What a psychiatrist does
A psychiatrist is a medical doctor who has specialised in mental health. Because they are doctors, psychiatrists can:
- make or review a diagnosis, taking both mental and physical health into account
- check whether another condition, such as bipolar disorder or anxiety, is part of the picture
- recommend, prescribe and review medication, including more specialist options
- look at how other medicines, physical illnesses, alcohol or drugs may be affecting your mood
- advise on which psychological therapies may suit you, and how to access them
Psychiatrists are different from psychologists and therapists, who provide talking therapy but do not usually prescribe. Many people with depression get well without seeing a psychiatrist. For others, a specialist opinion is an important step.
When a psychiatrist can help
It may be worth asking about a psychiatric opinion in situations like these.
Not improving after two treatments
The NHS notes that some people need to try 2 or more treatments before finding one that works. If you have had two adequate trials, such as two antidepressants or medication plus therapy, and still feel stuck, NICE recommends reviewing the diagnosis and looking for reasons treatment is not working. Some further options, such as adding a second medicine, may involve specialist advice.
Uncertainty about the diagnosis
NICE recommends asking people with depression about any history of elevated mood, to check whether depression could be part of bipolar disorder. This matters because bipolar disorder is treated differently. The NHS says GPs usually refer people with possible bipolar disorder to a psychiatrist. A psychiatrist can also help if symptoms might be explained by something else, such as ADHD, trauma or a physical health problem.
Complex medication
You may benefit from a specialist review if you take several medicines, have tried many antidepressants, or have physical health conditions that make prescribing more complicated.
Side effects or difficulty stopping
If side effects have made treatment hard to continue, or coming off an antidepressant has been difficult, a psychiatrist can look at alternatives and help plan changes with you.
Other conditions alongside depression
Depression often comes with anxiety, sleep problems, problems with alcohol or other conditions. A psychiatrist can look at the whole picture rather than one symptom at a time.
Long-standing or recurrent depression
For chronic depressive symptoms that have not responded to treatment and are having a big effect on life, NICE recommends offering a referral to specialist mental health services for advice and further treatment.
The NHS route
On the NHS, you usually see a psychiatrist through a referral from your GP. The GP may refer you to a community mental health team, which can include psychiatrists, psychologists, specialist nurses and occupational therapists.
NHS specialist care is free. Referral criteria and waiting times vary around the UK. The NHS says people with severe depression may be referred to a mental health team.
It helps to be clear with your GP about what you want: for example, “I’ve tried two antidepressants and I’d like a specialist opinion on my diagnosis and medication.”
The private route
Some people choose to see a psychiatrist privately, for example to get a specialist opinion sooner or to have more time to talk through their history. Private care is paid for by the patient or, sometimes, by health insurance.
Before booking with any private service, it is sensible to:
- check the psychiatrist is on the GMC register, which you can search online
- ask what the fee includes, including prescriptions and follow-ups
- ask whether a summary will be shared with your GP
- check what the service does not offer, such as therapy or crisis care
Going privately does not stop you using NHS services. Many people use both, for example a private psychiatric assessment alongside NHS Talking Therapies.
NHS and private compared
| Feature | NHS psychiatrist | Private psychiatrist |
|---|---|---|
| Referral | Usually needed from a GP | Often not needed |
| Cost | Free | Paid by patient or insurer |
| Waiting | Varies by area and need | Varies by service |
| Therapy | May be part of a wider team | Depends on the service |
Seeing a psychiatrist at Happy Clinic
Happy Clinic is a private online psychiatry service. Consultations are by video with GMC-registered consultant psychiatrists, for adults aged 18 and over anywhere in the UK. No GP referral is needed. Appointments are often available within a few days, depending on clinician availability.
Happy Clinic’s psychiatrists see adults with depression, and also offer medication reviews and diagnostic clarification.
How it works
- Book online through Happy Clinic’s website.
- Initial psychiatric assessment by video with a consultant psychiatrist. This lasts 60 minutes and costs £400.
- Treatment plan. This may include medication, advice on therapy options and follow-up appointments.
- Follow-ups of 20 minutes, costing £200, to review progress and medication where appropriate.
After your consultation, Happy Clinic sends a clinical summary to you and, with your consent, a letter to your GP. Fees are paid in advance. Prescriptions issued during appointments are included in the fee, but pharmacy dispensing charges are not. Fees checked September 2026 — see Happy Clinic’s pricing page for current fees, or the fees page on this site.
What to expect in an assessment
A psychiatric assessment is a detailed conversation. A psychiatrist will usually ask about your current symptoms, how long you have had them, past episodes, any periods of high mood, treatments you have tried, physical health, medicines, alcohol and drug use, family history, and what is going on in your life. It helps to have a list of your medicines and past treatments to hand.
What Happy Clinic does not do
- Happy Clinic does not provide talking therapy. Its psychiatrists may advise on therapy pathways. For free therapy in England, you can refer yourself to NHS Talking Therapies. See treatment.
- Happy Clinic does not provide emergency or crisis care.
- Happy Clinic does not see children or young people under 18.
- Happy Clinic does not write medico-legal or benefits reports.
Getting the most from your appointment
- Write down your main concerns and what you hope to get from the appointment.
- List all medicines, doses and how long you have taken them, plus any you stopped and why.
- Note past treatments, including therapy, and what did or did not help.
- Think about any times your mood was unusually high or you needed much less sleep.
- Have your GP’s details ready if you want information shared.
Read more about antidepressants before a medication review.