Psychiatric Evaluation

A psychiatric evaluation is the starting point for nearly everything we do. One appointment, roughly sixty minutes, in which your clinician gathers enough history to arrive at a working diagnosis, rule out the look-alikes, and build a real plan with you. Most people walk out of their first visit with a diagnosis named, a treatment plan discussed, and — if a medication is indicated and you want one — a prescription.

Evaluations are the same visit whether you end up on medication, therapy, both, or neither. The point of the evaluation is to find out.

When to come in for an evaluation

• You suspect something (depression, ADHD, anxiety, bipolar, PTSD) and have never been formally assessed
• You’ve been treated for something that doesn’t seem to be responding the way it should — second opinions are welcome
• You have a diagnosis from elsewhere and want a psychiatric clinician to take over ongoing care
• You’ve been managing on your own for years and want a clearer picture

You do not need to know what you have before you come in. That’s part of what an evaluation is for.

What the visit covers

About 60 minutes. Your clinician will ask about:

• What brought you in — in your own words, in whatever order makes sense
• Current symptoms — what they look like day to day, how long they’ve been going on, what makes them better or worse
• Psychiatric history — prior diagnoses, prior treatment (medications, therapy, hospitalizations), what worked and what didn’t
• Medical history — current and past conditions, current medications and supplements, allergies, anything that affects how we’d prescribe
• Family history — psychiatric and medical, where it’s relevant to your picture
• Personal history — enough to understand context: family, relationships, work or school, substance use, significant life events, trauma
• Safety — direct questions about self-harm and suicidal thoughts. Asking these does not create them; not asking them misses diagnoses that matter.

From that your clinician builds a diagnostic impression, checks it against alternatives that explain the same symptoms (thyroid, sleep apnea, substance effects, an anxiety disorder dressed up as depression), and discusses what they think is going on. You’ll be part of the conversation, not the subject of it.

What you’ll leave with

• A clear diagnostic impression — named out loud, explained, your questions answered
• A treatment plan — medication, therapy, both, or a recommendation to hold off and observe
• Prescriptions if they’re indicated and you want to start
• A specific follow-up plan — usually within 2–4 weeks of the initial
• Anything we agreed we’d send you in writing (a portal message summarizing what we decided, lab orders, a referral)

Specialized evaluations

ADHD assessment. A structured evaluation for attention and focus concerns, with attention to ruling out the usual confounders (sleep deprivation, anxiety, trauma, untreated depression). See the ADHD page for how we approach stimulant and non-stimulant options.

Medication review. If you’re already on a regimen that isn’t getting the job done, we can work through what you’ve tried, what’s left to try, and where you might be stuck.

Second opinions. You do not have to transfer care to get one. Some patients come in for a focused consult, then go back to their existing prescriber with our recommendations.

Evaluations for adolescents

Several of our clinicians see adolescents and young adults. These visits look similar to adult evaluations, with parents or guardians involved where clinically and developmentally appropriate. If you’re inquiring about a minor, tell us at scheduling so we can match you with the right clinician.

Confidentiality

What you share in your evaluation is confidential, with the limited exceptions required by law: imminent risk of serious harm to yourself or someone else, suspected abuse of a child or vulnerable adult, and court orders. Your clinician will outline these at the start of the visit.

Before your first visit

• Write down your current medications (name, dose, how often) and any supplements
• Know your pharmacy
• If you have prior psychiatric records you can share, send them in advance
• Bring (or have ready) a list of questions — you will not remember them in the visit otherwise

Frequently asked questions

Do I need a referral?

No. You can schedule directly.

How long is the first visit?

Typically 60 minutes. Complex cases sometimes need a second visit to finish the workup; your clinician will tell you if that’s where things are heading.

Will I get a diagnosis at my first visit?

Usually, yes — a working diagnosis, at least. A small number of presentations need more information or time to sort out, and in those cases your clinician will say so and explain what’s needed.

Will I leave with a prescription?

Often, if medication is clinically indicated and you want to start. There is no pressure — “not yet” is an acceptable answer, and so is “not at all.”

Can I bring a family member?

Yes, if you’d like. Let us know at scheduling. For adolescents, parent/guardian involvement is usually expected.

What if I need help before my evaluation?

For mental-health emergencies, call or text 988 (Suicide and Crisis Lifeline) or go to the nearest emergency room. Trend does not provide emergency or after-hours care.

Is the evaluation covered by insurance?

Most plans cover initial psychiatric evaluations. Ask us to verify your benefits before the visit and we’ll give you an estimate.

What happens after the evaluation?

Follow-up depends on what we decided. Medication visits are typically every 1–3 months once you’re stable. Therapy, if recommended, is weekly or biweekly. Often it’s a combination of both.

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Psychiatric evaluations are conducted by board-certified Psychiatric Mental Health Nurse Practitioners (PMHNPs) licensed in Colorado.