The Maze of Mental Health
By: Dr. William H. Reading
In the mental health world, knowing which professional to consult can be confusing. Navigating the mental health maze includes finding the right resources and the right mental health professional. Common questions among patients include: “Can a psychiatrist prescribe medication?” “What is the difference between a psychiatrist and a psychologist?” and “Which should you see first: a therapist or a psychiatrist?” The mental health maze consists of many questions. This article will attempt to answer some of them and help you navigate the maze by identifying the various mental health professionals and explaining what they do.
Mental health professionals include:
Psychiatrist (MD or DO)
Adult Psychiatrist-Mental Health Nurse Practitioner (APRN, PMHNP-BC)
Physician Assistant (PA)
Licensed Marriage and Family Therapist (LMFT)
Licensed Professional Counselor (LPC)
Licensed Clinical Social Worker (LCSW)
Licensed Chemical Dependency Counselor (LCDC)
Board Certified Coach (BCC)
Registered Play Therapist (RPT)
Below, you will find a profile of each type of mental health professional noting the specific credentials that identify their training and area of expertise. While there are specialties within each, these are the most common. Understanding the services each provides, as well as their areas of expertise, will help you make a more informed decision when choosing a mental health professional for yourself or someone in your family.
Psychiatrists are medical doctors (MD) or doctors of osteopathic medicine (DO), who go on to take specialized training in psychiatry. This additional training focuses mostly on the biological aspects of mental illness. Psychiatrists can prescribe medication and may be further specialized with board certifications. They can also provide therapy—psychotherapy for example—and other specific types of therapy.
Psychiatry is devoted to the diagnosis, prevention, study, and treatment of mental, behavioral, and emotional disorders. It also includes the treatment of substance use disorders. Psychiatrists have a strong background in biology and neurochemistry. They rule out to form a diagnosis and look at the biological, psychological, and social implications. For serious mental health issues, such as major depression, bipolar disorder, or schizophrenia, psychiatrists generally have more training and treatment options for their patients.
Some subspecialties include forensic, addiction, child and adolescent, and geriatric psychiatry. Psychiatrists sometimes work in tandem with other physicians and mental health professionals to devise a collective treatment plan.
Adult Psychiatric Mental Health Nurse Practitioners
This area of specialty in nursing offers primary care services to the psychiatric mental health population. APRNs assess, diagnose, and treat individuals and families, as well as prescribe medication and administrate psychotherapy. APRNs practice under the delegation of prescriptive authority of a supervising physician. Their degree is an advanced one, and is a specialty within nursing that requires extensive education and utilizes specific skills in practice. APRNs normally have advanced master’s and doctoral degrees, allowing them to function as psychiatric primary care providers and psychotherapists.
Physician Assistants (PA)
Physician assistants specialize in mental health or psychiatric services and provide these services under the supervision of a psychiatrist or an MD. They can be an important part of the health team, and can treat patients on an inpatient or outpatient basis. PAs can make a diagnosis and rule out other underlying medical conditions. Their responsibilities differ depending on the setting in which they work.
Psychologists (PhD & PsyD)
Psychologists have had six to eight years of formal mental health training and a year of supervised internship. They conduct psychological testing and evaluations, such as IQ and personality tests, and are also trained in psychotherapy. Psychologists pay close attention to the mind, and focus on human behavior.
Their clients include a wide variety of people with a wide variety of problems. These may include coping with stressful situations, trying to overcome addiction, or getting past barriers keeping them from attaining their goals. Using their expertise, psychologists help diagnose a condition or assist with therapy, including cognitive, behavioral, interpersonal, or humanistic. They may also choose to combine therapies.
Some psychologists practice on their own while others work with a group of other mental health professionals. Still others work in hospitals, prisons, universities, schools, and VA hospitals. Some subspecialties are inclusive of clinical, developmental, forensic, geriatric, and educational psychology.
Licensed Marriage and Family Therapists (LMFT)
LMFTs hold a master’s degree and are generally utilized by clients with both marriage and family difficulties. Clients may also need premarital counseling or assistance with other family challenges. Some overlap exists between the roles of psychologists and LMFTs. They are both mental health professionals, and both assess and treat clients with various problems. Often, LMFTs will involve the whole family in treatment. It is in this area that they have more expertise than psychologists.
Licensed Professional Counselors (LPC)
LPCs hold a master’s degree and specialize in working with individuals, families, and groups, treating mental, emotional, and behavioral problems and disorders. They help clients solve their own problems through a series of specialized methods. An LPC is trained to counsel clients so they can understand and solve problems, cope with mental or emotional stressors, find the best solution for specific problems, and communicate effectively with others.
Licensed Clinical Social Workers (LCSW)
LCSWs provide therapy to an individual and help them obtain resources.
Licensed Chemical Dependency Counselors (LCDC)
LCDCs work with individuals and families with drug and alcohol challenges.
Board Certified Coaches (BCC)
BCCs hold a master’s degree and are certified in professional coaching in social and behavioral issues.
Registered Play Therapists (RPT)
RPTs hold a master’s degree and help children who require therapy. They provide support and feedback that help children and their families resolve immediate and long-term problems.
Choosing the right mental health professional can be overwhelming. Recognizing the specific needs of an individual, however, whether it is you or a family member, and identifying which mental health professional specializes in those needs, can make navigating the mental health maze a lot less confusing.