Psychiatrist or psychologist: who should I see? A 2-minute self-check

Psychiatrists and psychologists both help with mental health, but they work in different ways, and many people are unsure where to start. This self-check asks 10 short questions about the kind of help you are looking for and the problems involved, then suggests a sensible first step.

You can answer for yourself or for the person you are seeking help for. The questions cover:

• how long the problems have lasted, and whether they affect daily life;
• whether medicine might help, or is already being taken;
• whether you mainly want to talk things through, or to learn practical skills;
• very low mood, or spells of very high energy with little need for sleep;
• hearing or seeing things others don't, or unusual beliefs;
• alcohol, drug or sleeping-pill use;
• whether the person who needs help is a child or a teenager;
• a physical illness or other medicines that might affect mood.

The last question asks about thoughts of ending life or self-harm, so that anyone who needs urgent help sees it straight away.

Each answer scores “No” 0, “Not sure” 1 or “Yes” 2. Some questions add points towards a psychiatrist; others take points away, towards talking therapy. This is a routing score, not a severity score: a higher number does not mean a more serious problem, only that more of the answers point to a medical assessment.

“Not sure” counts half. The total runs from −8 to 20:

Whatever the score, the result is “Start with a psychiatrist” when question 5 is answered “Yes” or “Not sure”, or question 6 is answered “Yes”. Questions 1, 8 and 10 are not scored. A “Yes” to question 1 adds a note not to delay, and a “Yes” to question 8 adds advice for children and teenagers. Any answer other than “No” to question 10 opens a panel with urgent help at once.

The result suggests a first step; it is not a diagnosis or a referral. Any qualified psychiatrist or psychologist can help you decide on the right care, and either can point you to the other if needed.

• A psychologist or counsellor is a good place to start: your answers point to talking therapy. If medicine might help later, a psychologist can refer you to a psychiatrist.
• Either is a reasonable first step: your answers fit both. If you are unsure, a psychiatrist can assess first and recommend therapy, medicine or both.
• Start with a psychiatrist: your answers include signs best assessed by a medical doctor, such as hearing or seeing things others don't (possible signs of psychosis³), very low mood or spells of very high energy (which can be part of bipolar disorder⁴), substance use, or a physical illness that may be involved.

A psychiatrist is a medical doctor who specialises in mental health, and can diagnose, check for physical causes and prescribe medicine if needed¹. A clinical psychologist assesses and treats with psychological therapies, such as cognitive behavioural therapy (CBT), and does not prescribe medicine¹. A counsellor offers talking support for life problems such as stress, grief or relationship difficulties. Our guide to the difference between a psychiatrist and a psychologist explains more.

A little preparation makes a first appointment easier, whoever you see:

• Write a short list: the main problems, when they started, and what has become harder at home, in study or at work.
• List any medicines and physical illnesses, including medicines for other conditions. Never start, stop or change a medicine without talking to a doctor.
• Note what you hope for: a diagnosis, advice about medicine, or someone to talk to regularly. Saying this at the start helps the professional plan with you.
• Check qualifications: psychiatrists are doctors registered with the BMDC, and you can ask any professional about their training.
• For a child or teenager, look for a specialist in child and adolescent mental health, and plan to go together. Read about child and adolescent psychiatry.

Effective prevention and treatment options exist for mental health conditions², and the first appointment is the start of working out which ones fit.

Problems that have lasted more than a few weeks and are affecting daily life deserve attention soon, whichever professional you choose. Care is available in private practice and at public hospitals.

See a psychiatrist urgently if there are:

• thoughts of self-harm or of ending life;
• unusual experiences, such as hearing voices;
• signs that someone cannot look after themselves.

If you are under 18, please share how you feel with a parent, guardian, teacher or another adult you trust. A parent or guardian can book an appointment for you.

The team at Dr. MR Siddique Psychiatry Centre wrote this guide to make choosing a first professional easier. It suggests a sensible first step; it is not a diagnosis or a referral, and it has not been scientifically validated. The questions are in our own words; they are not copied or translated from any published questionnaire. The points are a simple rule of thumb, not a measurement.

The sources below describe the two professions and the signs mentioned on this page. Some are written for readers in Australia or the UK, where services are organised differently, but the roles and the signs are much the same.