To think most psychiatrists are quite cold

They’re not there to be warm to you, they are there to clinically assess you and recommend treatment.

That’s like complaining a plumber knows nothing at all about rewiring a fuse box though. Totally different skill set.

I doubt your psychotherapist can explain how to investigate and manage neuroleptic malignant syndrome either, or identify a prolonged QT interval on an ECG. Your medically-trained psychiatrist will be able to.

Psychiatrists have to keep an emotional distance to be able to keep functioning in their jobs. You have to have a “ the patient is the one with the disease” ( House of God Samuel Shem) approach and not take on everyone you meet’s problems or you won’t last more than a week as a doctor. A psychiatrist is there to help you find a way through your life, not somyto transfer your problems to

The assessment is never going to be 5 minutes

Indeed, which is why nobody ever implied it would be.

The assertion was a psychiatrist having to make an evaluation about someone they have only just met 5 minutes prior, something you categorically rejected as impossible.

I've given you the details of the precise circumstances where this does indeed happen.

As I said no appointment with an NHS psych is 5 minutes so none are making decisions on 5 minutes of info as you incorrectly said

Yes, I must just be imagining all the times I've sat through an hours long MHAS assessment only for an RMO to turn up, barely look at the person in question, then immediately subject them to a detention despite knowing next to nothing about them. 🙄

Funnily enough, the exact same thing happens at the other end, just in reverse. Half of the time they don't bother turning up to a Tribunal to either explain why a CTO was necessary or argue that it should be extended. Perhaps I'm just imagining all of those as well?

It’s by the by. The assessment is never going to be 5 minutes. As I said no appointment with an NHS psych is 5 minutes so none are making decisions on 5 minutes of info as you incorrectly said.

They do not do a 5 minute assessment

Yes, I know, and have never suggested otherwise.

It’s an in-depth assessment done by a team, usually 2 doctors and somebody like a social worker

This depends on where you are. Where I am, it's an MHO, who is not a psychiatrist, who does the bulk of the legwork, including usually trying to cajole you willingly to hospital, whereupon they'll assess you for hours if that's what it takes, before the duty RMO will usually consult with the MHO, perhaps ask a few cursory questions, and then if they agree it's necessary you'll be detained on the authority of the RMO, the actual duty psychiatrist.

Said child had a long complex history as many do when it happens. The team communicated with professionals already known and the assessment was long. It was not a 5 minute meeting done with zero knowledge

This is your child. One single example of a detention. What do you suppose happens when they pull someone off the street who has had no prior involvement with MHAS whatsoever? It's exactly the same process, and yes, the RMO is expected to make a decision about someone they've never met before and likely have precious little background information on, hence why they usually defer to the MHO. I've sat through countless MHAS assessments and I can't recall a single instance of an RMO refusing to detain someone if the MHO has suggested it's necessary.

They do not do a 5 minute assessment. It’s an in-depth assessment done by a team, usually 2 doctors and somebody like a social worker. I do know because my child has had it done. Said child had a long complex history as many do when it happens. The team communicated with professionals already known and the assessment was long. It was not a 5 minute meeting done with zero knowledge .

No.

The reality is that an RMO is quite often present for no more than a few minutes even though it's on their authority you'll be detained. So yes, you do see psychiatrists on the NHS when they've only just met you 5 minutes prior, it's not at all uncommon, and nor is it the case that you'll only see one "after years of well documented history and diagnoses".

I saw my first NHS psychiatrist at 17, no prior interaction with NHS mental health services whatsoever before that meeting. It's 35 years on, I've never been given a formal diagnosis of any particular psychiatric condition, but I still see psychiatrists.

So you’re saying it’s a 5 minute assessment then?

So it’s a 5 minute assessment is it? Okaaay!!!

I presume you are asking a question because you don't know, so perhaps you should refrain from telling people who do that you somehow know better than them.

Is is standard for kids with autism to see a psychiatrist? I thought they were diagnosed and dealt with by educational psychologists?

How many EDO's have you been present for?

A 5 minute appointment with an EDO on the horizon - I think not.

You don’t get to see a psychiatrist on the NHS with only 5 minutes worth of info

Yes you do, it happens all the time when there is an EDO on the horizon.

You don’t get to see a psychiatrist on the NHS with only 5 minutes worth of info. You’re lucky if you see one after years of well documented history and diagnoses. They would have a hefty amount of info and longer appointments than 5 minutes if investigating CPTSD and if they can’t diagnose something like that properly what on earth are we paying them for?

It's not ridiculous at all.

Again, the reason why you perceive psychiatrists not to to be held to the same scrupulous standards as consultants in other disciplines is precisely because what they do is tantamount to an esoteric black art where mistakes are absolutely inevitable.

A brain surgeon can cut someone's skull open and operate on their brain forearmed with knowledge of precisely what the purpose is and how they need to treat the patient because physical ailments can be detected with scans and imaging.

There is no such equivalent for psychiatry. You can not cut someone's head open and take a slice of their brain matter to determine whether what you are dealing with is CTE or a schizophrenic illness. There is no blood test for CPTSD. They will run tests if you are being investigated for Bipolar, but only to check thyroid function, it doesn't come back with a marker saying "this person is Bipolar". Without an extensive knowledge of a patient's personal history, it's impossible to tell if an agitated or depressed state is due to an environmental factor or some underlying health condition. How is a psychiatrist who has met you for the first time five minutes ago supposed to know? Especially so when your agitated/subdued state means they aren't going to get anything meaningful out of you anyway, and you've had no prior engagement with mental health services to offer any leads?

Psychiatric medical model is far from perfect and there isn't really any serious opposition to that contention, but the mistakes made are more often a result of an imperfect understanding of the human brain and an absence of diagnostic tools compared to disciplines concerned with physical health, and not just the sheer incompetence or intransigence of mental health professionals. To coin a phrase, you can only work with the tools at your disposal, and if the tools are inadequate you will end up with unsatisfactory results. What is needed in order to improve psychiatry is far more serious investment in all aspects of mental health provision, not just chasing after existing psychiatrists with a shitty stick because of perceived wrongdoing. Where there is obvious shortfall in care it needs addressed, but the vast majority of psychiatrists are, like the overwhelming majority of other doctors, genuinely trying to help despite the fact they frequently get things wrong. That isn't a personal failing, it's part and parcel of psychiatry.

Are you expecting them to be your best mate or something? If they were an orthopaedic consultant or a cardiologist would warmth be obligatory? A certain level of professional distance is required to avoid unhealthy dependence. If you’ve had a psychiatrist since the age of 9 then I’m afraid to say that it might be your own attachment issues that are the problem.