A number of different doctors may treat patients during the stay in hospital and this can be confusing. If the patient is unsure as to the treating doctor is, ask one of the staff on the ward.

Admitting doctor

Normally, this will be the registrar (a trainee specialist psychiatrist often called a 'resident' in other countries). This doctor will continue to see the patient once he/she has been admitted throughout normal office hours, however, after hours medical staff are usually rostered on duty and become the duty doctors. A patient's care will almost certainly be the responsibility of a mental health team.

Intern/resident

This is a junior doctor, who is normally one or two years away from finishing their general medical training and who is initially responsible for all of the medical needs of the patients allocated to him or her. Many psychiatric inpatient facilities do not have such junior medical staff unless they are part of a General Teaching Hospital. The intern/resident tends to look after all patients on the one ward and is involved in completing the initial assessment, including organizing physical reviews and investigations. He/she may also become involved in dealing with any concurrent physical problems patients may have that could be contributing adversely to their mental state. An intern is in the process of obtaining experience in psychiatry and may be planning to complete further training in psychiatry.

Psychiatric registrar

This doctor is more senior than an intern or resident. They have completed several years of general medicine after graduation as a doctor and are often undertaking specialty training in psychiatry. Some registrars may have been GPs or medical registrars prior to deciding to take up psychiatry and therefore have broad experiences.

The registrar is normally the doctor who patients will see on a regular basis during their stay. The registrar will discuss the diagnosis and treatment with the patient (and the family/caregivers where possible) and will plan the treatment. He/she will discuss these matters on a regular basis with the supervising consultant and plans may be modified accordingly.

The registrar oversees the intern/resident to ensure assessment is accurate and completed. As well as having responsibilities for people admitted under the consultant on the ward, they also see people in outpatient clinics and have 'on duty' responsibilities. This means that they do not always stay on your ward and they will probably set times to see the patient and/or the family. The registrar may also have duties outside the hospital where they will see people in their homes, or with GPs and they may also have training responsibilities, e.g. attending lectures and tutorials.

Consultant psychiatrist

A consultant psychiatrist is a doctor with a specialist medical qualification in psychiatry. Consultants are legally and ultimately responsible for patients' clinical care. A consultant may not see patients as frequently as the registrar, however, they will be actively supervising the treatment through consultation with the registrar and the treating team. They will review the initial diagnosis and assessments and, together with the patient and the registrar, will set treatment goals for the admission. As well as their clinical responsibilities (i.e. those related to treating patients) they usually have many other roles, e.g. teaching, research and administration.

A multidisciplinary treatment team consists of several other mental health professionals who work together with the medical and inpatient nursing staff. They include:

Mental health nurse

Mental health nurses have qualifications in providing nursing care to people with mental health problems. Their duties include asking questions about the development of symptoms; assessing and monitoring the severity of such symptoms; dispensing and supervising the taking of medication; and providing education and support to patients and their families.

Occupational therapist

Occupational therapists (OT's) are professionals who have undertaken tertiary education and have specialized in the assessment of the functioning of an individual in various physical, social and vocational areas. They aim to help people achieve and maintain their highest level of independence. They also have skills in certain treatments, such as relaxation training and are skilled at working with individuals and groups. In the inpatient setting, an OT can help to explore creative and leisure activities; assist patients in dealing with stress; build on the skills needed for daily living such as budgeting and cooking; and help facilitate a comprehensive discharge plan.

Social worker

A social worker has undertaken tertiary training in social work and in social administration. Social workers aim to improve a person's well being through the promotion of social justice and social change. They liaise with many services, including public housing, rehabilitation agencies and other appropriate government facilities, e.g. disability services. They have specific therapeutic skills in individual counseling and family work. They can also facilitate group work for education, therapy and support. Social workers have a number of legal responsibilities including the writing of reports. They train and supervise other social workers and students and are required to be involved in their own professional development and maintenance of skills. They play an important role in planning for discharge and they continue to work outpatients.

Clinical psychologist

The clinical psychologist is a trained psychologist who has undertaken specialization in clinical psychology. The clinical psychologist may be involved in patient care by providing neuropsychological and other assessments such as intelligence or personality tests, or providing specific psychological interventions or therapy. They assist the clinical team in arriving at extended diagnostic assessment of various mental health problems and usually bring a powerful research approach to these matters. They undertake therapeutic assessment and therapeutic management, e.g. cognitive behavioral therapy (CBT) on an individual or group basis.

Pharmacist

The pharmacist advises and assists medical staff in the decision-making process with regard to specific medications or medication in general. They provide up-to-date information on drugs including side effects and possible interactions and may conduct education sessions about medications.

Community mental health nurse

A community mental health nurse is a nurse who has trained in mental health care in both inpatient and outpatient settings. If, on discharge there are ongoing issues that may interfere with your recovery it may be suggested that you see a community mental health nurse after you leave the hospital and perhaps on an ongoing basis. These specialist nurses can visit the patient at home or in other settings. They can provide support and counselling; monitor and supervise medications; and keep an eye on the patient's mental health. They may also liaise with the treatment team and the GP and they are able to assist in specific treatment, e.g. in applying exposure behavior therapy programs used in treating agoraphobia. They can assist the patient and caregivers in becoming involved in other supportive networks in the community thus reducing the need for him/her to be unduly dependent on the more centralized mental health services.

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