When people think of mental health support, the lines often blur between the various professionals available. Is a therapist enough? When is a medical doctor needed? While psychologists and counselors focus on talk therapy, psychiatrists are medical doctors who specialize in the biological and psychological aspects of mental health.
To help demystify this profession, we talked with Dr. Justin Miles, M.D., a psychiatrist at ACP, who has spent over a decade working in clinics and nursing homes.
Reasons to See a Psychiatrist
A common misconception is that a psychiatrist should be the first stop on a mental health journey. But for many, the most effective starting point is actually talk therapy. There is often a belief that medication is a “quick fix,” but the reality is usually more nuanced. As Dr. Miles notes, patients often benefit more from “gaining a little bit of insight” through therapy and learning self-advocacy techniques before introducing medication.
So, when is a psychiatrist necessary? They are often brought in when therapy alone isn’t resolving the issue, or when there is a physiological component to the mental health struggle that requires medical intervention.
Furthermore, a referral to a psychiatrist from a primary care doctor or a psychotherapist is often the way patients make their way into a psychiatrist’s office.
Types of Psychiatrists
Psychiatrists can practice medicine in a wide variety of settings. While some professionals stick to private practice, others work in hospitals, emergency rooms, or specialized facilities.
Dr. Miles’ career highlights these different types of psychiatrists and care settings. In a standard outpatient clinic, he treats the following common conditions:
Dr. Miles also provides psychiatry services in nursing homes, assisted-living, group homes, and transitional care units. In these environments, psychiatrists encounter a much wider range of conditions , including dementia, delirium, and severe personality disorders. This distinction is important for patients to understand: psychiatry spans the spectrum from helping someone manage daily anxiety to treating severe, persistent mental illness in a residential safety net.
Other Prescribers at ACP
While many people instinctively look for a psychiatrist when seeking medication management, it’s important to understand that specialized mental health care is provided by a diverse team of experts. At ACP, many of our prescribers are:
- Advanced Practice Registered Nurses (APRNs)
- Physician Assistants (PAs) who specialize in psychiatry.
These clinicians have extensive clinical training specifically in mental health and are fully board-certified to diagnose conditions, develop treatment plans, and prescribe medications. By utilizing a team of PAs and APRNs, we are able to provide patients with greater accessibility to care without compromising the quality or depth of clinical expertise.
Psychiatrist Skills
Unlike an orthopedic surgeon who can look at an X-ray to see a broken bone, a psychiatrist operates in a world of subjective experience. Consequently, the most critical psychiatrist skills involve active listening and the ability to interpret a patient’s story without objective data.
“The story really starts with the patient,” Dr. Miles explains. “It doesn’t start with lab values… If you see a practitioner and don’t feel as if you were able to tell your story, you’re probably not seeing the right practitioner.”
Another vital skill is the ability to manage patient expectations regarding medication. Many patients fear becoming dependent on medications or worry they are “signing up for lifelong use.” A skilled psychiatrist knows how to de-escalate these fears, offering strategies for “deprescribing” or setting boundaries early on.
Psychiatrist Daily Routine
The day-to-day reality of a psychiatrist varies wildly depending on their practice setting. Psychiatrist’s daily routines can range from the solitude of a private office to the collaborative bustle of a medical facility.
In a clinic setting, a psychiatrist might feel like an “isolated island,” working one-on-one with patients for hours at a time. However, in settings like nursing homes or hospitals, the work becomes a team sport. Dr. Miles notes that in these environments, he collaborates with social workers, nurses, and other healthcare providers.
Despite the challenges and the emotional weight of the job, the profession offers deep rewards. Dr. Miles views his patients as his teachers, noting that he loves having conversations with people from walks of life he otherwise would never encounter.
Ultimately, whether you are seeing a therapist or considering psychiatric care, the most important step is simply starting. As Dr. Miles concludes, “Breakthroughs often happen when we go out of our comfort zone.”
Psychiatry at ACP
If you feel that you could benefit from medication, the experts at ACP are here to guide you. Along with Dr. Miles, our experienced team of psychiatric prescribers can guide you to balance your brain chemistry to improve your daily life. Take the first step today- your future self will thank you.
