The Psych Eval...

[KeenString]

Okay, so I have one scheduled for two weeks from now, the very last thing I have to do before I meet with the surgeons and they decide if I go on the list of not. I have NO idea what this test is, only that the psychologist I'm doing it with says it's a 4 hour evaluation. Can anyone give me some info on it? What am I going to be doing for 4 hours? Is there anything I should know before I go in? Can I bring my Emotional Support Ferret? Will there be cake?

[MooseMom]

I have no idea what a psych eval even is, and I have a transplant after having been listed in two places.  So, I had two separate evaluations.  Each eval was about 3-4 hours, but that included everything; blood work, a chat with just about everyone in the department, and filling out forms.  I spoke to a dietician, the surgeon, a social worker, and the pre-tx coordinator who gave me a big binder full of information a tx patient would need.  I had to wait maybe 10 minutes or so before each of these people were available as I was not the only patient at the clinic on that day.  I'm not sure which bit was a "psych evaluation".  If I had to say anything about it, my guess is that they want to make sure you have a way to get to your clinic visits right after surgery ("Do you have a support system?") and that you understand the importance of compliance when it comes to taking your meds and keeping your clinic appointments and getting your labs done on a regular basis.

I was not offered cake, but the dietician gave me a teabag of her favorite tea.

[UkrainianTracksuit]

I did not need a psych eval either (thank goodness!  ) but I've heard it being a requirement for those with previous mental health issues. As MooseMom said, it will focus around compliance for the scheme of care and that you are "with it" in understanding about the whole thing/life afterwards.

In my case, my renal social worker at the dialysis clinic (this one is actually good when it comes to "social" work stuff) sent off a letter on her assessments. The transplant social worker reviewed it, asked me some questions about my life but she was more concerned about drug coverage. That's all I can offer!

[iolaire]

I've heard it being a requirement for those with previous mental health issues.

I believe this is the key point, they need to screen people for previous or possible mental health issues and if they have concerns figure out how work with you to minimize or come up with treatment plans/goals prior to accepting you to the program. 

The hospitals are invested in keeping their transplant recipients and the graft (kidney) functioning.  Part of that is to insure that external (to the kidney) factors will not harm the viability of the kidney and the recipients.  That's why they want to make sure you have a plan to pay for the transplant medicine, have a support network to insure you are able to get your labs, visits to the clinic and take your medicines.

Likely that four hour meeting is really about four meetings (financial, psychologist, diet, and maybe a nurse to go over medicines (costs and other medical related things))  and some waiting times.  When I was listed at the second clinic it was about 15 minutes per person (because they knew the other hospital covered it once before), the first clinic it was more like 30-45 minutes each.

[MooseMom]

Try to think of it this way.  This is YOUR opportunity to get all of the answers you need and to voice all of your concerns.  This is an opportunity for YOU to interview THEM.  If, after the evaluation, you do not feel comfortable with the team, you might be able to be listed elsewhere.  You will be putting your life in their hands, and you have to make sure these people deserve that honor.

[KeenString]

So strange. I'm not worried about it, more like curious. I've never met anyone else who has needed one, and I have absolutely no history of mental illness or depression or anything of the like. I put a call out to my coordinator to get some more details on it, but thus far she has not called me back. I'll share what she tells me. Thanks everyone!

[MooseMom]

I am very curious to hear what you coordinator says!  I can't imagine a 4 hour psych evaluation!  What do you talk about for 4 hours?   

[Cupcake]

KeenString you have a good sense of humor (I assume you were joking about the ferret) and that will take you a long way. I was listed at 2 places and don't remember much of a psyche eval-more of a social eval. There was a questionnaire that asked a lot of nosy questions that seemed ridiculous! Just express your confidence in having social support and opportunities to refill meds/make it to follow up appointments. Its not like they are going to call your neighbor and confirm that they will help you take out the trash!

[iolaire]

I've never met anyone else who has needed one, and I have absolutely no history of mental illness or depression or anything of the like.

They probably don't recall that they even had a Psych Eval!  But they probalby did if they recieved a transplant.

[Charlie B53]

I don't think it would be a very good idea to put me in a room with a Psych for 4 hours.

One of us might be leaving in a straight jacket headed for a padded cell.

I KNOW that I must be at least slightly Insane, if not then at least seriously bent and twisted.

I DID Volunteer to join the Army at the height of Viet Nam.  And I am a Service-Connected Disabled Veteran so you can be sure I have a Dark Twisted sense of Humor.

Complilant?       Well, I do take my Meds Religiously, and I am very careful with my Diet and Fluids.  I really don't have any choiice if I want to stay alive much longer.  So I have that much going for me.

Play well with others?      This can be a whole different story.

I get along fine with Veterans.  Civilians can be a problem as most haven't a clue.  Many are so self-centered and very little concern for anyone else, only concerned about what they can get.   Worthless.

Protesters?  It wouldn't bother me a bit if the Government called out the Military and made most of them extinct.

Once upon a time Protest were quite and Respectful, and they did not destroy property and leave the area trashed.  These Snowflakes now seem to act like a bunch of animals.  No Respect for any one or anything, least of all the property of everyone else. And leave a trail of trash behind that takes DAYS to clean up.

No, I don't think I would do well on any Psych Eval at all.

[Naynay99]

Hey.  The 4 hrs sounds bizarre, but one of my tx clinics did require what they called a psych evaluation.  It was bc I told them I have had depression in the past which I guess is a red flag.  So perhaps they require it if there is any history of mental health issues. 
But they said since I already see a therapist and psychiatrist regularly for treatment, that I just needed my doctor to semd them documentation that I was mentally healthy enough for a transplant. He wrote like a 5 sentence letter basically saying I wasn’t crazy and there was no psychiatric reason for me to not be approved for a tx.  I’m

I think when u see a new psych they do an intake exam which takes like an hour to go thru your history and crap.  No idea what the other 3 hours would be for tho.  I think as far the exam, just present as normal and u will be fine.  When talking to the social worker about my history of depression, i downplayed it and made sure to emphasize I was under a dr care and stable and he seemed satisfied with that.  I feel like it is a CIY on their part. 

As for the social worker appt. he was mostly concerned w my having a good enough support system so I’m glad I brought sonefbody with me to the evaluation appt.   It all seemsed like bullshat, he actually asked me if I had any stressors in my life!! Lol
Anyway, good luck.  I’m sure it is just a formality they make u go thru. 
Take care.

[KeenString]

I'm really disjointed that none of you said there would be cake.

Ok! So yesterday I had an appointment with my Nephrologist, and I got a call from my coordinator, and here's the scoop. The 'Psych Eval' isn't one specific test. Basically, it's a series of meetings you have with everyone on the team about everything the tx will involve, and everything after. There is a small 'personality' test where you meet with a psychologist to make sure you're mentally sound, then you meet with everyone else who will be working on your case. (Surgeons, dietitian, blah blah) and while you are meeting with them, they are taking their own notes on weather or not they believe you are in the right mindset to be able to go through the tx, and if you will be compliant in taking care of the new organs/yourself, afterward. They're also looking to see if you fully grasp how serious a matter a transplant is. Apparently, EVERYONE who has had or will have a tx goes through this test, you just might not know it, because it seems like you're just meeting with the dietitian or whoever.

I had made an apt with a psychologist near where I live because they could get me in for testing a lot sooner than Miami Transplant, but after talking to my Nephrologist, I've decided to just go get the testing done at the transplant center. He said that that way, there will be no hiccups that will delay me going on the list. The tx center knows exactly what they want, so I won't have to worry about having to go back just in case the other psychologist does the wrong test or forgets something or puts something in their notes that they're not sure about.

Charlie B53 when my father heard that I had to meet with a psychologist, he immediately says "Great, they're not going to give you the kidney."

[MooseMom]

KeenString, we do "psych evals" every day on people we have conversations with.  We just don't realize it.  Whenever we encounter someone, we can get a good sense of whether or not this person is a bright spark or is thick as a plank.  We don't ask them specific questions, but we don't have to because we innately just "know".

So, your tx team will certainly be able to get a "sense" of you over four hours.  And they will tell you straight up that there is work involved in keeping a transplant going.  My tx neph and my coordinator have both bemoaned the fact that too many of their patients just don't "get it" and so don't bother all that much in taking their meds correctly.  You can see the disappointment in their eyes as they relate the stories of patients who wait too long before calling about weird symptoms or with questions about their meds.  Non-compliance is apparently a MUCH bigger problem that I'd realized.

Let them know that you understand the meds and how they work and how they must be taken in the correct way.  Acknowledge the extreme measures you/they are taking in saving your life because that is just what this is.  They are taking an organ from one person and putting it into you so that you may live.  It is a quite extraordinary thing.  But that's just the beginning.  The real challenge is keeping that new organ working.  Show them that you understand this and that you are willing and able to do what is necessary to keep that kidney healthy.

Be confident, be inquisitive, be ENGAGED.  You will be fine!

[Mr Ken]

No, I don't think I would do well on any Psych Eval at all.

You are all right in my book! You passed!!!

[Paul]

No, I don't think I would do well on any Psych Eval at all.

Oh I know I wouldn't, and I have documentation to prove I wouldn't!

In my area (Health Department designated area) we have a service where, if your doctor feels it would help, you can have six free sessions with a psychiatrist. My doctor put me up for these, I went to all six, and at the end the psychiatrist gave me details of how to get paid help. I turned down her offer as I did not feel there was much point. Because my doctor had recommended me for this service she had to send a report to him after the six appointments were over. And by British law, patients have to be sent copies of all letters about them, sent between medical professionals, so I got a copy. In it she urged my doctor to try and get me to take up regular psychiatric visits (not necessarily with her practice, she did recommend a couple of cheaper practices, so it was genuine concern not commercial greed). Apparently she feels I desperately need psychiatric help.

Still didn't take her up on it though. Psychiatrists cost money, and since loosing my job money is tight. I cannot afford to be made sane!

[kristina]

Hello Paul,
Please don't let it get at you ... I look at it this way : if I have a chance to meet a sane psychiatrist, I might start to take psychiatry seriously and I might even come to the conclusion that psychiatrists know so much more about life and people than we ever could ... But do they ?
As it is, I went to school with three boys who later all became psychiatrists. I always thought they needed to study psychiatry because of their irreparable conflicts with their parents and my suspicion was always, that they hoped, psychiatry could provide them with all the answers, which obviously it did not and since they were three of them, it seems strange that psychiatry did no service to any of them ... and ... here I rest my case ...

[Paul]

Thanks.

[Charlie B53]

.............. this person is a bright spark or is thick as a plank. .......

Many days I feel somewhat like a board, warped, bent, and twisted.

A lot like my sense of humor.

[Naynay99]

I know I’m a little nutty, but my psychiatrist is a total whack job. 
Once when he got a brand new Apple Watch that I didn’t ooh and ahh over it he got totally offended and wouldn’t drop it.
And the last two times I’ve seen him he asked me if I noticed how much weight he has lost, acting hurt that I didn’t mention it to him.  But he takes my insurance and can write prescriptions so that is what he is good for. 

If anyone is looking for actual help with your mental health, don’t seek out a psychiatrist.  They r not like they r depicted ion the TV shows“Frasier” or “Monk”, doing talk therapy.   They see u for 10 minutes, give u drugs,  and shoo u on ur way.  I think just like people who were bad at school often become teachers, ppl who r nuts often become psychiatrists.  For actual “help” I see a clinical social worker for talk therapy.  They charge a lot less and tend to be much saner.  Lol

Oh by the way, the social worker at my latest tx evaluation found me to be psychologically healthy and and fit for transplant!  So If I passed with flying colors I think anyone probably can.   Take it easy.

[Simon Dog]

No psych eval here (my wife could have told them I am off the wall but capable of following protocols precisely), but pre-transplant meetings with -

- Social worker (perfunctory once she saw I was a mentally competent insured suburbanite)
- Surgeon (the other cutter did my xplant, but this surgeon covered for many of my appointments)
- Transplant nephrologist
- Transplant pharmacist (who has been very helpful since the xplant)

Also radioactive cardiac stress tests every couple of years, infectious disease interview about med history and vaccines, and calling my nephrologist on vacation in the Bahamas to get his clearance to accept me into the program.

I went inactive for a while (for hip surgery) and had to be re-presented to the committee to reactivate.