Frequently Asked Questions

A psychiatric assessment is important for the success of the provider and client. Without a solid assessment both the provider and client are set-up for failure. The better the Assessment, the better the Treatment Plan. The better the Treatment Plan, the better the outcome. ​ The goals of a thorough assessment are to: Understand what some of the core driving forces are behind the symptoms. Identify contributing factors that initiate, maintain or extend symptoms. Develop an understanding of the biological predispositions of the individual. Develop an understanding of the social and environmental factors that contribute to a given set of symptoms. Develop an understanding of the personal and psychological traits that are relevant to these topics. Investigate individual symptoms to determine if and how they fit into known diagnostic categories. Look at the person as a whole Integrate the unique aspects of this individual person and their history.

A psychiatric Assessment at Frontier Health Services (FHW) will be familiar and resemble assessments the individual has had from other physicians in the past (like your family doctor, a pediatrician, or another psychiatrist). The Assessment usually begins with the client talking about why they are looking to have the evaluation done. From there, questions are focused on the history of symptoms, relevant contributing factors, associated symptoms, severity of symptoms and patters over time. Additional questions may be focused on other symptoms and conditions that may seem irrelevant but do need to be ruled out. There will also be times during the interview when more traditional questions will be asked – family history, previous providers, current medications, previous treatments, social history, surgical history and medical history all fall into this category.

The first appointment is usually an hour. In rare cases a single one-hour meeting can allow for an adequate amount of information to be relayed for the provider to offer a meaningful diagnosis with a reasonable degree of confidence. For adults with any significant amount of complication, multiple diagnoses, previous treatment or need for additional screening, a second meeting will be needed to complete this assessment phase before the diagnosis and treatment options can be discussed. Between these two meetings the provider at FHW will request and review records, labs may be ordered, and other providers may be approached directly for more information. ​ Typically, the provider at Frontier Health and Wellness will provide the client with additional psychological measures to complete at home between the first and second meetings. These are chosen towards the end of the first meeting and are based on the content that was reviewed during that meeting. In nearly all cases an adequate amount of information can be obtained between the first second meeting to allow for a meaningful discussion focusing on diagnoses and treatment options during that second meeting. ​ Exceptions are more common for assessments that involve children and for more complex adult cases. These populations typically require a third meeting to complete the assessment.

Assessments for children and teens usually require the integration of information from the youth, the family and other providers. Teachers or other members of the community may be valuable sources of information as well. Multiple interviews are typically needed. There are usually interviews that involve one or more parents with the youth in the room. In certain cases, it may make sense to allocate time to one or more of the parents while the youth is outside of the room. A separate interview with the youth is the norm in Pediatric Psychiatry. This typically means that these Assessments will require a third one-hour meeting to get to the point where diagnoses and treatment options can be discussed. In the case of children, obtaining information from multiple settings is typical (home, school, daycare, a second parent’s home, etc.) Except in rare cases the provider at Frontier Health and Wellness will want to interview the child or teenager alone as a part of this Assessment. Care is taken to make sure everyone is comfortable with the process and under no circumstances would this be forced. Confidentiality is made reference to so all parties are aware of the kinds of things that a provider is obligated to relay to a parent and the kinds of things that are covered under the expectation of confidentiality.

Complex cases are those where an abnormally large amount of data needs to be reviewed. This can occur in cases when there are many previous providers, the client has gone through many different treatments, there have been numerous hospitalizations, and cases where the symptoms and history carry a level of detail that requires a larger time investment. Due to the amount of information to review with the client (both directly during the interview and indirectly via record review and communication with previous providers) these assessments typically require a third one-hour meeting. Dr. Hjellen has worked inside the hospital setting for years. In that setting he managed the more severe versions of the same mental health conditions that are present in the outpatient world. He is comfortable and experienced in assessment and management of this subcategory of client.

Yes. Previous records typically need to be reviewed after the first meeting. This approach allows the provider at FHW to review those records in the context of the known history presented by the client – this minimizes any unintentional bias that would come from the opinion of a previous provider. Those previous opinions are important, but they should not be the deciding factors for future care. Screening labs and other tests are also needed in many cases to rule out medical conditions that may be exacerbating, mimicking or complicating a mental health condition. Sometimes those tests have already been done and can be obtained from other providers. Sometimes they will require a separate set of orders. When these records and screening tests are needed, the assessment always requires a second meeting. The tests and previous records are obtained and reviewed between the first and second meetings.