Middlebury

 

Psychiatric Referral

Counseling contracts with the Counseling Services of Addison County (CSAC) to offer psychiatric evaluations, medication management and emergency services.  We are pleased to be able to facilitate psychiatric evaluations provided by one of our consulting psychiatrists or psychiatrist nurse practitioners at CSAC.  We have had a relationship with our local, community mental health agency since 1966. 

Counseling will assist in the referral process for CSAC and work collaboratively with the psychiatrist and/or nurse practitioner and student, providing counseling alongside psychiatric treatment.

If another health care provider is already prescribing psychiatric medication for you, we recommend that you continue seeing that health care provider to ensure continuity of care. 

Getting started

You must see a counselor before receiving a psychiatric referral to CSAC. The counselor will discuss your options, answer questions, and help you clarify what you hope to gain from a psychiatric evaluation. If you decide to proceed with a referral, our office will schedule the initial consultation.

Often, a psychiatric evaluation leads to lifestyle recommendations; medication may also be an option. People who are prescribed medication by CSAC psychiatric services are highly encouraged to participate in counseling, whether on campus or with a therapist in the community. In the treatment of depression, anxiety, and a number of other psychiatric conditions, medications are most successful when used in combination with counseling.

In order to provide continuity of care you will be required to send your pertinent medical records to CSAC before your initial consultation.

The initial consultation

The first appointment with CSAC psychiatry lasts 45 – 90 minutes and focuses on concerns that are interfering with your functioning and wellbeing. The psychiatric practitioner will perform a mental status evaluation, and ask questions about:

  • current mental health problems and symptoms;
  • previous psychiatric treatments, hospitalizations or medications;
  • current medical problems and recent surgeries;
  • family history of psychiatric illness;
  • substance use history; and
  • work, school and relationship issues.

After the evaluation

The psychiatrist and/or nurse practitioners may arrive at a diagnosis after the first appointment. Sometimes, medical evaluation by a primary care provider, as well as psychological, laboratory or other tests, may be recommended to clarify the diagnosis or rule out medical causes. Next, you and the psychiatrist and/or nurse practitioner will set up a treatment plan that may include psychiatric medications. Thirty-minute follow-up appointments will be scheduled throughout treatment, to monitor your symptoms and response to any medication. In the beginning, these visits will be more frequent; as treatment progresses, appointments may be one to three months apart.

Insurance and billing

Psychiatric evaluations and medication visits are billed to your primary health insurance plan.

ADHD diagnosis and treatment

ADHD is a long-term condition and a very challenging diagnosis to make in an adult who has not been previously diagnosed as a child.

IF YOU HAVE A CONFIRMED DIAGNOSES

If you have been diagnosed with ADHD, and you are being prescribed medication, we encourage you to continue with your current provider for treatment continuity.

If you have been diagnosed with ADHD, but it is not feasible to continue treatment with your former provider, you may make an appointment with Counseling to discuss a potential referral to CSAC Psychiatric Services.

For learning related challenges, students with ADHD receive helpful practical assistance from CTLR (Center for Teaching and Learning Resources)  and on campus and Student Accessibility Services.

John Young, MD, Psychiatrist at Counseling of Addison County (CSAC) guidelines ADHD Diagnosis

INFORMATION SHEET REGARDING ASSESSMENT FOR ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) – John Young, MD

This information form is intended to be reviewed by persons who are being referred to me to evaluate the possibility of ADHD. Before I schedule an appointment for this type of evaluation I request that you read the information below, sign a copy of this sheet and fax it back to me, and gather the requested information (see below).

  1. ADHD is a long-term condition and a very challenging diagnosis to make in an adult who has not been previously diagnosed as a child. Many people have read popular literature or websites related to ADHD and feel certain they have the diagnosis.
  2. Unfortunately, some treatments for ADHD (for example stimulant medication) are routinely misused or abused. Studies show that as many as 1 in 3 college students with ADHD share their medications with others. As such, it is now my practice to avoid prescribing stimulant medications to adults who have not been diagnosed with ADHD as a youngster.
  3. The process of diagnosing and treating ADHD in an adult takes time to do carefully and appropriately. It is unrealistic to expect rapid treatment benefits, even if they would be highly desirable, such as at the end of an academic semester.
  4. Testing and checklists for ADHD are not sufficient to diagnose ADHD, and sometimes can be misleading. I do not consider myself bound to prescribe medications because of another clinician’s evaluation.
  5. Before scheduling an evaluation for ADHD, it is essential that you gather the following information, or else a diagnosis of ADHD is unlikely to be supported.
  • All diagnostic information and treatment records from a physician of an ADHD diagnosis being made prior to high school.
  • Evidence of academic and other impairment when the person was younger (i.e. before age 10)
  • Up-to-date academic transcript reflecting all recent academic grades, especially covering the last 12 months.
  1. I will request that a person do a urine drug screen at their first visit, and randomly on visits after that. Any positive tests for an illicit substance or unwillingness to do a screen will preclude prescription of medications.
  2. Prescriptions will be given at face to face appointments only. It is not my practice to leave prescriptions to pick up or to be mailed. I do not provide prescriptions for periods of time of greater than a month that students will be away such as summer breaks, semesters away, or years abroad. Please plan accordingly.