Skip to content. | Skip to navigation

Careers in psychiatry

Careers in psychiatryInterested in psychiatry? Would you prefer to work with adults, children or older people? Check out the different areas you could specialise in when you qualify as a psychiatrist.

Adult psychiatry

The majority of psychiatrists in the UK work within this broad category, which involves the care of people with mental health problems in many settings.

Psychiatrists may be based in mental or university hospitals, psychiatric units in general hospitals, in the community, or a mixture of these. Because of the diversity of patients and psychiatric conditions requiring treatment and care, an adult general psychiatrist must be skilled in numerous treatment techniques.

Psychiatrists in this area must also have the knowledge and skills required to organise and administer a psychiatric service for a specific population. General adult psychiatrists may have a special interest in, for example, neuropsychiatry, the rehabilitation and care of patients with chronic disabilities, drug and/or alcohol problems or eating disorders.

They work closely with multi-disciplinary teams which can include community psychiatric nurses, social workers, psychologists and occupational therapists. This specialty also entails close liaison with hostels, crisis intervention centres, residential homes and sheltered workshops.

Psychiatry of old age

This is a rapidly expanding specialty: the number of old people in this country has increased dramatically, and is likely to continue to do so. In psychiatric units at present, about 45% of residents and 25% of people admitted are aged 65 years or more.

A major challenge for this area of psychiatry is the treatment and care of people suffering from senile dementia, but most specialists in the field deal with the full range of psychiatric disorders affecting patients over the age of 65.

Much ill health in old people is a mixture of physical and mental conditions, and so an active interest in general medicine is required. Psychiatrists working in this specialty are based in hospitals, geriatric units, day-care centres, or in the community.

Experience in general medicine, geriatrics, general practice and psychology is particularly valuable.

Child and adolescent psychiatry

Psychiatrists working in this area are primarily concerned with the intellectual, emotional and behavioural mental health problems of children from birth until school-leaving age.

The development of a close working relationship with the child concerned - and their family - is essential. Skills in diagnostic assessment, including interviewing and examination, are particularly valuable.

You would use a variety of treatments ranging from individual psychotherapy to behavioural and family therapy. You could be based in hospitals, child guidance clinics, day units, special schools (boarding and day) for children experiencing difficulties, or in community and remand homes. It may also be necessary to engage in court activities.

Prospects are also excellent for those wishing to work part-time.

Forensic psychiatry

This is concerned with the interaction between and overlap with psychiatry and the law. The forensic psychiatrist cares for and treats offenders with mental health problems in a number of different settings: general and special hospitals, crisis intervention centres, and prisons.

In addition, forensic psychiatrists work with the courts to help explain medico-legal problems such as criminal responsibility, fitness to plead and the management of mentally abnormal offenders.

Special skills are needed in assessing behavioural abnormalities, understanding and using security as a means of control and treatment, writing reports for courts and lawyers and giving evidence.

Forensic psychiatry is challenging, since it sometimes involves dealing with very disturbed patients, who may have violent tendencies.

Psychiatry of learning disability

Psychiatrists working in this area are concerned with the prevention, diagnosis and treatment of the mental health problems which often occur in people with learning disability. For example, a patient with Down's Syndrome may also suffer from depression or anxiety.

Psychiatrists in this area work closely with the patient's family, taking into consideration their care and education. In addition to psychiatric and administrative skills, expertise in related subjects such as paediatrics, neurology, genetics, biochemistry and psychology are required.

To an increasing extent, learning disability psychiatrists work in teams based in special schools and training centres, hospitals, residential hostels and sheltered workshops.

Psychotherapy

All psychiatrists need some basic psychotherapeutic skills, but specialists in this area are also required to assess and treat people with, for example, psychoneuroses, personality and behavioural disorders, and sexual and interpersonal problems.

In addition to specialised treatment procedures, psychotherapists need expertise in the application of psychotherapeutic principles, including the psychodynamic use of the doctor-patient relationship as part of the general management of all patients with mental health and psychosomatic disorders.

Psychotherapists also need to be skilled in cognitive and behavioural therapies. During training, it may be necessary to experience personal psychotherapy. This gives psychiatrists a valuable insight into their patients' problems.

An increasing number of psychotherapists work closely with various clinical teams in hospitals, child and adolescent units, child guidance clinics, student health centres, and in doctors' surgeries.

Related links

(Information taken from the Royal College of Psychiatrists)