When Is It Time to Seek Psychiatric Help – And What Are The Treatment Options

At Silver Hill, we are frequently asked about seeking help — when is it time, what are the options. As the hospital’s Physician-in-Chief, I’m going to try and give you some answers.

Before discussing what I consider to be my basic guidelines, there is one rule that is hard and fast, no matter what: If a person is in danger of harming him/herself or anyone else, get immediate help. Take them to the ER, a psychiatric facility, or call 911.  In fact, calling 911 is probably the best option. An individual in that state is volatile and unpredictable and it is best to call professionals.

Aside from that, we need to put our lives — and expectations — in perspective. Outside events — having a hard day at work, divorce, loss of a loved one, a health crisis, losing some money in the stock market, losing your job, moving, changing schools, even a change in the weather — can affect our emotional well being. That’s normal.

No one should expect to feel happy all the time. We all need to learn to live with the ups and downs of life. But the flip side of that is also true: No one should feel sad all the time. 

As a psychiatrist, I evaluate emotional and mental condition and, like all physicians, I strive for as much patient recovery as possible.

At the examination, I assess the level of individual functioning. One of the most pressing concerns is whether the individual is suicidal or in danger of hurting someone. This is the most severe situation and would require immediate hospitalization.

To examine the severity of someone’s condition, I ask if they are able to get out of bed, get dressed, eat, get to school or work and engage productively with society.  If the answer is no, or they are having significant difficulty doing these activities, they may need inpatient treatment.  

Duration is another important factor — how long they have been experiencing these symptoms or been distressed. If these symptoms persist for weeks in spite of getting outpatient therapy, then I may recommend inpatient treatment.

Outpatient therapy is defined as visiting with a psychiatrist, psychologist or other clinician on a regular basis. Often it is weekly, but can be more or less depending on each situation. This intervention is indicated if symptoms are not as severe as to interfere with functioning, but have been persisting for several weeks.

Outpatient therapy may include talk or prescription therapy, or a combination of both. The outpatient therapist may decide that the person’s symptoms could be stabilized faster, and more safely, in an inpatient treatment program.

The more severe the symptoms, that is the more they interfere with the individual’s normal level of functioning, the more likely the individual may need inpatient treatment. Finding the right treatment can be a delicate balance. Therefore, it is always best to seek professional guidance.

There is another group of people, whose symptoms may not be so evident, that need intervention. These are individuals who are able to maintain their lives — they can function — but not within the normal capacity. For example, they don’t just have a glass of wine at night, they have several — and they crave the time of day when it is socially acceptable to drink. People like this are often self-medicating and help would be a tremendous benefit.

The U.S. Surgeon General has reported that at least one in five people have a diagnosable mental illness in a given year. It almost goes without saying that at various points in our lives, we will all either know someone who needs psychiatric care or need it ourselves.

The last guideline for when to seek psychiatric treatment is this: As in dealing with most health issues, it’s usually easier to treat a condition when addressed earlier in the course of the illness. Acknowledge it. Take action. Get help. We are here.