t need to remember them. Knowing the doses, time periods, and side effects can be helpful. If you’re unsure, you can get this information from your pharmacist or the clinician who previously prescribed it.

Because psychiatric assessments can be draining, it may help to prepare by getting a good night’s rest and eating a balanced meal beforehand. If you’re attending your evaluation in person, give yourself some extra time to arrive so you don’t feel rushed. You may also want to bring a trusted friend or family member for additional support. After your appointment, set aside time to rest and practice self-care.

What happens after your psychiatric evaluation?

After a psychiatric evaluation, your mental health clinician will review the findings. Some results may be discussed with you right away, whereas other items may need additional assessment. Depending on the results, they may be able to provide you with a diagnosis. If a diagnosis is not yet clear, they can discuss patterns or concerns they’ve identified that may be contributing to how you’re feeling.

From there, you and your clinician can work together to create a personalized care plan. This may include recommendations for therapy or medication, as well as referrals to other services or healthcare providers.

Virtual vs. in-person psychiatric evaluations

Substance Abuse and Mental Health Services Administration (SAMHSA) reports that virtual psychiatric evaluations are as reliable and accurate as in-person ones. Virtual psychiatric assessments also have some additional benefits. They can be more convenient, and some people find them less stressful because they are in a familiar environment. Virtual evaluations can also give mental health professionals insight into a person’s home environment and make it easier to connect with a wider range of specialists who may not be available in your area. 

However, there are some situations where in-person mental health evaluations may be better suited. This includes cases where severe symptoms make technology hard to use or where the individual feels uncomfortable using technology. If a medical exam is required, it must be done in person.

Need a psychiatric assessment sooner? Willow Health can help

If you're a New Yorker looking for an urgent psychiatric assessment, Willow Health can help. Willow Health offers urgent assessments in under 48 hours. After your assessment, you'll begin a personalized care plan and receive guidance on next steps. Talk to a clinician to get started now.

Frequently asked questions

Can a psychiatric evaluation be done online?

Yes, you can do a psychiatric evaluation online with a mental health professional using secure videoconferencing software. SAMHSA states that virtual psychiatric evaluations using videoconferencing are just as reliable as in-person ones.

Will I be prescribed medication at my first appointment?

You may be prescribed medication at your first psychiatrist appointment. However, the purpose of the first appointment is to evaluate. Depending on the severity of symptoms and clarity of diagnosis, your mental health professional may or may not recommend starting medication.

Can a psychiatric evaluation result in hospitalization?.

A psychiatric evaluation may lead to hospitalization, but that’s not usually the case. Clinicians typically recommend hospitalization only when they're concerned about your ability to care for yourself or maintain your safety or the safety of others.

Is a psychiatric evaluation confidential?

Yes, a psychiatric evaluation is generally confidential. However, there are important exceptions to confidentiality, including certain situations involving serious and imminent safety concerns. The specific rules vary by state and circumstance, and your clinician can explain the limits of confidentiality at the beginning of your evaluation. 

What's the difference between a psychiatric evaluation and a therapy intake? 

Both types of appointments include a comprehensive assessment of your background and symptoms, and providers can diagnose mental health conditions, clarify your goals, make recommendations for treatment, and identify additional needs and helpful services. The difference is the treatment options the provider can offer. Intake appointments with psychiatric professionals can provide medication management services, while intake appointments with therapists can offer a roadmap for therapy.  

Sources

Ponte, K., Costa, M., & Pavlo, A. J. (2021, December 10). How to prepare for your psychiatric appointment. NAMI. https://www.nami.org/blog/how-to-prepare-for-your-psychiatric-appointment/ 

Substance Abuse and Mental Health Services Administration. (2021). Telehealth for the treatment of serious mental illness and substance use disorders (Publication No. PEP21-06-02-001). U.S. Department of Health and Human Services. https://library.samhsa.gov/sites/default/files/pep21-06-02-001.pdf