- FilePatients collect their prescription at the Bellevue Hospital's pharmacy, the country's leading mental health institution.
Toni-Ann Neita, Staff Reporter
IN TIMES past, it was generally thought that only someone who was "crazy", or someone who had a "nervous breakdown" had reason to see a psychiatrist or psychologist. Today, these two professionals not only treat serious mental disorders, but they also provide services for other reasons as well.
There are times that the challenges in our lives may lead to isolation, job dissatisfaction, anxiety, depression, and other health problems. Maybe it's time you considered protecting your sanity by getting some help.
Help is available and, despite common misperceptions, is actually quite affordable.
Psychiatrists versus psychologists
So, you're feeling stressed out. Everything needs your attention all at once. You might even be feeling a bit depressed. You decide to talk to someone, but whom do you talk to? A friend tells you to go to the psychiatrist. Your sister suggests that you see a psychologist. So to add to your stress, you have to figure out the differences between these two persons to know where to go for help!
A psychiatrist is seen as a physician who only deals with mentally ill ('mad') patients. However, this is a misconception. Psychiatrists are medical doctors (MDs) so they can prescribe medication. As a result, they usually, but not exclusively, deal with issues that are more clinical in nature, such as schizophrenia, whose treatments tend to require medication.
Psychologists, unlike psychiatrists, are not MDs. A psychologist has a doctorate (Ph.D., Psy. D., or Ed.D.) in psychology and examines situational (or environmental) and psychological causes of emotional difficulties. In other words, they deal more with emotional and behavioural issues than clinical issues.
For example, a person experiencing low self-esteem would visit a psychologist rather than a psychiatrist because they do not have anything physically wrong with them; they need to talk things out and be helped in acquiring the social skills and so on, to help alleviate the problem.
On the other hand, an evaluation by a psychiatrist may be most appropriate in a situation where it is suspected that medical factors may be contributing to your problem or that medications prescribed by a psychiatrist might be helpful in alleviating distressing symptoms you are experiencing. Thus, a person with depression would be better served visiting a psychiatrist because it is felt to have a physiological cause and so they would need medication to correct the problem.
Some people see a psychiatrist and psychologist simultaneously. They go to the former for medication, but meet regularly with the latter to talk about their issues. Both of these types of professionals are trained in assessment, consultation and treatment. They have the expertise required to work with people. They know how to help people deal with their feelings and attitudes and develop healthier and more effective patterns of behaviour.
Why would anyone need a psychologist?
Most people don't, but here is why some people do: Let's begin by defining the nature of a 'problem'. A problem exists when there is a discrepancy between what you are doing and what you would like to be doing. Sounds familiar? If so, you may need help in solving your problem.
Often, the first visit to a psychologist is in response to a family, personal or career crisis. However, people work with psychologists for many reasons- they may have aspirations related to their personal and/or career development and ask a psychologist for assistance in achieving these goals.
Some areas that psychologists deal with are personal growth, career planning and life transitions, learning and attention difficulties, marital and relationship issues, separation and divorce, stress, anxiety, traumatic experiences, pain management, substance abuse, depression and performance enhancement.
In other words the scope of a psychologist is very wide; covering most of the everyday issues we face.
Costs
"Psychiatric and psychological treatment, in the main, in Jamaica is free in clinics and in the main hospitals," says psychiatrist, Dr. Aggrey Irons.
In fact, trips to clinics for counselling or treatment average a few hundred dollars (on average $600), with follow-up appointments generally going at a discounted rate ($300). Patients with financial difficulties are often exempted from paying or offered a reduced rate.
For example, the fee for counselling at Family Life Ministries, in St. Andrew, range from $1,000 to $1,500 per session, but on certain days of the week they take a contribution from persons who are unable to pay the full fee.
Operations at Bellvue Hospital are currently funded by the Government and so treatment is free. They are currently working on a cost-recovery programme.
Although community health centres and clinics frequently offer low-cost care, many persons still hold private sessions in higher regard.
Currently, the costs for private sessions of therapy is significantly low when compared to the rates charged in other countries. For example, in the United States the cost per session with a psychiatrist or psychologist averages US$100 per session which is equivalent to approximately J$4,800.
In Jamaica, psychiatrists and psychologists who operate private practices quoted per session rates of about $2,500, on average. Counsellors, persons who have received a masters degree in counselling or psychology and thus who are trained to provide professional counselling, offer lower rates of about $1,000 to $1,500 per session.
Sessions on average last about 50 minutes to an hour.
Persons considering a visit to a psychiatrist or psychologist must bear in mind that it takes at least three sessions to adequately address a problem. The number of sessions of course depends on the type of problem and the treatment required. Thus, one must budget for an average of five sessions, maybe more.
Does seeing a psychiatrist mean you will be put on medications? No. The psychiatrist will make recommendations based on their evaluation. It will be your decision to accept or decline these recommendations. If it appears that medication will be useful, the psychiatrist will discuss with you all that is involved in taking the medication, such as benefits, risks, side effects, dietary restrictions and alternatives to the medication treatment.
The prices for the different types of medication that psychiatrists may prescribe, varies considerably. "A month's supply of anti- psychotics ranges from as low as $100 to as high as $5,000 or even more," according to one pharmacist. "The popular antidepressants such as Paxil and Prozac are quite expensive."
However, as with most prescription medication, persons have the option of generic brands which are more affordable. Also, most medications are covered by health insurance which further helps to minimise the costs.
Insurance
In the United States, health insurance often covers psychiatric treatment but not psychological treatment. Here in Jamaica both psychiatric and psychological treatment is generally covered by most insurance plans. However, as one clinical psychologist explained, some insurance companies specify that they will only provide reimbursement if the person is going to therapy for a problem that is psychiatric in nature. In other words they only cover mental illnesses.
On the other hand, other insurance companies will also reimburse for treatment of problems that are deemed more psychological in nature such as Attention Deficit Hyperactivity Disorder (ADHD) which is a fairly commonly diagnosed childhood disorder.
Thus it is important to find out if your therapy will be covered by your health insurance. There is often a very fine line between what will be covered and what won't; so don't assume that you will be reimbursed.
In conclusion, psychiatric or psychological treatment may be worth considering. It may turn out to be a very good economic decision; one which could lead to improvement in one's functioning and performance in both your personal and professional life.
A word of caution: There are a lot of charlatans out there posing as psychologists and counsellors. So be careful when "shopping" for someone to help you. It could make the difference between money wasted and money well spent.
