Your First Private Psychiatry Appointment

Most people are a little nervous before a first psychiatric appointment. Often it is the first time they have set out the whole story to anyone, and there is a worry about being judged, or about not being believed. This page walks through what happens, in order, so the hour holds no surprises.

Appointments are by video with a GMC-registered consultant psychiatrist. Consultations are provided by Happy Clinic, which is registered with the Care Quality Commission (CQC), and are open to adults aged 18 and over anywhere in the UK, with no GP referral needed. How online psychiatry works covers the format.

What to gather beforehand

You do not need a dossier. But an hour goes quickly, and the people who get the most from it arrive with facts rather than half-memories. Worth having to hand:

• Your current medicines, with doses. Names and milligrams, including anything for physical health, plus contraception and supplements. A photo of the boxes works.
• What you have tried before, and what happened. The most useful thing you can bring. For each medicine: roughly when, what dose, how long for, whether it helped, and why you stopped. “Sertraline, about 2023, made me feel sick for two weeks then flat” tells a psychiatrist more than a name alone.
• Any past diagnoses, letters or discharge summaries. If you have an NHS clinic letter, have it open.
• A GP summary if you can get one. Many practices will print one, or view your record in the NHS App. Not essential.
• Family history. Whether anyone in your family has had depression, bipolar disorder, ADHD, autism, psychosis or problems with alcohol or drugs — and whether any of them did well on a particular medicine.
• A short timeline. When things started, what was happening then, what has changed since. Six bullets is plenty.
• Any questionnaires you were sent. Complete these beforehand. They shape the questions and save time.

If you are being assessed for adult ADHD or for autism, add one more: someone who knew you as a child. The NHS page on ADHD in adults says the specialist may want to contact someone who knows you well, such as a family member or close friend, because the assessment turns on the history of your symptoms in childhood and how they affected you at school. A parent, older sibling or long-standing friend fills gaps nobody remembers about themselves. Old school reports are gold if you still have them.

Getting the set-up right

Ten minutes of preparation prevents most of the things that spoil a remote consultation.

Device. A laptop or tablet beats a phone: it will not ring mid-sentence and it can sit still. Plug it in or charge it fully.

Connection. Test the camera and microphone beforehand, not at the start. A wired connection, or a spot near the router, beats the far corner of the house.

A quiet, private space. This matters more than the technology. You need somewhere you are not overheard, because you will be asked things you would not say in front of a housemate. A car in a quiet car park works if home does not. Calling from work, book a room rather than using an open office.

Headphones. They improve the sound both ways and keep your half of it private.

Have to hand: your notes, your medicines or a photo of them, water, and something to write with.

If the call drops, rejoin with the same link. If it will not hold, the psychiatrist will usually phone the number you gave when booking, so keep that phone nearby and unmuted. Connection problems are common and nobody minds.

Log on five minutes early and take a moment to settle before you start talking.

How the hour usually goes

An initial assessment is 60 minutes. The shape varies with the clinician and with what you bring, but it usually runs something like this.

The opening few minutes. Introductions, a check on who you are and where you are calling from, and confirmation of your GP details and consent. The psychiatrist explains how the session runs.

Your story, in your words. Then the main part: a broad, open question — what has brought you here, what is happening, how long it has gone on. Let this run. You will not be hurried, and it is the most important information in the appointment.

Structured questioning. The psychiatrist then fills the gaps methodically, which can feel like a change of pace. Sleep, appetite, concentration, energy, mood through the day, anxiety, panic, intrusive thoughts, alcohol and drugs, and questions about risk and self-harm. Those last ones are asked of everybody. They are not an accusation and not a trap.

Background. Your medical history, your family history and your own — childhood, school, work, relationships.

The last stretch. The psychiatrist tells you what they think, sets out the options and agrees a plan with you. Leave time for your questions; do not let this part be squeezed.

Why childhood and family history come up

People are sometimes thrown by how far back the questions reach, particularly when the problem feels entirely about the present.

There are good reasons. For ADHD and autism, childhood evidence is part of the diagnosis itself, not background colour — the symptoms have to have been present early. For mood and anxiety, the lifetime pattern is what separates one diagnosis from another: a first episode of depression is a different thing from a mood that has swung for twenty years, and the treatments differ. Family history helps too, because how a close relative responded to a medicine is a genuine clue about how you might.

None of it is curiosity. If a question seems irrelevant, it is fair to ask why it is being asked.

How to raise something difficult

Most people have one thing they are dreading saying: how much they are drinking, a thought they are ashamed of, self-harm, something that happened to them, or that they have not been taking the tablets they were prescribed.

Say it anyway, and early rather than in the last five minutes. A plan built on a partial picture is a worse plan, and the omission usually costs you the wrong medicine. If saying it aloud is too hard, type it in the chat, or write it down and read it out. “There is something I need to tell you and I am finding it hard” is a perfectly good opening — psychiatrists hear it often, and none of it will shock them.

You are also allowed to hold something back and come to it next time. That is common and entirely reasonable.

What you leave with

By the end of an initial assessment you should have:

• A diagnosis, or a formulation. Sometimes there is a clear label. Sometimes a formulation is more useful: an explanation of what is going on and why, which may not reduce to one word. Either way you should understand it, and feel able to say if it does not fit.
• A plan. What happens next, and why. That may include medication, advice on therapy pathways, physical health checks and what to watch for. Happy Clinic does not provide psychological therapy, but the psychiatrist can advise on which therapy would suit and how to get it.
• A prescription, where clinically appropriate. Not always. Sometimes the answer is therapy, or a change to a medicine you already take, or watching and reviewing. Prescriptions issued during an appointment are included in the fee; pharmacy charges are not. See prescriptions.
• A clinical summary, to you and, with your consent, to your GP. Agreeing to share it is usually the right call: it puts your record straight, avoids duplicated treatment, and is what makes later NHS prescribing or shared care possible at all.

Fees checked September 2026 — see the fees page for the current list.

What happens next

Very little is settled in one appointment, and it is not meant to be.

If a medicine is started, expect a follow-up within a few weeks rather than months, to check how you are tolerating it before anything is adjusted. Follow-ups are 20 minutes.

If you are starting ADHD medication, the process is called titration. The dose begins low and rises in steps, with a review between each step and physical health checks including pulse, blood pressure and weight. Finding the dose that works takes several appointments, not one, and that is normal rather than a sign of anything going wrong. Once treatment is stable, a Shared Care Agreement can be proposed to your NHS GP, who decides whether to accept it — see NHS or private for what that means for your costs.

If the diagnosis needs more information, the next step may be a longer assessment, questionnaires or an informant interview with a family member.

Happy Clinic is not a crisis service. If a life is at risk, call 999 or go to A&E; for urgent mental health help, call 111 and choose the mental health option; Samaritans are on 116 123, free, at any hour.

Questions worth asking

Write down two or three of these and ask them before the session ends.

• What do you think is going on, and how confident are you?
• What else could it be?
• What are my options besides medication?
• If we start this medicine: what should I expect in the first two weeks, which side effects matter, and when would we know it is working?
• How long would I expect to stay on it?
• When will I see you next, and what will we check?
• Will you write to my GP, and what will the letter say?
• What should I do if I feel worse before then?

The Royal College of Psychiatrists sets out what to expect of your psychiatrist in the UK, worth reading if you want to know what good practice looks like.

If you are nervous

Almost everyone is, and psychiatrists take that as read. You do not have to tell the story well or in order, and you will not be marked on how you say it. You can cry, stop or ask for a moment, and you can ask for a question to be repeated or explained. Nothing you say goes to your GP without your consent, or to your employer or family at all.

And you can change your mind. If the psychiatrist is not the right fit, you are not obliged to continue with them.

When you are ready, look at the conditions covered, then book an appointment. If you have a question first, get in touch — better to ask before paying than to wonder afterwards.

This page is general information and is not a substitute for personal medical advice. Consultations, diagnosis and prescriptions are provided by Happy Clinic, which is registered with the Care Quality Commission (CQC). If you are in crisis, call 999, go to A&E, call NHS 111 or call Samaritans free on 116 123.