Mental health illnesses are among the most common health conditions in the United States. According to the Centers for Disease Control and Prevention (CDC), more than 50% of Americans will be diagnosed with a mental health illness or disorder within their lifetime.
That’s why eradicating the stigma around seeking help is so important. But if you have never seen a mental health professional before, you might not know where to start. So we asked Cathy Frank, M.D., a clinical psychiatrist at Henry Ford Health, to explain the difference among psychiatrists, psychologists and psychiatric social workers—and how to know you’re seeing the right person.
- Psychiatrists are medical doctors. “They go to medical school and complete—at minimum—a four-year residency in psychiatry, so they can diagnose a wide variety of medical and psychiatric illness,” says Dr. Frank. They can also prescribe medication to manage a variety of mental illnesses and are trained in a variety of psychotherapies (commonly known as talking therapy).
- Psychologists can have two different postgraduate degrees. Some have a master’s degree and some have a doctorate degree—generally either in philosophy (Ph.D) or psychology (Psy.D). “Psychologists are not medical doctors,” says Dr. Frank. “They can’t prescribe medication, but they have expertise in a variety of psychotherapies. Psychologists with doctorate degrees have specialization in research and psychological and neuropsychological testing. Testing is utilized to clarify diagnostic issues, as well as aid in treatment strategies.”
- Psychiatric social workers graduate from a two-year master’s program. “They have training in psychotherapy including individual, group, family and marital therapy,” says Dr. Frank.
To Start Your Mental Health Journey, See Your Primary Care Doctor
“Primary care physicians are the main providers of initial mental healthcare in the United States,” says Dr. Frank. “They also have the advantage of knowing you, their patient. They can say, ‘these are symptoms of a mental illness, or ‘these symptoms sound like a situational stressor.’ Depending on the mental health complaint and its severity—as well as the patient and family’s wishes—they’ll help find the best referral for you.”
Primary care doctors can also prescribe medicine for mild to moderate anxiety or depression, but if you don’t respond to initial treatment—or if your problem is more complicated—they will likely refer you to a psychiatrist.
Your primary care doctor may also refer you to a psychiatrist if you have comorbidities, meaning you have more than one health condition. This could mean you have alcohol-use disorder along with severe depression, or heart disease and severe anxiety, or that you’re pregnant with a mental illness.
“Having more than one condition can complicate things in terms of what medications you’ll take. It will make your case more suitable for a psychiatrist,” says Dr. Frank. Psychiatrists work in tandem with psychologists and psychiatric social workers to help patients with mental illness.
Different Types Of Psychotherapy
A big part of your success will be determined by the type of psychotherapy you receive. So whether it’s a psychiatrist, psychologist or psychiatric social worker, it’s important to see someone who is well versed in a variety of psychotherapies. They can help choose the type of therapy that is best for you. Common types of therapy include:
- Cognitive behavioral therapy (CBT), which is often used for those with anxiety, depression, marital problems and substance abuse issues. It emphasizes the effect that our thoughts can have on our emotions and behaviors. It concentrates on developing strategies to break the cycle of what is called automatic thoughts. “We all have such thoughts at times,” says Dr. Frank. “These are often irrational or negative self-talk, which we may not be aware of.”
- Dialectical behavioral therapy, which is based on CBT, was originally designed as treatment for those who struggle with borderline personality disorder, suicidal thoughts or self-injury. It is now also used for those struggling with substance abuse disorder, eating disorders and PTSD. It focuses on finding strategies related to mindfulness and expressing your emotions in healthy ways. “This therapy is specifically adapted to help those who experience emotions very intensely,” says Dr. Frank.
- Psychodynamic psychotherapy, which helps us understand the unconscious effect our childhood can have on our adult lives. It pinpoints the psychological roots behind issues we may have and can be helpful for people with depression and anxiety.
"Finding the best mental health professional and treatment for you is not a one-size-fits-all approach," says Dr. Frank. "Everyone's plan should be individualized. While it can seem overwhelming, just start with getting a diagnosis from your primary care doctor, and then they'll refer you to a specialist. Don't hesitate to make that first step, because most mental health illnesses are very treatable. And treatment can be life-changing—and lifesaving."
At Henry Ford, pediatric and adult primary care doctors work alongside a behavioral health team to give you or your child a referral for any mental health issue you may be struggling with. To find a doctor at Henry Ford, visit henryford.com or call 1-800-436-7936.
Cathy Frank, M.D., is a clinical psychiatrist and Chair of Psychiatry and Behavioral Health Services at Henry Ford Health.
