Who is qualified to diagnose and treat depression?
Many
clinicians of various educational backgrounds are qualified to diagnose
and treat depression. The choice of practitioner type in part will depend
on need for therapy, medication, or both. Your internist or family
practice doctor can diagnose and treat depression, as can a nurse
practitioner. They may wish to refer you to a mental health specialist,
however, if therapy is needed or it a more in-depth evaluation is
warranted.
Most insurance
plans have participants who can provide mental health services, although
sometimes the choices available on a given plan are limited. Geographic
location also may dictate choice of practitioner, as shortages of certain
clinicians exist in some areas (e.g., child and adolescent
psychiatrists). Mental health specialists who can evaluate for and treat
depression include the following:
In seeking a
mental health specialist, it is important to choose someone with proper
credentials and training. Anyone can call himself or herself a
psychotherapist without having specialized training or a degree. It is
appropriate to ask the therapist about his or her training and background
in the assessment and treatment of depression. Credentials for the
previously noted mental health specialists follow.
Social workers provide a full range of mental health services, including
assessment, diagnosis, and treatment. They have completed undergraduate
work in social work or other fields, followed by postgraduate education
to obtain a Masters of Social Work (MSW) or a doctorate degree. An MSW is
required in order to practice as a clinical social worker or to provide
therapy. Most countries require practicing social workers to be licensed,
certified, or registered. Postgraduate education is 2 years with courses
in social welfare, psychology, family systems, child development,
diagnosis, and child and elder abuse/neglect. During the 2 years of
coursework, social work students participate in internships concordant
with their interest. After completion of the master's program, direct
clinical supervision is usually required for a period of time to apply
for a license, which may vary from country to country.
Psychologists have completed undergraduate work followed by several years
of postgraduate studies in order to receive a doctorate degree (PhD or
PsyD) in psychology. Graduate psychology education includes study of a
variety of subjects, notably statistics, social psychology, developmental
psychology, personality theory, psychological testing (paper and pencil
tests to help assess personality characteristics, intelligence, learning
difficulties, and evidence of psychopathology), psychotherapeutic
techniques, history and philosophy of psychology, and psychopharmacology
and physiological psychology. After the coursework, a year is spent in a
mental health setting providing psychotherapeutic care and psychological
testing under the supervision of a senior psychologist. Psychologists
must demonstrate a minimum number of hours (usually approximately 1,500)
before eligibility to sit for psychology licensure exams.
Psychiatric nurse specialists have completed undergraduate work,
typically in nursing, and have obtained postgraduate education in nursing
at the master's or doctorate level. Master's programs are 2 years with
coursework consisting of study in physiology, pathophysiology,
psychopathology, pharmacology, psychosocial and psychotherapeutic
treatment modalities, advanced nursing, and diagnosis. The training
includes clinical work under supervision.
Psychiatrists
are medical doctors with specialized training in psychiatry. They have
completed undergraduate work followed by 4 years of medical school.
Medical education is grounded in basic sciences of anatomy, physiology,
pharmacology, microbiology, histology, immunology, and pathology,
followed by 2 years of clinical rotations through specialties that
include medicine, surgery, pediatrics, obstetrics and gynecology, family
practice, and psychiatry (as well as other elective clerkships). During
this time, medical students must pass two examinations toward licensure.
After graduation from medical school, physicians have a year of
internship that may include at least 4 months in a primary care specialty
such as medicine or pediatrics and 2 months of neurology. After
internship, physicians must take and pass a third exam toward licensure
in order to be eligible for licensure (and subsequently practice).
Psychiatrists in training have 3 more years of specialty training in
residency, the successful completion of which makes them eligible for
board certification. After residency, many psychiatrists pursue further
training in a fellowship that can last an additional 2 years. Such
fellowships include child and adolescent psychiatry, geriatric
psychiatry, consultation–liaison psychiatry, addiction psychiatry,
forensic psychiatry, and research. To become board certified,
psychiatrists take both written and oral examinations. Certain psychiatry
specialties also have a board certification process. Board certification
is not a requirement to practice and may not be obtained immediately
after completion of residency, although many hospitals and insurance
companies do require physicians to be board certified within a specified
number of years in order to treat patients in their facility or receive
reimbursement.
In addition to
seeking a private practitioner for mental health services, different
types of facilities/programs are available to obtain an evaluation and
treatment, in which various mental health specialists work, including
community mental health centers, hospital psychiatry departments and
outpatient clinics, university-affiliated programs, social service
agencies, and employee-assistance programs.
