How do I know whether I should seek help from a psychiatrist or psychologist?

Doctor's Answers 1

Many people are confused by the terms ‘psychiatrists’ and ‘psychologists. They are both trained to help people with mental health issues and, very often, they work in collaboration with one another to provide the best possible treatment for an individual.

Nevertheless, there are salient differences between the two professions and the services they provide differ in terms of content and scope.

First, in terms of training and education. Psychiatrists in Singapore are medical doctors to begin with. That is, they are graduates from a medical school; they then go on to specialise in a field of medicine called psychiatry or psychological medicine. They are trained in the assessment and treatment of mental health disorders.

Psychologists have a Masters or Doctorate degree in an area of psychology, the study of the mind and human behaviour. Clinical psychologists have special training in the diagnosis and treatment of mental illness. They are not medical doctors. Unlike psychiatrists, psychologists are also trained in giving psychological tests (like IQ tests, personality tests, neuropsychological evaluation, specific psychological assessments for attention deficits, dyslexia, etc).

Second, because of their medical training, psychiatrists can prescribe medications. A few states in America (such as New Mexico and Louisiana) do allow psychologists to prescribe a limited number of psychiatric medications after they have completed a training course to enable them to prescribe psychiatric medicines. Till this date, psychologists in many parts of the world are not given the rights to prescribe medications for their clients.

Third, both psychiatrists and psychologists are typically trained to practice psychotherapy -- talking with their patients about their problems. But the differences in background and training affect their approaches to mental health issues. Psychologists tend to look closely at the person’s behaviour; they will track sleep patterns, eating patterns and the negative thoughts that might be perpetuating a problem. Psychiatrists have a stronger sense of biology and neurochemistry. For instance, before a patient is diagnosed with major depression, the psychiatrist would like to entertain the possibility of medical problems and medication-induced depression. Many psychiatrists are also well-versed in cognitive behavioural therapy.

Many psychiatrists are trained to provide a wide variety of treatments, according to the particular problem and what has been demonstrated to be effective. These include:

• medication

• general medical care, including checking the physical health and the effects of medication

• psychological treatments

• brain stimulation therapies such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS).

Psychiatrists tend to manage people with complex conditions, e.g, schizophrenia, affective disorder, schizoaffective disorder. They have more formal training and treatment options available. Someone who has attempted suicide or has suicidal thoughts will usually be seen by a psychiatrist. Being medical doctors, psychiatrists can also work more readily with your primary care doctor or other specialists. Psychiatrists are medical doctors and they can issue medical certificates; psychologists cannot do so.

Psychologists are more likely to see people with conditions that can be helped effectively with psychological treatments. This might include behavioural problems, learning difficulties, depression and anxiety.

In the treatment of less severe kinds of mental health problems, who to see can often be more of a matter of personal preference. The type of approach needed often depends on the severity of the symptoms and the needs and wishes of the patient.

According to research, patients differ as to what is preferred— psychotherapy alone or in combination with medication — which, therefore, can affect what professionals they see. The expense can also be a mitigating factor; some studies have found that combining treatment approaches may also be more cost-effective for patients/clients. If you intend to claim the expenses from your insurance company, it will be good to check with your insurance company if your policy covers treatment with psychiatrist or psychologist.

Similar Questions

Which kinds of health care professionals offer treatment for psychosis in Singapore?

Psychosis is a serious mental illness that should be treated by the best people out there, to prevent deterioration and long term consequences. The best people out there are part of this team called the "EPIP", which stands for the early intervention program for psychosis in Singapore. The team leader is usually a senior psychiatrist, with a team of mental health nurses, psychologists and other therapists. Some of the milder cases can be seen by family doctors with an interest in mental health. If you are not sure where to look, you probably can start from seeing one of these GPs first.

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