Consultation and Referral

UCS offers consultation and referral services to students, faculty, and staff at Truman State University. UCS staff are available to talk with you about a variety of concerns and often consult with residence hall staff and concerned parents. In addition, should a university employee be in need of ongoing counseling services, UCS staff can provide a list of community resources and referral agencies and help find the appropriate services.

The Psychiatric Evaluation

Why Am I Being Referred for a Psychiatric Evaluation?

It may be difficult to hear when your counselor believes that you would benefit from consulting with a psychiatrist or psychiatric clinical nurse specialist. Many people believe that psychiatric interventions are only needed in cases where a person is “crazy.” This attitude is the result of outdated notions and misinformation.

Knowledge in our understanding of how the body and mind function has increased a great deal in the last few decades. A general practitioner is no longer expected to know all there is to know about diseases and treatments in all areas of the body. People are often referred to specialists in order to receive the best possible care for their illnesses. Psychiatrists and psychiatric clinical nurse specialists are specialists in diseases which affect the functioning of our minds. These specialists work with a wide variety of illness, some very severe, some very common and managed relatively easily with medication, counseling, and/or lifestyle changes.

A referral for a psychiatric evaluation is not an indication that you are severely mentally ill – you probably would not be in college if that were the case. A referral for a psychiatric evaluation usually means that there may be a biological cause for the difficulties you are experiencing. Since the staff at University Counseling Services (UCS) are not physicians, we cannot fully evaluate biological aspects of your symptoms. We are, therefore, ethically and morally bound to encourage you to see someone who might be better able to assess and treat conditions that may have a biological cause or contributor.

Who Can Provide a Psychiatric Evaluation?

Although any medical professional can prescribe medication that might assist in alleviating your symptoms, we recommend that your initial psychiatric evaluation be completed by a psychiatrist or a psychiatric nurse practitioner/clinical nurse specialist.

Psychiatrists are physicians who specialize in treating mental disorders. They are medical doctors (M.D.’s) or doctors of osteopathy (D.O.’s). They should also be licensed to practice psychiatry in the state where their practice is located. To specialize in psychiatry, a physician must complete four years of medical school followed by one year of internship and three years of training in a psychiatric residency program. During their residency, psychiatrists receive instruction and experience in the treatment of a wide range of psychiatric disorders while under the supervision of more experienced practitioners. Upon graduation from a residency program, a psychiatrist may seek specialty certification in psychiatry from the American Board of Psychiatry and Neurology. Those practitioners who successfully complete the board’s written and oral examinations are designated as “board certified.” Although this certification is not required to practice psychiatry, the vast majority of psychiatrists today opt to take the board exams.

Psychiatric nurse practitioners/clinical nurse specialists receive additional training after completing general nursing credentials and a master of science degree in the specialty. This additional training may come in the form of supervised counseling and clinical practice. Their education is grounded in the medical and social sciences, and they are knowledgeable about physical conditions that relate to mental disorders. Psychiatric clinical nurse specialists are certified by the American Nurses’ Association. They generally take a qualifying examination after a period of practice and supervision. In most states, psychiatric clinical nurse specialists prescribe medications independently or in collaboration with psychiatrists.

Your counselor can provide you with the names of individuals in the Kirksville area who are qualified psychiatrists or psychiatric clinical nurse specialists. Your counselor can also assist you in locating appropriate specialists in other geographic areas.

What Will Happen During a Psychiatric Evaluation?

Actually, your psychiatric evaluation will be quite similar to your Intake appointment at UCS. You will be asked to provide a variety of information. When you go to your appointment, you should be prepared to share with the practitioner detailed information regarding your symptoms and your medical history. You will also be asked to provide information about your personal and family history in addition to the medical and psychiatric history of close family members. The practitioner may ask a variety of questions that may not seem to be related to your problems but will provide the information needed to get a more complete picture of your functioning. It is very important that you respond to the questions openly and honestly. The practitioner cannot accurately assess your situation or plan appropriate treatment if you do not share all pertinent information. You may be hesitant to share information about alcohol or drug use or other behaviors about which you may be somewhat embarrassed. Remember, however, that these mental health practitioners are trained to respond to you in a sensitive and appropriate manner and there is little that will shock these well-trained and experienced professionals. Their job is not to judge you but to help you.

What If the Psychiatrist or Psychiatric Nurse Prescribes Medication?

Many people are very frightened at the prospect of taking medication to assist with a mental health problem. Although any medication should be taken as directed and with proper medical supervision, drug therapy can be very effective in safely minimizing and controlling symptoms of mental illness and emotional disturbances. If you are prescribed a medication, be sure you get all the information you need in order to use the medication properly. Some questions you might want to ask are:

Ÿ Why is medication necessary?	Ÿ How can I tell if the drug is working?
Ÿ What specific symptoms will it relieve?	Ÿ Should I call if any particular side effects develop?
Ÿ What are the risks and benefits of taking this medication?	Ÿ Is there any danger from skipping a dose? From taking a double dose?
Ÿ How long will it be before the medication begins to help?	Ÿ What are the risks of overdosing?
Ÿ How often must the drug be taken?	Ÿ Does this medicine interact with any other medications?
Ÿ Is there a preferred time of day or night for taking	Ÿ Can I drink alcohol while taking this medication?
the drug?	Ÿ Are there any food or substances I should avoid?
Ÿ Do I have to avoid eating before or after taking it?	Ÿ How long will I have to take this medication?
Ÿ Should it be taken with food?	Ÿ Is there a danger that I’ll become addicted?
Ÿ Will it affect my ability to drive or operate machinery?	Ÿ What are the alternatives to using this drug?
Ÿ Will it affect my ability to work?	Ÿ What if this drug doesn’t work?
Ÿ What is the initial dosage?	Ÿ What are the odds that this medicine will help me?

Will I Continue to Work with my UCS Counselor?

Most psychiatrists and psychiatric nurses are very willing to work in collaboration with UCS. Because they are bound by similar legal and ethical requirements for confidentiality, your written permission for collaboration will be required. You will most likely be given the option of continuing to work with UCS if our services can be of assistance to you or to work exclusively with your psychiatrist and psychiatric nurse if you would prefer.

What Does a Psychiatric Evaluation Cost?

The cost of psychiatric evaluations are covered by most insurance plans. You will need to check with your insurance company to see what restrictions apply. If you do not use and/or have insurance, a psychiatric evaluation in the Kirksville area averages $100 - $200 depending on whom you see and the time it takes to complete the evaluation. In most cases, a payment plan can be arranged.