What can I expect if I come in/bring my child in for an appointment?

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You'll get started with an initial evaluation, in which you'll answer about a million questions. The provider should go over: what is currently going on, psychiatric history, medical history, current and historical medications/allergies, social history (work/school/job/relationship/military/abuse history/living situation etc.), family history, as well as a full review of systems. For kiddos gestational and developmental history should also be reviewed. Yes. It's a lot. A lot of it may not seem relevant but all of these areas can factor into what is currently going on with an individual. This typically takes 45 minutes - 1 hour, depending on the thoroughness of the evaluation. An hour is generally sufficient to do a thorough evaluation, however when I do evaluations in which the patient/parent want to utilize a more holistic approach two or more hours can easily get eaten up doing a thorough assessment of dietary, exercise, and sleep habits as well as evaluation of other environmental factors. Follow up appointments are usually much briefer depending on the stability of the patient. Generally speaking my follow up appointments are 30 minutes, and review any changes to psychiatric, social, or medical history, evaluation of efficacy of current medications, any adverse effects, and any new concerns that may have arisen.

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Should I see a therapist/psychologist/or psychiatrist/psychNP?

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All providers serve invaluable roles in mental health treatment. Your decision of who to see depends on what you want out of treatment and which modality you prefer. Psychologists and therapists (LCSWs, MFTs) often provide what most people know as "talk therapy" which may be hour-long weekly sessions (depending on need/preference) that in a basic sense (this summary by no means encompasses the skills or techniques these professionals offer) guide individuals in: processing stressors or traumas, improving communication in relationships, or changing maladaptive thoughts, beliefs, or behaviors. In addition to these skills psychologists may perform psychological testing which may range for neuropsychological assessments for attention deficit disorders, personality disorders, or psycho-educational evaluations which may evaluate learning disabilities. 

Psychiatrists or psychiatric nurse practitioners focus more on the biological and genetic treatment of mental health conditions. Many psychiatrists or psychiatric nurse practitioners often incorporate different types of therapy or alternative treatments (nutritional, natural supplements, behavioral changes/mindfulness practices) into their treatment. However with the focus being on the biological or genetic aspects of mental health there is often more of a focus on the neurology/neurobiology associated with mental health conditions. Psychiatrists or psychiatric nurse practitioners are psychopharmacologists who often incorporate treatment modalities such as medications into their treatment. 

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I want to bring my kid in, can I come in to the session with him/her?

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Absolutely! Especially for kids providers should be getting the perspective from key people in the patient's life, parents often bring up topics that initially the kiddo is hesitant to talk about. That being said, you may be asked to step out of the room at some point so the provider can talk to the child one on one. There may be things the child feels more comfortable discussing without a parent present. On that note, parents and the child should know that nurses, nurse practitioners, psychiatrists, etc. are legally bound by HIPPA which is a law to protect patient privacy, this means that there may be things discussed that your child does not want shared with you, and that, by law must be honored by the provider. A provider can share medical/psychiatric information with the patient's consent, a court order, in certain emergent provider to provider situations, or if a person is an imminent danger to themselves, others, or cannot reasonably take care of their basic needs. That freaks parents out sometimes, what I will say is if there is something you, as a parent, should know, a good provider will work with the child to find a way he/she is comfortable expressing or discussing whatever the issue is.

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I feel like my current provider isn't helping, what can I do?

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Like treatment for anything else, who you get care from is completely up to you! It is ok to express this or ask for what you need. If you don't feel a particular medication is helping/you're having intolerable side effects, or the therapy style isn't working for you, don't be afraid to speak up! Remember that this is YOUR TIME and YOUR TREATMENT. It's a funny phenomenon that can happen that patients can actually get worried about expressing these concerns because they don't want to 'disappoint' or upset the provider they are working with. As a provider, let me tell you this, it is not about us. It is about you. There are going to be people who click or don't click with others. There are different styles and preferences. That's fine. One of the most important aspects of treatment is that you feel comfortable with your provider. If a patient felt he/she wasn't clicking with me or that treatment wasn't progressing how he/she wanted I would much rather get the individual set up with someone who will be a better fit, so please, if you need to make a change, make it!

 

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I think I need help, but I'm really afraid of medications, is there anything else I can do?

 

Absolutely. Sometimes prescription medication is necessary, however there are always alternatives! Ask your provider about nutritional/lifestyle modifications, natural supplementations, other complementary alternative therapies (acupuncture, sensory deprivation therapy, etc.), or TMS/ECT (Transcranial Magnetic Stimulation, electroconvulsive therapy).

 

 

I'm afraid to get treatment because I don't want it to go on my 'record' what can I do?

 

First off, mental health conditions are no different than any other medical condition. If you had a broken arm would you forego treatment because you didn't want anyone to find out about it? Absolutely not! You'd get it casted right?! One thing we as a society need to get better at is reducing stigma around mental health treatment. However if you are at a place where you still feel uneasy about seeking treatment here's what you should know: If you use insurance, yes, the company will see you saw a psychiatric provider and possibly obtained psychotropic medications, with very, very, very, rare exceptions (court orders) no one will have access to this information without your consent. If you are admitted to a psychiatric hospital on an involuntary hold, meaning you were deemed to be an imminent danger to yourself, others, or gravely disabled (unable to provide for basic needs because of a mental health issue) and were unwilling to accept hospitalization voluntarily, this may be reported to a database for background checks related to the purchase of firearms for a period of years.

***laws may very state to state, this is what is currently applicable to California law***

 

 

I need help now. What do I do?

 

Ask for help. If you are experiencing a psychiatric emergency, go to your nearest emergency department or call 911. The National Suicide Prevention Lifeline can be reached 24/7 at 1-800-273-8255. Our primary jobs are to protect your safety and promote your wellness. Mind Bloom La Jolla is not an emergency psychiatric facility, if an individual is an immediate threat to themselves or others your provider is mandated to contact emergency services to protect the wellbeing of yourself and others.