To think most psychiatrists are quite cold

[Forpetslikethecats]

Just that I’ve had psychiatrist from around the age of nine now in my late 20’s and most have been cold and uncaring

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

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

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.

No. An educational psychologist alone wouldn’t usually diagnose Autism, they would note that there are signs and list them, it is usually a multidisciplinary team, psychologist,SLT, OT, sometimes a psychiatrist depending upon the mental health impact.

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

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.

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 .

I don't know " most psychiatrists ", and I doubt you do, either.

The lead psychiatrist doing it was none the less cold, arrogant and pretty vile. Not acceptable or excusable.

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.

As a long term psychiatric patient , I am not especially concerned about warmth at this stage. What use is warmth if the treatment approach is ultimately rigid and paternalistic?
It often comes across as performative anyway. I do value politeness, respect and above all transparency although the latter is rare in the context of NHS MH.
Cynical as it may be I think it is healthier for both parties to think of the relationship as transactional rather than inherently therapeutic.

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.

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?

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

Someone not somy.

I said “You don’t get to see a psychiatrist on the NHS with only 5 minutes worth of info.”
You don’t . To see a psychiatrist now the bar is high and will involve info, history and journeys that involve more than 5 minutes of interaction with NHS staff.

And re MHAS the team as a whole will have gone through the whole process which is a whole lot longer and more involved than somebody barely glancing at them for 5 minutes. A psych will be drawing on that info to be making a decision .

Bit of a stretch. The best and most productive psychs we’ve met are the ones who aren’t cold or arrogant. My dc open up and have more productive sessions with psychs who are warmer and more down to earth.

They need to be able to look at traits, symptoms and behaviours holistically though rather than in a vacuum when looking at MH disorders and how they interplay with environmental and trauma backgrounds.

I work in mental health, it’s a fairly widely held belief among many psychologists that psychiatrists are failed doctors that couldn’t hack medicine - not saying I believe it but have heard it said often.

Also the two professionals I’ve come across in my career who had affairs with patients were both psychiatrists, one male and one female as it happens.

some have a better bedside manner than others same as any discipline really

No, but considering who they’re treating, empathy and compassion are probably more important than they would be for some other medical branches.

My first one was horrific. Unpredictable moods, always running hours late, poor advice, inflexible, archaic infrastructure. My new one is the mirror opposite in all areas.