Careers in Mental Health

Psychiatrist

A psychiatrist is a physician who specializes in the diagnosis, treatment and prevention of mental illnesses and substance use disorders. It takes many years of education and training to become a psychiatrist: He or she must graduate from college and then medical school and go on to complete four years of residency training in the field of psychiatry. (Many psychiatrists undergo additional training so that they can further specialize in such areas as child and adolescent psychiatry, geriatric psychiatry, forensic psychiatry, psychopharmacology and/or psychoanalysis.) This extensive medical training enables the psychiatrist to understand the body's functions and the complex relationship between emotional illness and other medical illnesses. The psychiatrist is thus the mental health professional and physician best qualified to distinguish between physical and psychological causes of both mental and physical distress.
Although some psychiatrists will specialize in "biological" psychiatry and others will specialize as psychotherapists, most psychiatrists employ a number of different types of treatment, tailoring each combination to the needs of the individual patient. However, all psychiatrists are able to prescribe medication if they believe it is necessary. They tend to be called upon to treat the more serious mental illnesses such as schizophrenia and manic depression.

THE CHILD AND ADOLESCENT PSYCHIATRIST

The child and adolescent psychiatrist is a Doctor of Medicine or Doctor of Osteopathy who specializes in the diagnosis and, if indicated, the treatment of disorders of thinking, feeling and/or behavior affecting children, adolescents and their families. A child and adolescent psychiatrist offers families the advantages of a medical education, the medical traditions of professional ethics and medical responsibility for providing comprehensive care.
The child and adolescent psychiatrist uses knowledge of biological, psychological and social factors in working with patients. Initially, a comprehensive diagnostic examination is performed to evaluate the current problem with attention to its physical, genetic, developmental, emotional, cognitive, educational, family, peer and social components. The child and adolescent psychiatrist arrives at a diagnosis and diagnostic formulation, which is shared with the patient and family. The child and adolescent psychiatrist then designs a treatment plan, which considers all the components and discusses these recommendations with the child or adolescent and the responsible adults.
An integrated approach may involve individual, group or family psychotherapy; medication or consultation with other physicians or professionals from schools, juvenile courts, social agencies or other community organizations. In addition, the child psychiatrist is prepared and expected to act as an advocate for the best interests of children and adolescents. Many child and adolescent psychiatrists perform consultations in a variety of settings (schools, juvenile courts, social agencies).

Psychologist

Unlike psychiatry, psychology is a non-medical discipline that has been concerned with the normal functioning of the mind and has explored areas such as learning, remembering and the normal psychological development of children. Psychologists will have earned a psychology degree at a university. However only a small proportion of those who complete a psychology degree go on to work with patients. Those who do are known as clinical psychologists. Many will have gone on to complete a doctorate before doing a further, compulsory three years of work and training with patients on one of the training plans established around the country.

Psychologists are not able to prescribe medication; they concentrate exclusively on psychological or "talking treatments." They treat a wide range of conditions, including phobias, depression, other individual emotional problems and family problems.

Social Worker

  • While a bachelor’s degree is the minimum requirement, a master’s degree in social work or a related field has become the standard for many positions.
  • Employment is projected to grow faster than average.
  • Competition for jobs is expected in cities, but opportunities should be good in rural areas.

Nature of the Work Social work is a profession for those with a strong desire to help improve people’s lives. Social workers help people function the best way they can in their environment, deal with their relationships and solve personal and family problems.
Social workers often see clients who face a life-threatening disease or a social problem. These problems may include inadequate housing, unemployment, lack of job skills, financial distress, serious illness or disability, substance abuse, unwanted pregnancy or anti-social behavior. Social workers also assist families that have serious domestic conflicts, including those involving child or spousal abuse.
Through direct counseling, social workers help clients identify their concerns, consider effective solutions and find reliable resources. Social workers typically consult and counsel clients and arrange for services that can help them. Often, they refer clients to specialists in services such as debt counseling, childcare or eldercare, public assistance or alcohol or drug rehabilitation. Social workers then follow through with the client to assure that services are helpful and that clients make proper use of the services offered. Social workers may review eligibility requirements, help fill out forms and applications, visit clients on a regular basis and provide support during crises.
Social workers practice in a variety of settings. In hospitals and psychiatric hospitals, they provide or arrange for a range of support services. In mental health and community centers, social workers provide counseling services on marriage, family and adoption matters, and they help people through personal or community emergencies, such as dealing with loss or grief or arranging for disaster assistance. In schools, they help children, parents and teachers cope with problems. In social service agencies, they help people locate basic benefits, such as income assistance, housing and job training. Social workers also offer counseling to those receiving therapy for addictive or physical disorders in rehabilitation facilities and to people in nursing homes who are in need of routine living care. In employment settings, they counsel people with personal, family, professional or financial problems affecting their work performance. Social workers who work in courts and correction facilities evaluate and counsel individuals in the criminal justice system to cope better in society. In private practice, they provide clinical or diagnostic testing services covering a wide range of personal disorders. Social workers working in private practice also counsel clients with mental and emotional problems.
Social workers often provide social services in health-related settings that now are governed by managed care organizations. To contain costs, these organizations are emphasizing short-term intervention, ambulatory and community-based care, and greater decentralization of services.
Most social workers specialize. Although some conduct research or are involved in planning or policy development, most social workers prefer an area of practice in which they interact with clients.

Clinical social workers offer psychotherapy or counseling and a range of diagnostic services in public agencies, clinics and private practice.

Child welfare or family services social workers may counsel children and youth who have difficulty adjusting socially, advise parents on how to care for disabled children, or arrange for homemaker services during a parent’s illness. If children have serious problems in school, child welfare workers may consult with parents, teachers and counselors to identify underlying causes and develop plans for treatment. Some social workers assist single parents; arrange adoptions; and help find foster homes for neglected, abandoned or abused children. Child welfare workers also work in residential institutions for children and adolescents.

Child or adult protective services social workers investigate reports of abuse and neglect, and intervene if necessary. They may initiate legal action to remove children from homes and place them temporarily in an emergency shelter or with a foster family.

Mental health social workers provide services for persons with mental or emotional problems. Such services include individual and group therapy, outreach, crisis intervention, social rehabilitation and training in skills of everyday living. They also may help plan for supportive services to ease patients’ return to the community.

Healthcare social workers help patients and their families cope with chronic, acute or terminal illnesses and handle problems that may stand in the way of recovery or rehabilitation. They may organize support groups for families of patients suffering from cancer, AIDS, Alzheimer’s disease or other illnesses. They also advise family caregivers, counsel patients and help plan for patients’ needs after discharge by arranging for at-home services—from meals-on-wheels to oxygen equipment. Some work on interdisciplinary teams that evaluate certain kinds of patients—geriatric or organ transplant patients, for example.

School social workers diagnose students’ problems and arrange needed services, counsel children in trouble and help integrate disabled students into the general school population. School social workers deal with problems such as student pregnancy, misbehavior in class and excessive absences. They also advise teachers on how to cope with problem students.

Substance abuse social workers counsel drug and alcohol abusers as they recover from their dependencies. They also arrange for other services that may help clients find employment or get training. They generally are employed in substance abuse treatment and prevention programs.

Criminal justice social workers make recommendations to courts; prepare pre-sentencing assessments; and provide services to prison inmates, parolees, probationers and their families.

Occupational social workers usually work in a corporation’s personnel department or health unit. Through employee assistance programs, they help workers cope with job-related pressures or with personal problems that affect the quality of their work. They often offer direct counseling to employees whose performance is hindered by emotional or family problems or substance abuse. They also develop education programs and refer workers to specialized community programs.

Gerontology social workers specialize in services for senior citizens. They run support groups for family caregivers or for the adult children of aging parents. Also, they advise elderly people or family members about the choices in such areas as housing, transportation and long-term care; they also coordinate and monitor services.

Social work administrators perform overall management tasks in a hospital, clinic or other setting that offers social worker services.

Social work planners and policy makers develop programs to address such issues as child abuse, homelessness, substance abuse, poverty and violence. These workers research and analyze policies, programs and regulations. They identify social problems and suggest legislative and other solutions. They may help raise funds or write grants to support these programs.

Counselor

Significant Points

  • Over half of all counselors have a master’s degree.
  • Most states require some form of counselor credentialing, licensure, certification, or registry for practice outside schools; all states require school counselors to hold a state school counseling certification.

Nature of the Work Counselors assist people with personal, family, educational, mental health and career decisions and problems. Their duties depend on the individuals they serve and on the settings in which they work.

Educational, vocational, and school counselors—in elementary, secondary and post-secondary schools—help students evaluate their abilities, interests, talents and personality characteristics in order to develop realistic academic and career goals. Counselors use interviews, counseling sessions, tests or other methods when evaluating and advising students. They operate career information centers and career education programs.
Elementary school counselors observe younger children during classroom and play activities and confer with their teachers and parents to evaluate their strengths, problems or special needs. They also help students develop good study habits. School counselors at all levels help students understand and deal with social, behavioral and personal problems. These counselors emphasize preventive and developmental counseling to provide students with the life skills needed to deal with problems before they occur, and to enhance personal, social and academic growth. Counselors provide special services, including alcohol and drug prevention programs, and classes that teach students to handle conflicts without resorting to violence. Counselors also try to identify cases involving domestic abuse and other family problems that can affect a student’s development. Counselors work with students individually, with small groups, or with entire classes. They consult and work with parents, teachers, school administrators, school psychologists, school nurses and social workers.

Vocational counselors (also called employment counselors when working outside a school setting) help individuals make career decisions. They explore and evaluate the client’s education, training, work history, interests, skills and personal traits, and arrange for aptitude and achievement tests. They also work with individuals to develop job search skills and assist clients in locating and applying for jobs.

Rehabilitation counselors help people deal with the personal, social and vocational effects of disabilities. They counsel people with disabilities resulting from birth defects, illness or disease, accidents or the stress of daily life. They evaluate the strengths and limitations of individuals, provide personal and vocational counseling, and arrange for medical care, vocational training and job placement. Rehabilitation counselors interview individuals with disabilities and their families, evaluate school and medical reports and confer and plan with physicians, psychologists, occupational therapists and employers to determine the capabilities and skills of the individual. Conferring with the client, they develop a rehabilitation program, which often includes training to help the person develop job skills. They also work toward increasing the client’s capacity to live independently.

Mental health counselors emphasize prevention and work with individuals and groups to promote optimum mental health. They help individuals deal with addictions and substance abuse, suicidal impulses, stress management, problems with self-esteem, issues associated with aging, job and career concerns, educational decisions, issues related to mental and emotional health, and family, parenting and marital problems. Mental health counselors work closely with other mental health specialists, including psychiatrists, psychologists, clinical social workers, psychiatric nurses and school counselors.

Substance abuse and behavioral disorder counselors help people who have problems with alcohol, drugs, gambling and eating disorders. They counsel individuals who are addicted to drugs to help them identify behaviors and problems related to their addiction. They hold counseling sessions for one person, for families or for groups of people to assist them in dealing with problems.

Marriage and family therapists apply principles, methods and therapeutic techniques to individuals, family groups, couples or organizations for the purpose of resolving emotional conflicts. In doing so, they modify perceptions and behavior, enhance communication and understanding among all family members and help to prevent family and individual crisis. Individual marriage and family therapists also may engage in psychotherapy of a non-medical nature, with appropriate referrals to psychiatric resources, and in research and teaching in the overall field of human development and interpersonal relationships.
Other counseling specialties include gerontological or multicultural counseling. A gerontological counselor provides services to elderly persons who face changing lifestyles because of health problems, and helps families cope with these changes. A multicultural counselor helps employers adjust to an increasingly diverse workforce.

Mental Health Tech

  • While a bachelor’s degree usually is not required, employers increasingly seek individuals with relevant work experience or education beyond high school.
  • Social and human service assistants are projected to be among the fastest growing occupations.
  • Job opportunities should be excellent, particularly for applicants with appropriate post-secondary education, but pay is low.

Nature of the Work Social and human service assistant is a generic term for people with various job titles, including human service worker, case management aide, social work assistant, community support worker, mental health aide, community outreach worker, life skill counselor or gerontology aide. They usually work under the direction of professionals from a variety of fields, such as nursing, psychiatry, psychology, rehabilitative or physical therapy or social work. The amount of responsibility and supervision given varies a great deal. Some have little direct supervision; others work under close direction.
Social and human service assistants provide direct and indirect client services. They assess clients’ needs, establish their eligibility for benefits and services and help clients obtain them. They examine financial documents such as rent receipts and tax returns to determine whether the client is eligible for Food Stamps, Medicaid, welfare and other human service programs. They also arrange for transportation and escorts, if necessary, and provide emotional support. Social and human service assistants monitor and keep case records on clients and report progress to supervisors and case managers. They also may transport or accompany clients to group meal sites, adult daycare centers or doctors’ offices; telephone or visit clients’ homes to make sure services are being received; or help resolve disagreements, such as those between tenants and landlords. They also may help some clients complete insurance or medical forms, as well as applications for financial assistance, and may assist others with daily living needs.
Social and human service assistants play a variety of roles in a community. They may organize and lead group activities, assist clients in need of counseling or crisis intervention, or administer a food bank or emergency fuel program. In halfway houses, group homes and government-supported housing programs, they assist adults who need supervision with personal hygiene and daily living skills. They review clients’ records, ensure that they take correct doses of medication, talk with family members and confer with medical personnel and other caregivers to gain better insight into clients’ backgrounds and needs. Social and human service assistants also provide emotional support and help clients become involved in their own well being, in community recreation programs and in other activities.
In psychiatric hospitals, rehabilitation programs and outpatient clinics, social and human service assistants work with professional care providers, such as psychiatrists, psychologists, and social workers, to help clients master everyday living skills, to teach them how to communicate more effectively, and to get along better with others. They support the client’s participation in a treatment plan, such as individual or group counseling or occupational therapy.