LEXINGTON, Ky. — Child and adolescent mental health professionals will tell you that as the honeymoon period of the school year wanes and the temperatures cool, the volume of children and families seeking mental health support increases. Where do you turn if you are a caregiver to a child exhibiting signs of a mental health disorder? There are many types of mental health professionals in different settings, with different degrees, licensure and skills. It can be difficult to know where to start.
Psychologist or psychiatrist?
Let’s start with the origin of the root word, “psych” or “psyche,” which is of Greek origin and means “the human soul, mind or spirit.” Both professions address mental health, focusing on how the mind interacts with the body to create well-being. Psychologists and psychiatrists provide psychotherapy to address the health of the mind and spirit. However, you are more likely to find a psychologist in that role as they do not spend time addressing medication.
Psychology boards license psychologists and have master’s degrees and doctorates. A psychology doctoral degree can be a Ph.D.or Psy.D. In these degree programs, psychologists learn how to evaluate (via semi-structured interviews, observation and standardized assessment), diagnose developmental disorders and mental health conditions and implement behavioral health interventions to address these disorders. Psychologists with master’s degrees receive or have received extensive supervision from psychologists with doctorates to practice psychology.
Psychiatrists are physicians who have gone to medical school and received extensive behavioral health training through their fellowships (post-medical degree training). Thus, they are prepared to prescribe medication that can improve mood and they are prepared to evaluate and diagnose developmental disorders and mental health conditions. They are also prepared to provide behavioral health interventions, although their training in and interest in applying them (versus referring to a psychologist/therapist) varies. They can also provide psychological testing, although this is often something that a psychologist does instead.
What is confusing and sometimes a subject of ethical debate is that in some states, psychologists can prescribe medication. In Kentucky, psychologists cannot prescribe medicines.
In Kentucky, the key difference between psychological services and psychiatric services are:
- Psychiatrists are medical doctors (M.D. or D.O.) who can prescribe and monitor medication
- Psychologists have doctoral degrees (Ph.D. or Psy.D.) or a master’s degree and are more likely to provide therapy and testing
So, who do you go to first? That all depends on where you think you need to start and what you want to know or do. A good place to start is with a conversation with your child’s pediatrician. Pediatricians will refer children to a psychiatrist if they feel that further assessment is needed to provide a diagnosis and/or they cannot manage the medication your child needs to improve their mood or behavior.
Start with a psychologist if:
- You are concerned your child may have ASD, ADHD or a learning disability.
- Your child needs therapy — particularly if your child has a neurodevelopmental disability like ASD or ADHD.
Start with a psychiatrist if:
- You are pretty sure that your child has ADHD or anxiety or depression and you think medication is needed for your child to benefit from therapy.
- Your child already has a mental health diagnosis and the person who provided the diagnosis or the therapist recommended you discuss medication management with a medical provider.
For more information on how to tell the difference between a moody teen and one who needs a mental health evaluation, go here: https://ukhealthcare.uky.edu/wellness-community/blog/it-typical-teenage-moodiness-or-depression-heres-how-tell.
