One in five — that’s how many adults in the US suffer from a mental illness. But only 40 percent sought treatment for their condition.
Mental illness can appear with a myriad of other issues — a higher risk of chronic medical conditions, shorter lifespans, or substance abuse. Not to mention there’s also the pain and suffering of living with an untreated condition.
Mental illness appears disproportionately in the population: Almost a quarter of homeless adults live with mental illness. Seventy percent of youth in the juvenile justice system live with it, too. And one-third of US service members returning from Iraq and Afghanistan experience a mental health condition.
No matter how you slice it, mental health is an increasingly salient touchstone of medicine, making the role of a psychiatrist all the more critical to helping those who need it. But exactly what is a psychiatrist, and how do they help individuals cope with and overcome mental illness? What role do they play in the health care system? And what difference can they make for those needing treatment?
We spoke with two practicing psychiatrists to learn more about the incredibly important roles they play. Keep reading to learn more about their day-to-day practices and the difference they can make in the lives of their patients.
What is a psychiatrist?
First, what is a psychiatrist, exactly?
“A psychiatrist is a physician who completed four years of medical school and four years of residency in psychiatry,” explains psychiatrist Dr. Danielle J. Johnson, Fellow of the American Psychiatric Association. “Psychiatrists diagnose, treat, and prevent mental, emotional, and behavioral disorders with the use of medication, neuromodulation, and psychotherapy.”
"Psychiatrists diagnose, treat, and prevent mental, emotional, and behavioral disorders with the use of medication, neuromodulation, and psychotherapy."
Psychiatry encompasses more than you may have realized. Psychiatrists examine, diagnose, and treat the mental and physical aspects of psychological conditions. Some conditions that psychiatrists may commonly see in patients include insomnia, anxiety, post-traumatic stress disorder, depression, and bipolar disorder. After evaluating patients and making a diagnosis, they may prescribe medications or other forms of treatment, such as psychotherapy or electroconvulsive therapy.
Note that psychiatrists differ from psychologists — it’s a commonly confused area of the field. Both of these professionals work in mental health, but their roles differ significantly.
“People often believe that psychiatrists and psychologists are the same. Psychiatrists have an MD and attended medical school like other physicians,” explains Psychiatrist Dr. Dion Metzger. “Also, not all psychiatrists have a comfy couch in their office.”
"Psychiatrists have an MD and attended medical school like other physicians."
The main difference between the two is that psychiatrists are medical doctors, while psychologists are not. While both professionals typically practice psychotherapy, only psychiatrists can diagnose conditions and prescribe medications.
A day in the life of a psychiatrist
Now that you know a bit about what a psychiatrist does, let’s take a look at what their days look like.
“There is no such thing as a typical day,” Dr. Metzger says. “As you can imagine, our days can be quite unpredictable. It obviously varies depending on the level of severity of the patients.” For example, she explains that a hospital psychiatrist may be more likely to see acute symptoms more frequently as compared to a psychiatrist in private practice.
"As you can imagine, our days can be quite unpredictable."
Depending on their specialty and work location, a psychiatrist’s day can vary quite a bit. Take, for instance, Dr. Johnson, who works at a private psychiatric hospital. She provides both inpatient and outpatient care.
“In the mornings, I provide inpatient care — usually for patients who are suicidal, have attempted suicide, or are severely depressed, manic, or psychotic,” she explains. “I have rounds with the treatment team to discuss patient care and then see each patient to assess current symptoms, treatment progress, medication effectiveness, or side effects and safety,” she explains.
Because the hospital is affiliated with an academic medical center, part of Dr. Johnson’s days center on teaching. Residents and medical students accompany her in her patient visits as part of their learning process.
“In the afternoons, I see outpatients for medication management and psychotherapy. Often, patients will see a psychiatrist for medication management and a psychologist or other therapist for psychotherapy, but some psychiatrists do both. The majority of my patients are seen for medication management and the majority have mood disorders,” she explains.
"The majority of my patients are seen for medication management and the majority have mood disorders."
Like many doctors, psychiatrists can work in hospitals or clinics. They can work for large health care facilities or smaller ones. About half of all psychiatrists in the US maintain private practice.
The immeasurable rewards of working in psychiatry
In a field as vast and varied as medicine, there are many medical specializations to choose from. So why should one pursue a career in psychiatry? For starters, the satisfaction of helping patients achieve a higher quality of life is a very rewarding aspect of this field.
“In psychiatry, there are not always tangible outcomes like there are in other specialties, but the intangible outcomes are beautiful,” Dr. Johnson says.
"In psychiatry, there are not always tangible outcomes like there are in other specialties, but the intangible outcomes are beautiful."
“A person with anxiety is now able to give a speech in a room full of people. A person with depression is no longer missing days at work and received a promotion. A person with mania returned to college. A person with an addiction stays sober. A person with psychosis gets their own apartment. A person who attempted suicide found a reason to live,” Dr. Johnson shares.
Outcomes in psychiatry may not be as black-and-white as in other specialties. For example, a cardiologist may see success in the form of a patient’s blood pressure rates returning to normal levels. But in psychiatry, success reveals itself in a range of immeasurable results.
“I am grateful to be part of someone's journey to mental wellness,” Dr. Metzger states. “As a psychiatrist, you have a tremendous impact as you treat these symptoms where the person not only feels better but you also see improvement in their relationships, career, and other ventures in life. It is a gift to see them get their joy back.”
"It is a gift to see them get their joy back."
Beyond the satisfaction of helping patients overcome their own personal challenges, psychiatry also offers many specialties for doctors to pursue throughout a career.
“I would absolutely recommend a career in psychiatry,” Dr. Metzger says. “It is a career that offers a variety of opportunities including specialties in forensics, child psychiatry, and substance abuse just to name a few.”
How do you become a psychiatrist?
If psychiatry sounds like an intriguing field to you, here’s what you need to know. Like other medical doctors, psychiatrists must attend medical school to obtain their medical degree. They must also complete a four-year psychiatric residency in addition to more training in their area of specialty. Finally, they must become licensed and board-certified in their state.
"Psychiatry is a varied field with opportunities to work in multiple types of treatment settings."
“Psychiatry is a varied field with opportunities to work in multiple types of treatment settings,” Dr. Johnson adds. Psychiatrists may work in a hospital with inpatients or doing consultations. They may work in psychiatric hospitals, jails or prisons, substance use programs, and outpatient facilities such as a private practice. They may also find a career in psychiatric research.
“We see patients as referrals, or patients can directly schedule an appointment without one,” Dr. Metzger explains. “Psychiatrists work in many different settings including the hospital, office, or within a community clinic. They can work with psychologists, nurses, and licensed social workers.” Dr. Metzger explains you may see partnerships where the psychiatrist provides the medications for the patient and the psychologist does the therapy.
Psychiatrists may work alongside physicians in other specialties, nurses, social workers, advanced practice nurses, physician assistants, psychologists, and other therapists in order to serve the population’s psychiatric needs, according to Dr. Johnson.
Alarmingly, the US is facing a psychiatrist shortage in the coming years. In fact, 77 percent of counties already report a severe psychiatric shortage. And of currently practicing psychiatrists, 60 percent are 55 and older and nearing retirement age, making now the perfect time to step up and serve the mental health needs of the patient population.
Could you change lives as a psychiatrist?
So what is a psychiatrist, exactly? They’re the doctors helping patients overcome debilitating mental illness. They’re the ones removing barriers and helping people find a greater quality of life. They’re the ones deconstructing the stigma of mental illness and serving one of the greatest health needs in the US.
And right now, they’re needed more than ever.
Could psychiatry be the field for you? Are you up for the challenge of serving the population’s mental health needs on a greater scale? Do you have what it takes to complete medical school first? Check out our article, “Should I Go to Medical School? 7 Questions You Should Ask First,” to learn what you need to know before taking the leap.
Find out if medical school is right for you.Learn More