General psychiatry

General psychiatrists are medically qualified doctors who contribute to the management and treatment of adults with mental health problems

This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you. 

Nature of the work

The work is based around developing a therapeutic alliance with the patient and often involves co-operating as part of a team with other professional disciplines.

Specific interventions include medication and psychological interventions including cognitive behaviour therapy and other talking therapies, as well as interventions that take into account the social factors that might be contributing to the clinical picture.

Watch a video of Arthita Das talking about general psychiatry:

Note: this video is part of a longer film that can be watched from the psychiatry introductory page.

General psychiatry is underpinned by a detailed knowledge of anatomy, physiology, psychology and pharmacology as well as a good understanding of the social factors that contribute to mental wellbeing and mental ill health.

Mental illness is more common than we might think – in any one year about 25% of the population suffer with a mental health problem.

Mental health disorders include:

  • mood disorders such as depression and bipolar disorder
  • psychoses including schizophrenia, schizoaffective disorder and bipolar disorder with psychotic symptoms
  • eating disorders
  • anxiety disorders and phobias
  • obsessive compulsive disorder
  • drug and alcohol abuse, including psychosis in association with substance use
  • post-traumatic stress disorder (PTSD)
  • organic disorders such as dementia
  • personality disorders

Psychiatrists emphasise the importance of developing a good collaborative therapeutic alliance with their patients and their patients’ families. They work as part of multi-disciplinary teams in which they have a key leadership role.

Psychiatrists, with their deep and broad training, often take a lead role in establishing the strategic management plan for an individual patient, utilising their therapeutic skills to involve the patient and develop a constructive pathway to recovery.

In straightforward cases they may work individually with patients. Most psychiatric care is delivered in community settings and patients live in their own homes. A range of different community based services are available, including Early Intervention in Psychosis teams, Crisis and Home Treatment Teams and Access and Recovery Teams. Other specialist teams include Eating Disorders and Perinatal services. 

In-patient care remains available and is an important part of the care pathway for some patients.

The work is varied and fascinating. General adult psychiatrists usually work with patients of working age from 18 years and may work in specialised teams or in more generic teams dealing with a range of different diagnoses.

“I run outpatients clinics most days of the week, and see patients with substance misuse problems”. Grace Ofori-Attah, Higher specialty trainee,Camden Specialist Drug Service.

Read Grace’s story

Common procedures/interventions

Psychiatrists are trained in, and able to use both pharmacological and non-pharmacological approaches and to develop therapeutic alliances in situations which may appear initially unpromising.

They are trained to understand the social contexts within which their patients lead their lives with an explicit aim of working to instil a sense of hope and optimism.

They have an understanding of different psychological and social approaches and are supported by social work and psychology colleagues. Psychiatrists will also work closely with specialist pharmacists in their trusts (in England only) who can assist with more unusual drug treatments.

When someone is referred to a psychiatrist, an initial assessment is carried out, sometimes alongside another member of the multi-disciplinary team.

Most patients receive their interventions in the community. Treatment will often include a combination of medication and psychological and social interventions. The talking therapy may be provided by the psychiatrist themselves or by another professional such as a therapist or psychologist.

When admission to an in-patient unit is required, most patients are admitted on a voluntary or informal basis. However, a proportion of psychiatric patients are admitted under sections of the Mental Health Act 1983 (England and Wales only). This legislation allows in certain circumstances for patients to be admitted to hospital against their wishes and the legal ‘sections’ in which the law is set out  lead to the colloquial term ‘being sectioned’.

Some psychiatrists choose to develop a particular interest for instance in the drug or alcohol fields or eating disorders and go onto receive additional training and develop particular expertise in these areas.

Sub-specialties

There are three recognised sub specialties within general adult psychiatry:

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