What are psychiatric services?
A psychiatrist is a medical doctor who helps to determine if your mental health symptoms are in some way caused, or contributed to, a physical issue. Psychiatric consultation is recommended when a) biological or medical factors may be contributing to your presenting symptoms or concerns, b) the type of medications prescribed by a psychiatrist might be helpful in alleviating symptoms that interfere with your daily functioning, c) medication could help manage your symptoms while you learn additional coping strategies, and/or d) to help maintain improvements made in psychotherapy over time. The psychiatrist may also be called upon to provide further diagnostic information.
What is the difference between psychiatry and psychotherapy?
Psychotherapy is the use of psychological methods based on regular personal interaction to help a person change and overcome problems in desired ways. Psychotherapists focus on helping an individual gain additional insight and coping strategies while a psychiatrist focuses mostly on the use of medication and psychoeducation to address mental health issues. The simplest answer lies in the educational background required for each profession. A psychiatrist has a degree in medicine and a psychotherapist has a Masters or Doctoral degree in Social Work, Counseling or Psychology.
Who is eligible to see the psychiatrist?
The psychiatrist at the Counseling Center typically works with full-time undergraduate and graduate students who are being seen by one of our therapists or a therapist in the community. Rarely is it recommended that a person works with a psychiatrist without at least an evaluation by a therapist because it has been found that people who do so don’t get the full effects of the treatment and may not get much better. If you are no longer enrolled as a student, the psychiatrist and the Mental Health Services Coordinator will work with you to find a provider that can continue to support you with your medication needs. When you are ready to end psychotherapy, the psychiatrist will talk to you about appropriate options for medication if your need continues.
How do I make use of these services?
Discuss a referral to psychiatric services with your counselor, your physician, or the Mental Health Services Coordinator. You may reach the Counseling Center at (757) 221-3620 if you do not already have a counselor, therapist, or physician who can provide an appropriate referral. Unless you are already in psychotherapy you will be expected to attend an Initial Assessment appointment and follow other recommendations in order to be considered for a psychiatric referral.
What will happen during my appointment with the psychiatrist?
Your first appointment with the psychiatrist will typically last about an hour. During this initial evaluation, the psychiatrist will want to discuss your concerns and symptoms, as well as any medical or emotional problems you or any family members have experienced. The psychiatrist will also ask about your use of medications, drugs, and alcohol and things you do to take care of yourself. They will provide you with a diagnosis, if you have one, and discuss the rationale for any recommendations they make for you in accordance with the standard of care for their practice. You will be scheduled for a follow up appointment or appointment(s) to discuss the plan, how it is working, and any changes for treatment that are determined to be necessary.
Does seeing a psychiatrist mean I will be put on medications?
Not necessarily. The psychiatrist will make recommendations based on this initial evaluation. It will be your decision to accept or decline these recommendations. If it appears that medication would be useful, the psychiatrist will discuss with you all that is involved in taking this medication, such as benefits, risks, side effects, medication and dietary restrictions, and alternatives to the medication treatment. It is extremely important that you have sufficient information and time to make an informed decision about your treatment. You are encouraged to be open with the psychiatrist. Please do not hesitate to ask any questions you might have, such as the benefits and potential side effects of any medications. The cost of any medication prescribed is your responsibility. Please let the psychiatrist know if your medications become unaffordable and are interfering with your ability to continue your treatment consistently. Many medications can be obtained at the pharmacy in the Student Health Center using your health insurance.
Pre-Authorization for Medications:
Some insurance companies require pre-authorization for certain medications. If pre-authorization is not obtained before filling your prescription, the pharmacy may charge you the full cost of your medication. Since there are many insurance policies with different requirements for pre-authorization, it is your responsibility to find out what the requirements are by calling your insurance company. If authorization forms must be completed, please arrange to have these papers delivered to the psychiatric provider to be completed. Some insurance companies will offer a substitute medication for the medication that was prescribed. In this case, the psychiatric provider will discuss further options and make recommendations based on your individual situation. If you need help with this, the Mental Health Services Coordinator can help you.
What if I stop taking my medication(s)?
Sometimes you may be tempted to stop your medications. However, please discuss this with your counselor and the psychiatrist before doing so. Some medications when stopped abruptly can cause extremely unpleasant and possibly dangerous effects. Others may not seem to have an impact until later, but once you notice the returning symptoms it could take some time to regain the positive effects the medication may have had.
What if I need medication for ADHD (psychostimulants)?
The W&M psychiatrist and the physicians at the Student Health Center do not see students who only need prescriptions for ADHD medications. If this is what you need you can schedule an appointment with the Mental Health Services Coordinator who can help you with a referral. If you have already been prescribed these medications, but they are insufficient to address all of your symptoms you can consult with the psychiatrist about this. You will need to bring your previous documentation and prescription to the appointment for the consultation.
What if I have to miss an appointment?
Out of respect for other students who may also need psychiatric support, you are strongly encouraged to keep all of your scheduled appointments with the psychiatric provider. Failure to keep appointments may result in a long delay in your treatment, as well as a delay for others. If you must cancel or reschedule an appointment, it is important that you call the Counseling Center as soon as possible (preferably 24 hours prior to the appointment) so that the time may be used for another student.
If you miss two psychiatry appointments without notifying the Counseling Center in advance we reserve the right to terminate your on-campus psychiatric services. In that case, you will be provided psychiatric referrals off-campus at your own expense.
Does the psychiatrist take walk-ins like the other providers at the Counseling Center?
No. If you are having a medical emergency related to a medication prescribed for you, please go the Student Health Center or your local emergency room. If you are experiencing emotional distress, contact your primary therapist or call the Counseling Center to speak with someone.
What psychiatric services are available during the summer months?
The psychiatrist will provide limited time during the summer. Please contact the Counseling Center for available dates and times.
Who will know about my visit to the psychiatrist?
When you are seen by the psychiatrist, a copy of your psychiatric diagnosis and treatment plan (including any medications prescribed) will be sent to the Student Health Center for inclusion in your SHC health file. Both the Counseling Center and the SHC will treat your psychiatric records as confidential health information. Exceptions to confidentiality apply (e.g. when there is a substantial likelihood that you will cause serious physical harm to yourself or another person, when there is reasonable cause to believe that a child or aged person is being abused or neglected, when a court order demands information be released, etc.).The psychiatric provider may also exchange information with your counselor and with individuals who are involved in the provision of and payment for any medications you are prescribed or laboratory tests ordered (e.g. pharmacies, and insurance companies). All other exchanges of your information will require your written authorization.