Understanding what psychiatrists do

Psychiatry health profession is the most misunderstood within the medical fraternity by both the public and other practitioners. The aim of this article is to basically describe what we do and that we are highly trained cadres and able to help patients wh

MANY people confronting mental illness for the first time fall back on often quite inaccurate, negative preconceptions about what mental illness is, what sort of treatment is available, and who does the treating.

The most common scenario I have encountered is one in which people think that mental illness involves hallucinations and delusions (e.g., that mental illness reduces to schizophrenia), and that it is treated primarily by mental health medical doctors in corduroy coats and where the patients are tied in strap restrictive jackets and in small seclusion rooms under heavy security guard.

This scenario was actually a little accurate 50 years ago, but it resembles too little or nothing to do with reality today.

Mental health treatment in the 21st Century generally involves coordination among several healthcare professionals drawn from different disciplines.

While medical doctors still run the show in the form of psychiatrists, their role has typically diminished to that of diagnostician and prescriber of medication and the occasional assessment and/ or ECT. Clinical psychologists are often called upon to handle assessment work such as psychological and cognitive testing, as well as psychotherapy.

Social workers increasingly offer psychotherapy services as well.

A host of related professionals; occupational therapists who assess and prepare the functionality of patients and lest we forget, psychiatric nurses are still around too, handling much of the hands-on work involved in in-patient hospital care.

Psychiatrists are specialist mental health physicians who have completed medical school, plus a multi-year residency in psychiatry in a hospital setting.

As medical doctors, psychiatrists are able to prescribe medicine, and to engage in medical and physical treatments for mental disorders.

Thirty to twenty years ago, it was pretty common for a psychiatrist to practice psychotherapy, but these days it is less common, but still being done. As a field, psychiatrists have gravitated away from therapy and towards the usage of medicine as treatments of choice for treating mental illness. Having a psychiatrist involved in treatment planning is essential for moderate to severe forms of mental illness where the state of the art treatment protocols necessitate the use of medicines.

Bipolar illness and schizophrenia are good examples. Some (not all) psychiatrists are also experts at administering electro-convulsive shock therapy (ECT), a remarkably effective treatment of last resort for medication and therapy-resistant forms of depression and schizophrenic catatonia.

Psychiatry health profession is the most misunderstood within the medical fraternity by both the public and other practitioners.

The aim of this article is to basically describe what we do and that we are highly trained cadres and able to help patients who need our help. ◆ Dr Sacrifice Chirisa is a passionate mental health specialist at the Parirenyatwa Group of Hospitals, one of the country’s major referral centres.