Nurse Practitioner, Psychiatrist or Therapist: Who Should You See?

When you decide to get help for your mental health, the next question is often: who should I see? Psychiatrists, psychiatric nurse practitioners and therapists all help with mental health, but they do different things. This guide explains each role in plain terms, so you can choose where to start. It is written for patients and families in Hilliard, Columbus and Central Ohio.

The short answer

• If you think you may need medication, or you already take a psychiatric medication, see a psychiatrist or a psychiatric nurse practitioner.
• If you want to talk things through and learn coping skills, see a therapist.
• Many people see both: a prescriber for medication and a therapist for regular sessions.

If you are not sure, that is fine. A first evaluation can help you work out what kind of care fits.

What does a psychiatrist do?

A psychiatrist is a medical doctor (MD or DO) who specializes in mental health. After medical school, psychiatrists complete several years of specialty training in psychiatry.

Psychiatrists can:

• evaluate and diagnose mental health conditions
• prescribe and manage medication
• order lab tests and look at how mental and physical health affect each other
• provide therapy, although many focus mainly on evaluation and medication

What does a psychiatric nurse practitioner do?

A psychiatric mental health nurse practitioner (PMHNP) is a registered nurse with a graduate degree and national board certification in psychiatric mental health care. In Ohio, nurse practitioners are licensed as advanced practice registered nurses (APRNs).

Psychiatric nurse practitioners can:

• evaluate and diagnose mental health conditions
• prescribe and manage medication
• order lab tests
• provide therapy and education about your condition and treatment

In Ohio, nurse practitioners prescribe under a written agreement with a collaborating physician. For patients, the visit itself looks much the same as a visit with a psychiatrist: an evaluation, a conversation about options, and regular follow-ups.

What does a therapist do?

"Therapist" is a broad word. In Ohio it can include licensed professional counselors (LPC, LPCC), licensed social workers (LSW, LISW), marriage and family therapists (LMFT) and psychologists (PhD or PsyD).

Therapists:

• meet with you regularly, often weekly or every other week at first
• help you understand patterns in your thoughts, feelings and behavior
• teach practical skills for stress, anxiety, low mood, relationships and life changes
• use approaches such as cognitive behavioral therapy (CBT) and mindfulness

Therapists in Ohio do not prescribe medication. Psychologists also carry out psychological testing.

How do I know which one I need?

Here are some common situations and where people often start.

You have never had mental health care and are not sure what is wrong. Start with an evaluation. A psychiatrist or psychiatric nurse practitioner can assess what is going on and suggest a plan, which may or may not include medication.

You already take a psychiatric medication and need someone to manage it. See a psychiatrist or psychiatric nurse practitioner for medication management.

You want support with stress, grief, relationships or a life change. A therapist is often a good first step. Learn about individual therapy.

You are looking for an ADHD or other evaluation. See a provider who offers diagnostic testing.

Your symptoms are making daily life hard. Medication and therapy together often work better than either one alone. Many people see a prescriber and a therapist at the same practice, so their care is coordinated.

Who you will see at Elevate Behavior Health

Elevate Behavior Health in Hilliard offers psychiatric evaluations, medication management, diagnostic testing and individual therapy for patients aged 6 and older.

Your care is with Fardowsa Sheikh, PMHNP, a psychiatric mental health nurse practitioner. Fardowsa Sheikh provides evaluations, medication management and therapy, so you can see one provider for both medication and talk therapy. If you already have a therapist or primary care provider, we can coordinate with them, with your permission.

Fardowsa Sheikh also speaks Somali and Arabic. Visits are available in person in Hilliard or by telehealth.

Frequently asked questions

Is a psychiatric nurse practitioner as good as a psychiatrist?

Both are trained and licensed to diagnose mental health conditions and prescribe medication. Psychiatrists have medical school and psychiatry residency training. Psychiatric nurse practitioners have nursing training plus graduate education and board certification in psychiatric care. For many patients, either is a good choice. What matters most is finding a provider you trust and can see regularly.

Can a therapist diagnose me?

Licensed therapists can assess and diagnose many mental health conditions. They cannot prescribe medication. If medication might help, a therapist can refer you to a prescriber.

Do I need a referral to see a psychiatric provider?

Some practices and insurance plans ask for one. Elevate does not: you can book with us directly.

Can I see a prescriber and a therapist at the same time?

Yes. This is common, and it often works well. Your prescriber manages medication, and your therapist meets with you more often to work on skills and goals.

What if I choose the "wrong" type of provider?

You cannot really choose wrong. If you start with one type of provider and another would suit you better, they will tell you and help you take the next step.

If you are in crisis, call or text 988. In an emergency, call 911.

Reviewed by Fardowsa Sheikh, PMHNP, psychiatric mental health nurse practitioner at Elevate Behavior Health.