If you think you live with ADHD (attention deficit/hyperactivity disorder) and want to be seen by a medical doctor specializing in the treatment of psychiatric conditions (ADHD is one), you will want to get an appointment with a psychiatrist. Psychiatrists in Canada have completed medical school and have gone on to receive special training and extensive internships in the field of psychiatry. Unlike our family doctors who are general practitioners, the medical practices of psychiatrists focus on mental, emotional, or behavioural issues. A general practitioner will certainly have exposure to and experience with mental health issues, but it will be markedly less than that of a psychiatrist. Because mental health conditions are often complex and are best evaluated and treated with thoroughness and great care, many people would prefer to work with a psychiatrist.
Unfortunately, waitlists for specialist doctors of any stripe are long in British Columbia, Canada. The same can surely be said across Canada and the United States. As a mental health counsellor, I have heard many stories from clients frustrated by their inability to get an appointment with a psychiatrist. Some have had to resort to going to emergency rooms at local hospitals where they have waited long hours in hopes of being seen be a psychiatrist.
ADHD in and of itself is considered to be a less serious psychiatrist condition than, say, bipolar disorder or schizophrenia, but it creates a host of challenges and often has comorbidities like anxiety and depressive disorders, bipolar disorder, and substance use disorders. That said, seeing a psychiatrist if you suspect ADHD is a good idea.
So, the reality is that waitlists to see a psychiatrist for a scheduled appointment are long. If you are not in dire straits, you may be waiting over a year. For two reasons, then, you must begin your journey by seeing your family doctor or a general practitioner at a walk-in-clinic (see my first blog post which outlines steps and tips for doing just that): (1) A general practitioner can treat ADHD – they can talk to you about it, give you suggestions, and they can prescribe medications to try and you can get an appointment much faster than you would with a psychiatrist (yay!); and, (2) if you are going to see a psychiatrist, you must get a referral from a general practitioner (GP).
If you and your GP decide to refer you to see a psychiatrist, you can continue to work with your GP as you wait. This is good news! I have heard complaints about some GPs not understanding or seeming to care about a person’s concerns about ADHD and have counselled them on how they might circumvent those challenges. If you are having a hard time feeling heard by your doctor, you can seek help from a counsellor or social worker. We are trained in communication skills and can help you to prepare for another attempt. You may also value our emotional support, validation, and guidance.
Fortunately, more and more awareness and understanding of ADHD is happening all the time thanks to advocacy, education, and scientific research initiatives. This means that more GPs are receptive to meaningful discussions with patients about the possibility of ADHD. This is great news!
If you decide you want to wait to see a psychiatrist and your doctor writes a referral, know that you may have options within your community. Some psychiatrists work in private practice – they still require a referral from a family doctor and their fees are covered by our health care system; however, they are not employed by provincial health authorities. This means they have offices in town and you may find it feels more like going to see a helping professional like, say, a physiotherapist. And, they may have shorter waitlists than those working for your local health authority.
Whether you are seen by a psychiatrist in private practice or one working for your local health authority, here are my suggestions for preparing yourself for your appointment:
1. Bring along a family member or long-time friend , if possible, one who has firsthand experience of your ADHD or ADHD-like symptoms.
2. Be prepared to answer a lot of questions. The psychiatrist is going to ask you questions about your childhood and schooling because ADHD is a neurodevelopmental condition (meaning it develops in the brain early in our development/childhood).
3. If you get flustered or feel overwhelmed by the questions when you are with the psychiatrist, be open and honest about this: ADHD effects our ability to process information and organize our thoughts! It is common for ADHD symptoms to be triggered during appointments like these – this may seem ironic but, really, it makes sense when you think about it.
4. Bring a bullet point list of reasons why you suspect you live with ADHD.
5. Bring a bullet point list of questions you would like to have answered by the psychiatrist – you might not need to refer to this list but it will be good to have it.
6. Know that psychiatrists are medical doctors and their first line of defense for treating ADHD is medication. If the psychiatrist is confident that you have ADHD, they will suggest a medication trial. ADHD medications are safe and they have been studied for years.
7. The psychiatrist will schedule a follow-up appointment with you, especially if you agree to a medication trial.
8. If you work with a psychiatrist in private practice, the likelihood of being able to work with them long-term is far greater than if you work with a psychiatrist employed by a health authority. (Those in the provincial health care system may be mandated to refer patients back to their family doctors as soon as possible to alleviate wait times for a long list of other patients. Follow-up care for ADHD medications with family doctors is typically a positive experience anyway, so take heart.)
Psychiatrists are the medical experts when it comes to prescribing psychiatric medications. Some will also provide a bit of talk therapy and may even suggest behavioural and lifestyle changes. Psychiatrists often get a bad wrap for being “pill-pushers”. Their intention is to effectively treat the condition using reliable scientific evidence and evidence shows that medications for ADHD are, indeed, effective and (as noted) safe.
ADHD medication trials are often very good news stories: their effect is quick (unlike other medications like SSRIs for anxiety and depression which can take up to six weeks to take full effect) and often the results are very positive and a huge relief. If, however, the effect of the medication is unfavourable, the good news here is that the effect wears off quickly. At any rate, any questions you may have about medications can be answered thoroughly and reliably by a psychiatrist.
My brain works best with to-the-point information, so I am going to summarize what I consider to be the most important points about working with a psychiatrist for the assessment and treatment of ADHD.
- To see a psychiatrist in Canada, you need a referral from a doctor.
- Wait times to see a psychiatrist are often a year or more (ask your doctor if they know how long it will likely take in your area).
- Psychiatrists have specialized training in mental health/psychiatric conditions.
- Psychiatrists have much more experience in the treatment of conditions like ADHD than general doctors.
- Appointments with psychiatrists are much longer than those with general doctors, allowing for a more thorough evaluation (.
- Psychiatrists can assess and diagnose ADHD and/or any other possible psychiatric conditions.
- Psychiatrists (particularly those not working in private practice) often refer patients back to the care of their family doctors once the patient is stabilized.
- The cost of seeing a psychiatrist in Canada is covered by our health care system.
For those whose brains prefer tables, I’ll present a comparison of working with a general/
family doctor and a psychiatrist:
General Doctor | Psychiatrist |
-Can diagnose ADHD. -Can prescribe medication to treat ADHD.
-If you want to see a psychiatrist, your doctor must refer you. -Often can get an appointment within days or weeks. -If you don’t have your own GP, you can see one at a walk-in-clinic. -There is no cost for patients to be seen by doctors in Canada. -GPs have gone through many years of medical training, with minimal exposure to psychiatry. -Have about 10-15 minutes for each patient’s appointment.
-Can offer follow-up appointments. -Wait times in between follow-up appointments are usually about 2 weeks.
| -Can diagnose ADHD. -Can prescribe medication to treat ADHD and have much more experience doing so. -You must be referred by a doctor before you can get an appointment. -Can take over a year to get an appointment after referral is received. -Some work for local health authorities, others are in private practice. -There is no cost for patients to be seen by psychiatrists in Canada. -Have gone through many years of medical training, with a special focus on and extended internship in psychiatry. -Have about an hour for each patient’s appointment, often longer for initial appointments/assessments. -Can offer follow-up appointments. -Wait times in between follow-up appointments may be markedly longer than GP follow-up appointments (e.g., months instead of weeks). |
Though the shortage of doctors and specialists like psychiatrists makes for a less-than-ideal situation for those seeking assessments and treatment of ADHD in Canada, it remains that we do have options. If you choose to go the route of working with a psychiatrist, I hope you have found this article to be of some help! My next article will be about seeking the help of a Registered Psychologist for the assessment, diagnosis and treatment of ADHD (spoiler alert: you have to pay for those appointments and Registered Psychologists cannot prescribe medications).
Thanks for reading and bye for now!
Warmly,
Tara 😊
P.S. My next blog post is about preparing for an appointment with a Registered Psychologist.
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Tara Hope is a Registered Clinical Counsellor and Educator in private practice in the Comox Valley on Vancouver Island, BC. She offers a range of therapeutic services for diverse populations with specializations in Positive Psychology for Entrepreneurs, Adult ADHD, Late-in-Life ADHD Diagnoses, ADHD & Addiction/Impulsivity, and ADHD Parents Parenting ADHD Kids. http://www.tarahope.ca