(Note that this is my opinion and my limited understanding of the mental health system as of 2015 in my part of North Carolina. It is very complex and constantly changing. The purpose of this article is to help others to have a structure to build their understanding upon.)
Questions? Questions? Questions? Many times, I am asked questions by laypersons about the mental health profession. And oftentimes, I find myself having to explain the mental health system to them before I can adequately answer the question. So to save time, I decided to succinctly and thoroughly as possible write what I know below. Let me begin with the professionals.
THE PROFESSIONALS (persons paid for their mental health work)
*I have arranged these according to the amount of education, pay level, and responsibility level (meaning how much responsibility or money they may be required to pay if they are sued).
Psychiatrists are medical doctors (MD). They have a 4 year bachelor’s degree and 4-5 years of education in medical school, and a 3-8 year residency, totally about 11-17 years of education beyond high school, before they are fully licensed. They have to pay the most for their education.
They are licensed by the state to practice medicine, meaning they can prescribe medication. Although other medical doctors can prescribe psychotropic medication, typically psychiatrists understand the medications better. They understand how they interact with each other, which can be complex.
Typically, psychiatrists do not counsel or provide psychotherapy. They usually meet with a patient long enough to understand their symptoms and prescribe them medications. Most psychiatrists do not have time to counsel because they have so many patients needing medication management, and it does not pay as much.
2. Psychologists (PysD or PhD level professionals)
Psychologists, PhD level counselors, or PhD level therapists are graduate school doctors. PhD is the abbreviation for doctorate of philosophy, and PysD is for doctorate of psychology. They have a 4 year bachelor’s degree, 4-7 years of graduate school education, and at least 2 years of supervision, totally about 10-13 years of education beyond high school before they are fully licensed.
They are licensed by the state to administer psychological tests, counsel or provide psychotherapy. They cannot prescribe medication. Typically, psychologists and doctorate level professionals administer psychological tests or teach at the graduate school level. Most do not counsel or provide psychotherapy because it does not pay as much as testing.
3. Master’s Level Medical Professionals (PAs or NPs)
Physician Assistant (PA) and Nurse Practitioner (NP) are master’s level medical professionals. They have a 4 year bachelor’s degree, about 2 years of graduate school and ongoing supervision by a physician, totaling 6+ years of education beyond high school.
They are licensed by the state, but they cannot practice alone. They must be supervised by a physician, but the physician does not have to be physically present at their office. Some specialize in mental health. They can prescribe medication and that is what they primarily do in the mental health setting. Although some do provide counseling or psychotherapy, it is rare.
4. Master’s Level Therapists (LPAs, LCSWs, LPCs, LCASs, or LMFTs)
Licensed Psychological Associate (LPA), Licensed Certified Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Clinical Addiction Specialist (LCAS), or Licensed Marriage and Family Therapist (LMFT) are all therapist/counselors who have a graduate degree. Each one of these abbreviations may have an “A” or “P” added to it which means that they are an “associate” or “provisionally” licensed–not fully licensed. They have a 4 year bachelor’s degree, about 2 years of graduate school, and about 2 years of supervision, totaling about 8 years of education beyond high school, before they are fully licensed.
These mental health professionals provide counseling and/or psychotherapy. They cannot prescribe medication or administer psychological tests. They provide the bulk of private practice counseling, and can be reimbursed by insurance companies.
5. Associate Professional (AP) & Qualified Professional (QP)
Associate Professional (AP) and Qualified Professional (QP) are mental health workers who have a bachelor’s degree. So, they have a 4 year bachelor’s degree and they are supervised by a licensed clinician. Their education beyond high school totals about 4 years.
They typically work for an agency. (My definition for an agency is a private or government mental health center that is paid by tax-payer dollars via Medicaid and/or Medicare.) They provide counseling, assessments, case management, etc. for the poor.
6. Certified Mental Health Workers
Certified Substance Abuse Counselor (CSAC), Certified Substance Abuse Prevention Consultant (CSAPC), Certified Criminal Justice Addictions Professional (CCJP), etc. are mental health workers who have a high school diploma or the equivalency. They have completed high school and have some training after graduation. They are supervised by licensed clinicians.
Like the AP and QP, they typically work for an agency. They provide counseling, assessments, case management, etc. for the poor.