Family and Caregiver Schizophrenia Discussion Forum

Should he be seeing a psychiatrist instead?


#1

Since my son was diagnosed with sz he has been seeing a LiSW at one of the behavioral centers in my area. He switched once because he didn’t trust the first one. I’m wondering if that is the right place for a person with his condition. Should he be seeing a psychiatrist instead? When this started about a year ago I had zero experience and just looked for some mental health professional that accepted Medicaid. He is doing pretty well and is on risperidol and mirtazapine, prescribed by a nurse practitioner. He behaves pleasantly and I finally (!) convinced him to shower. So maybe I should leave well enough alone. But I wonder if he’s missing something that should be happening.


#2

In the past we have used private psychiatrists (cash paid), private insurance paid and those provided thru Medicaid…they really only deal with prescribing the meds…and want a therapist to deal with the daily issues and therapy. In fact we have always tried to get all psychiatrists to be more active in treatment and they politely refuse. They will show up in court to support the guardianship effort. The last one was $500 for the first hour and $250 per hour after that. Where we currently live and successfully got guardianship we couldn’t find a cash paying psychiatrist…but once she was on Medicaid we could find numerous providers. Downside…only a few could prescribe/administer the Invega Sustenna shot…many could provide a prescription but had no nurse or facilities to administer the shot. Very odd that by far better care was thru Medicaid. Private Insurance was the worst.


#3

Pyschiatrist for the med. Pyschologist for counseling, although a LPC or similar could be great. Ask around from people who are also dealing with SMI in your area. We found a LPC who is way more knowledgeable about this illness than the psychologist we were using previously. She comes highly recommended by several who are using her and by the treatment center where she used to work. So we are hopeful.


#4

Thanks for reply hope4us and nevertoolate. This discussion helped me understand better what the options are. He likes his current counsellor so we’ll leave it as is. But if he ever drops her ther is a mental health center that has a spmi section so he would get a therapist, meds and caseworker. I wish I had found that first, but for now I think he should stay where he is happy.


#5

You said he is doing well so far, and he likes the therapist. Given some of my son’s struggles, I would take that as a very good sign and leave well enough alone.
In my son’s case, he went to a clinic where he saw the psychiatrist for meds and a counselor for therapy. Problem was, the counselors were all recent grads and as soon as they found a better job , they were gone. It made it hard to form a therapeutic relationship, for sure.
As long as he’s med compliant and is willing to see this therapist, you’re ahead of the game.