There can be a lot of people involved in mental healthcare. This is a quick overview to help you navigate some of the titles and services.
Primary Care Doctor
This is probably the first person a lot of us go to when we decide it’s time to do something about our mental health. They are a great place to get started, and will be able to prescribe medication and suggest resources. Still, they are not specialists in mental health. They may recommend seeing a psychiatrist who knows more about these issues, or you may decide on your own if/when it’s time to do.
A psychiatrist is a prescriber who specializes in treating mental illness. Though there are some exceptions, the psychiatrist generally prescribes medication and manages a treatment plan, but does not do talk therapy. You might see your psychiatrist in any of a variety of settings, from a small, specialized clinic to a large hospital outpatient department. Psychiatrists also work in inpatient settings.
The person you see for medication doesn’t have to be a doctor! Doctors with MD after their name are probably the most common, and are trained to treat disease. Those with DO are also doctors, but their training teaches them to look at the patient as a whole, and to treat the whole person, not just an ailment. Nurse practitioners (NP’s) and physician assistants (PA’s) also see their own patients and prescribe medications. Nurse practitioners are nurses who have received additional schooling, and are trained with a more patient-centered approach to medicine. Physician assistants receive a condensed training similar to that of MD’s. Though they see their own patients, they work under the supervision of a physician (MD or DO).
Counselors are the ones who provide talk therapy, which is a hugely important part of mental health treatment. Counselors help you learn skills to cope with challenges and strong emotions, to identify unhealthy patterns and change them, and to problem-solve personal difficulties. Counselors may work in large or small practices, in a hospital’s outpatient or inpatient mental health program, in rehabilitation programs, with hospitalized patients, and so on.
Counselors are formally trained and certified. They hold at least a master’s degree, though some have a PhD (doctor of philosophy) or PsyD (doctor of psychology) and therefore use the title Dr. (these therapists are not medical doctors). Other counselors might have any of several titles—usually, you can tell which by the initials they use after their name. The most common that I’ve seen is LCSW, which stands for “licensed clinical social worker”; others include LMFT for “licensed marriage and family therapist” and LPC for “licensed professional counselor.”
Counselors go by many different titles, including “therapist” and “social worker.” Many counselors have some type of specialty, which might be a certain modality of therapy, a certain mental illness, or a certain age group. In my experience, these kinds of specialties don’t have a lot to do with what official title they have, and it’s more useful to look for information they provide about their specialty than it is to compare counselors based on their title or the initials after their name.
A neuropsychologist performs testing to try to figure out what all might be going on psychologically when other efforts—like seeing a psychiatrist—aren’t helping or aren’t helping enough. Neuropsychologists administer any of a number of tests that help them identify things like Autism spectrum disorder, ADHD, or a specific learning disability in addition to mood disorders. They do this with tools like interviews and pen-and-paper tests, and the evaluation process can take several hours. A neuropsychologist has a doctorate degree, which may be a PhD or PsyD, so they will use the title Dr., but aren’t medical doctors. They don’t make a diagnosis, but do provide test results and make recommendations to help a doctor (or other prescriber) do so. They also don’t perform therapy, and they don’t prescribe medication. Not everyone who is looking for help with a mental health issue will go see a neuropsychologist.
I’ve noticed that some programs use peer mentors as a resource for individuals who are struggling with their mental health. I’ve noticed them specifically with programs for substance abuse recovery as well as programs for those with Autism spectrum disorder, and a hospital near me has a “warm line” staffed with peer mentors to offer support and encouragement. Peer mentors may have specific training for the program they’re involved with, but don’t have any particular certifications or schooling like other providers on this list do.
There are a range of other providers you might work with as part of a mental health team.
Nurse: Nurses are caregivers in clinics and hospitals, and have many roles. They might see you first when you go to a doctor’s appointment, they may assist a doctor or other provider, they might administer medication and help take care of you in an inpatient setting.
Medical assistant: Medical assistants preform many tasks similar to what nurses do, though their training is more condensed.
CNA or technician: These individuals help care for patients and assist other health care providers. Their titles, training, and duties vary.
Occupational therapist: This individual’s job is to help individuals perform tasks of daily living. Sessions might include working on things like independent living, organization, or better focus.
Case manager: Having a case manager might be part of a participating in a specific treatment program or receiving governmental services. As you can see from this post, there can be a lot of people involved in mental health care! A case manager helps coordinate all these people and services.
Others: This isn’t a comprehensive list. Mental healthcare is specific and individualized–because it’s for individuals! Leave a note below about anything I’ve left out.