Mental health problems can be distressing. Whether a one-off or an ongoing concern, feeling distressed or unwell for a reason that may not be easily apparent or may not be well understood by family or friends, or the wider community, is disconcerting and disruptive to everyday life.
Helping people cope with these types of concerns is the job of a wide range of professionals with skills in providing assistance, support and specific treatments. People who feel mentally unwell are commonly encouraged to contact many different types of experts in order to access effective treatment. This list often includes counsellors, psychologists, psychotherapists and psychiatrists as well as doctors in general practice. All these people can often provide excellent support and make a valuable contribution. However in the health environment there are two key experts in mental health who people are most likely to be referred to: a psychologist and a psychiatrist. This page aims to highlight their respective roles and to provide more clarity for people seeking assistance with mental health concerns.
Training to be a psychiatrist or psychologist
Both psychiatrists and psychologists undertake training to provide treatments for mental health problems. Both are commonly accessed after a discussion with your family doctor, and generally appointments with both can be claimed under Medicare (Australia only) or private health insurance; both work in private practice and in hospitals and publically funded community mental health services. Which treatments they deliver however, and how they diagnose illness are very different.
Psychiatrists are specialist medical doctors. Like all doctors, psychiatrists complete a medical degree at university (generally taking six years) which covers human anatomy, biochemistry and physiology, function of the body’s organs including the central nervous system and the effects of all drugs. After university and an intern year as a new graduate doctor at a hospital, psychiatrists choose to undertake specialist training in psychiatry. This involves additional study and assessment on top of full-time work as a hospital and community doctor called a ‘Registrar’ over a period of at least a further five years. This study focuses on teaching registrars about psychiatric and psychological treatments and social and other health impacts in addition to their biological knowledge. By the time a doctor becomes a psychiatrist they have usually completed a minimum of twelve years medical training.
There are many types of psychologists. Clinical psychologists are trained to provide psychotherapeutic treatments for mental health problems. They usually complete a Bachelor of Arts or Bachelor of Science at a university with Honours in psychology which generally but not always includes substantial practical experience in a clinic helping people with everyday problems such as stress and relationship difficulties. Clinical psychologists then complete a clinical Masters or a Doctorate which provides additional experience in a hospital or community mental health service environment and enables them to specialise in treating people with a mental illness. All together this will generally take six to eight years, during which they will receive extensive training in psychotherapy and research methodology.
These different training methods mean that psychiatrists and clinical psychologists have different approaches to diagnosing and treating disorders such as anxiety and depression. It is commonly accepted that psychiatrists use their broader biological-psychological-social knowledge effectively with patients at the more severe end of mental illness and especially those in hospital environments. They also often provide support for people who are not always severely unwell but are having a serious episode, and might work with these people as part of a multi-disciplinary team including psychologists and other doctors. Psychiatrists also see people with less serious disorders, sometimes offering direct care and sometimes providing guidance to other health professionals who are involved in providing care.
Some psychologists may not have trained in a hospital environment and should refer a patient who is not responding to psychotherapeutic treatment on to a psychiatrist who will review the nature of the person’s problems and assist with diagnosis and who can then also explore other treatment options. In some cases a psychiatrist may refer the person back to a psychologist for ongoing psychotherapeutic treatment or work together with the psychologist to provide a broader range of treatment. Both psychologists and psychiatrists help people to develop the skills needed to improve their function and to prevent ongoing problems.