Psychologist vs psychiatrist: who does what in UK mental health care

The simplest distinction is training and toolkit. A psychiatrist trained as a doctor first and then specialised in mental health, which means they can diagnose mental illness, take account of physical health, and prescribe or arrange medicines as well as use psychological treatments. A clinical psychologist trained in psychology, then in clinical psychology, and focuses on understanding and treating thoughts, feelings and behaviour through assessment and psychological therapies.

In practice the two work alongside each other and with nurses, social workers and occupational therapists, and the right person depends on what you need, which is usually decided at assessment.

According to the Royal College of Psychiatrists, a psychiatrist is a medically qualified practitioner who has spent 5 to 6 years training as a doctor, then worked as a doctor in general medicine and surgery for at least a year, then had at least 6 years of further training in helping people with psychological problems. The college lists their core skills as assessing a person's state of mind, using a biopsychosocial model of understanding, diagnosing a mental illness, using a range of psychological treatments and medications, and helping a person recover. Many then specialise, for example in child and adolescent, older adult or general adult psychiatry.

NHS psychiatrists work in community mental health teams, outpatient clinics, hospital wards and sometimes in general practices. They often act as a consultant to a team, reviewing people with other team members. They sometimes see patients alone in a clinic. The college says a psychiatrist is always involved in the decision to admit someone to hospital against their will but cannot do it on their own.

The college describes clinical psychologists as having a degree in psychology followed by a further 3 years of training in clinical psychology, during which they work with clients and learn how to give psychological treatments. They will usually meet you regularly for a number of sessions to talk through how you are feeling, thinking and behaving. Although cognitive behavioural therapy is a common approach, they may use psychodynamic and behavioural psychotherapies. They also help other members of the team to work psychologically with their clients.

The word psychologist is also used for other kinds of psychologist; this page covers the clinical psychologist role described by the college.

The Royal College of Psychiatrists says most mental health problems do not need a psychiatrist. A GP can support you, prescribe antidepressants or refer you to a counsellor or psychotherapist. If problems are more complicated, the GP may refer you to a community mental health service, where team members might include a psychiatrist, community psychiatric nurse, social worker, occupational therapist, clinical psychologist and pharmacist.

You might be more likely to see a psychiatrist for a diagnostic assessment of a complex or severe illness, or when medication needs specialist oversight or review. You might be more likely to see a psychologist for structured talking therapy for problems such as anxiety, trauma or depression. If you are unsure, your GP or the team can explain who will see you.

A psychiatrist will usually ask about the problem that brought you, anything that has happened in your life, your thoughts and feelings and your physical health, so they can understand your situation. You can ask about your diagnosis, how they have made sense of your situation, your care plan, what to do in an emergency and local self-help groups. They will not usually need a physical examination that requires you to undress, and they do not "psychoanalyse" people they meet. A psychologist will similarly begin with an assessment before agreeing a plan with you.