In addition to psychiatrists, social workers, professional counselors and psychiatric nurse practitioners, there are several other types of mental health care workers providing valuable services in various aspects of mental health care. Although specific training is required for each specialty, there are common elements involving patient care, confidentiality and compassion.
Psychiatric nurses treat patients with all types of psychiatric disorders. Their training in behavioral therapy enables them to assist those who deal with patients, as well as patients themselves. They are well-equipped to interact with patients’ loved ones, teachers and law enforcement personnel. Psychiatric nurses are trained to work with patients of all ages, to deal with challenging behavior, and to administer psychiatric medication. Psychiatric nurses are involved in two major aspects of psychiatric care: assessment and intervention. Assessment includes taking patient histories and evaluating patient behavior. Intervention may be physical, pertaining to a patient’s safety, for example; biological, concerning the administration of medication; or psychosocial, involving psychotherapy. Because psychiatric nurses have medical training, they are able to intervene and assist in medical, as well as psychiatric, crises.
Psychologists evaluate, diagnose and treat psychiatric illness. They are also involved in studying mental processes and human behavior. They have doctoral degrees, usually in psychology. There are three primary categories of psychologists:
• Clinical and school psychologists
• Academic and research psychologists
• Organizational psychologists
Psychologists who work in hospitals with psychiatric patients are usually clinical psychologists, who focus on testing and evaluating patients, and on psychotherapy. Psychologists are not licensed to prescribe medication.
Physician assistants (PAs) are trained to do many of the tasks physicians perform. They are capable of interviewing patients, taking family histories and making diagnoses. Like physicians, they have medical training and so are able to evaluate whether there may be physical causes for psychiatric symptoms and vice-versa. They are also certified to prescribe medication. After obtaining an undergraduate degree, a PA must complete a two-to-three-year program of study, log many hours of clinical experience, and pass a certifying examination. In addition, to specialize in a particular area, a PA must complete a residency in her or his field.
Nursing Aides and Orderlies
Nursing aides, sometimes called nursing attendants, provide direct assistance to patients. When patients are physically, as well as psychiatrically afflicted, or when psychiatric illness prevents patients from caring for themselves physically, nursing aides are the primary caregivers. Typically, they assist patients with everyday tasks, such as eating and dressing. If patients are severely disabled, nursing aides may be required to lift or reposition them or to push their wheelchairs. Nursing aides receive many hours of training to learn how to handle patients physically and emotionally, and are required to pass an examination. An aide who goes on to complete a certification exam earns the title of certified nurse aide (CNA), and is then qualified to work in a supervisory capacity.
Orderlies provide some of the same care as nursing aides, although they do not usually interact as much with patients. Typically, they are concerned with patient transport, or the cleaning of facilities and equipment.
Occupational Therapists and Art Therapists
Several other types of therapists are involved in mental health care. Each has different training, and each approaches patient care from a slightly different perspective. Each of these specialists is likely to be found in any well-staffed psychiatric environment, such as a hospital, nursing home or special education classroom.
Occupational therapists (OTs) help psychiatric patients handle everyday life. Patients with psychiatric disorders may find normal activities, such as shopping, riding the train or eating in a restaurant, daunting because of their fears or compulsions. OTs assist patients in evaluating their problems, and in setting goals and providing focused therapy to help achieve them.
Trained in both art and psychology, art therapists use the creative process to help psychiatric patients examine their inner turmoil and tame their emotional demons. These therapists may use graphic art, poetry, music or drama to help patients uncover subconscious thoughts, explore buried feelings, and feel more aware of and in control of their lives.