What to Expect in Your First Psychiatric Evaluation

If you've never seen a psychiatrist or psychiatric provider before, the idea of a first evaluation can feel overwhelming. What will they ask? Do I need to prepare? Will I get a diagnosis right away?

The truth is, a psychiatric evaluation is a collaborative conversation — not a test you can pass or fail. It's the foundation of your treatment, and understanding what happens beforehand can help you feel more comfortable and get the most out of your visit.

Here's a step-by-step guide to what your first psychiatric evaluation looks like at EnnHealth Psychiatry, whether you're joining us via telehealth from your living room or anywhere across the 30+ states we serve.

Before Your Appointment: How to Prepare

A little preparation goes a long way. You don't need to have everything figured out — that's what the evaluation is for — but having some information ready helps your provider give you the best care.

Don't worry if you don't have all of these. Your provider will work with whatever information you have.

The Evaluation: What Actually Happens

Your first appointment is typically 60 minutes. This is intentionally longer than follow-up visits because it's the most important session — it's where your provider builds a complete picture of your mental health.

1. Getting Connected (First 5 Minutes)

For telehealth appointments, you'll click the secure video link sent to your email. Your provider will greet you, confirm your identity and location (required by telehealth regulations), and make sure your audio and video are working well.

This is also when your provider sets the tone. At EnnHealth, Dr. Michel is known for her warm, down-to-earth style — patients consistently say she makes them feel comfortable from the first minute.

2. Chief Complaint & History of Present Illness (15-20 Minutes)

Your provider will ask about what brought you in today. This is your chance to share what's been going on in your own words. There are no wrong answers.

Expect questions like:

• When did you first start noticing these symptoms?
• How are they affecting your daily life — work, relationships, sleep?
• Have you experienced anything like this before?
• What have you tried so far (therapy, medication, self-help)?
• Are there specific triggers or patterns you've noticed?

"I always tell my patients: I'm not here to judge. I'm here to listen, understand, and help. The more honest you can be, the better we can work together." — Dr. Nageley Michel

3. Psychiatric & Medical History (10-15 Minutes)

Your provider will review your broader mental health and medical background:

• Past psychiatric diagnoses — depression, anxiety, ADHD, PTSD, etc.
• Previous treatments — medications that worked, didn't work, or caused side effects
• Family history — mental health conditions in close relatives (genetics play a real role)
• Medical conditions — thyroid issues, chronic pain, neurological conditions, etc.
• Substance use — alcohol, cannabis, caffeine, nicotine (honest answers help with accurate diagnosis)

4. Mental Status Examination (Ongoing Throughout)

Throughout the session, your provider is conducting what's called a Mental Status Examination (MSE). This isn't a formal test — it's a clinical observation of:

• Your mood and how you express emotions
• How organized your thoughts are
• Your speech patterns and energy level
• Your insight into your own condition
• Any safety concerns (suicidal thoughts, self-harm)

This happens naturally during the conversation. You don't need to "perform" in any way — just be yourself.

5. Safety Screening (5 Minutes)

Every psychiatric evaluation includes a brief safety assessment. Your provider will ask about:

• Thoughts of self-harm or suicide (current and past)
• Thoughts of harming others
• Access to means of harm
• Support system and safety plan

These questions are routine and required — they're asked of every patient, not because your provider suspects anything. It's simply part of responsible, thorough care. Your answers are confidential.

6. Discussion & Treatment Plan (10-15 Minutes)

This is the part most patients look forward to. Based on everything discussed, your provider will share their clinical impressions:

• Working diagnosis — what they believe is going on (this may be refined over time)
• Treatment recommendations — medication, therapy, lifestyle changes, or a combination
• Medication discussion — if recommended, your provider will explain what the medication does, expected timeline, and potential side effects
• Follow-up plan — when to schedule your next appointment (usually 2-4 weeks)
• Questions — your provider will make time for any questions you have

After Your Evaluation

Here's what happens in the days following your first visit:

1. Prescriptions sent electronically — if medication was agreed upon, it goes directly to your preferred pharmacy
2. Follow-up scheduled — typically 2-4 weeks for medication patients, 1-2 weeks for therapy
3. Secure messaging available — DPC members can message their provider anytime with questions between visits
4. Insurance claims filed — we handle all billing and claims automatically

Common Concerns (Answered Honestly)

"Will I get diagnosed right away?"

Usually yes — your provider will share a working diagnosis at the end of your first visit. However, some conditions require additional assessment over multiple sessions before a definitive diagnosis is made. This is especially true for ADHD and bipolar disorder, where symptoms can overlap with other conditions.

"Can this really work over video?"

Yes. Multiple studies show telehealth psychiatric evaluations are clinically equivalent to in-person visits for most conditions. At EnnHealth, every session uses secure, HIPAA-compliant HD video. Many patients actually prefer telehealth because they feel more relaxed in their own environment.

"What if I cry or get emotional?"

That's completely normal and expected. A psychiatric evaluation often involves discussing difficult experiences. Your provider is trained to hold space for these emotions. There's no need to apologize — it's a sign you're being open and honest, which is exactly what leads to good care.

"How much will it cost?"

If you have insurance, your cost is typically a copay of $20-$50. We verify your benefits before your first visit at no charge. For our Direct Psychiatry Care (DPC) members, evaluations are included in your monthly membership starting at $99/month. No surprise bills, ever.

Ready to Take the First Step?

If you've been thinking about seeing a psychiatric provider, the hardest part is often just booking that first appointment. At EnnHealth Psychiatry, we've designed the process to be as simple and comfortable as possible — from online booking with real-time availability to a warm, judgment-free first session.

You deserve to feel better. And understanding what to expect is a great first step.