What Happens at a Private Psychiatric Assessment? A Step-by-Step Guide

Taking the decision to seek professional support for your mental health is rarely straightforward. For many people, the hardest part is not making the decision itself but understanding what actually happens once they do. If you have been considering a private psychiatric assessment in London, you may have questions you have not yet found clear answers to. What will the psychiatrist ask? How long does it take? Is there a right or wrong outcome? What happens after?

These are not trivial questions. Understanding what happens at a private psychiatric assessment is often what makes the difference between picking up the phone and putting it off. This guide sets out the process honestly, step by step, from first contact through to receiving your outcome report. It is written for anyone who has already decided they want support and wants to know what to expect when they get there.

At Psyche Clinic, all assessments are conducted by consultant psychiatrists with substantive NHS experience before entering private practice. No assessment is delegated to junior or trainee clinicians. What follows reflects our approach and, more broadly, what a thorough private psychiatric assessment should look like wherever you choose to be seen.

What is a private psychiatric assessment?

A psychiatric assessment is a structured clinical conversation between you and a consultant psychiatrist. Its purpose is to understand your mental health difficulties in depth, to arrive at a clinical formulation of what is happening and why, and to determine the most appropriate path forward, whether that involves therapy, medication, further investigation, or a combination of these.

It is not a test. There are no right or wrong answers and no outcome you are trying to achieve. The assessment exists to give the psychiatrist an accurate clinical picture so that any recommendations made are genuinely tailored to you, rather than applied generically.

Private psychiatric assessments differ from NHS pathways in several practically important ways. You can access a private assessment without a GP referral. You will typically be seen within days rather than months. You will meet with a consultant psychiatrist rather than a junior member of a wider team, and that same clinician will remain your point of contact throughout any subsequent treatment if you choose to continue. An initial consultation lasts around 60 minutes, though specialist assessments, including adult ADHD assessments, involve additional structured tools and may extend across more than one appointment.

How to prepare for a private psychiatric assessment

Most private clinics will send a pre-assessment questionnaire to complete before you attend. At Psyche Clinic, this covers your presenting concerns, relevant personal and family history, previous diagnoses or treatment, and current medication. If you have existing clinical letters, previous assessments, or GP correspondence, bringing copies is helpful, though not required.

It is also worth thinking through what has prompted you to seek help now. How long have you been experiencing these difficulties? How are they affecting your work, relationships, and daily life? You do not need a precise account prepared. A rough sense of the picture is enough, and the psychiatrist's role is to draw out the relevant detail through skilled clinical questioning. Your role is simply to be as honest as you can.

If there are things you find difficult to talk about, you do not need to resolve that before arriving. A good psychiatrist will create the conditions in which difficult disclosures feel possible rather than requiring you to arrive already open. Equally, nothing will be forced. You are in control of what you share and when.

What happens during a private psychiatric assessment

Arrival and setting

At Psyche Clinic, assessments take place at 10 Harley Street, London W1G 9PF, or via Zoom for those who prefer a remote consultation. The environment is calm and deliberately discreet. You will be greeted by a member of the administrative team and shown to a waiting area. Appointments begin on time.

Opening the conversation

The psychiatrist will introduce themselves and explain how the session will work, including the limits of confidentiality. These are narrow and clearly explained: the only circumstances in which confidentiality may be broken concern serious risk to you or someone else. Outside of those exceptions, everything discussed remains private.

The assessment typically opens with an invitation to describe, in your own words, what has brought you to the appointment. Some people arrive with a clear account prepared. Others find this question the hardest part. Both are entirely normal, and the psychiatrist will follow your lead, gently steering the conversation wherever it clinically needs to go.

Exploring your mental state and presenting difficulties

The core of the assessment involves a detailed account of your current symptoms and experiences. In practice, this unfolds as a conversation rather than a formal procedure, though the psychiatrist is carrying out what is known as a mental state examination throughout: attending carefully to how you think, how you feel, how you are functioning day to day, and how you are relating in the room.

They will ask about the nature, frequency, and duration of your symptoms, and how they are affecting specific areas of your life, including sleep, energy, motivation,

concentration, and relationships. Where relevant, they will ask about particular symptom clusters in more detail. For anxiety, they will want to understand its form and triggers. For depression, they will explore mood, motivation, sleep, appetite, and thoughts about the future. For trauma, they will approach the subject carefully and without pressure.

Taking a personal history

Understanding your background is integral to understanding your current difficulties, and a thorough assessment will always include a personal history. This covers childhood and development, family environment, education, significant life events, work history, and any previous contact with mental health services or medication.

This part of the appointment can feel more personal than the symptom-focused sections. It is entirely normal for some areas to feel easier to discuss than others, and the psychiatrist will follow your pace. They are not looking for a complete biography. They are looking for the context that helps them make sense of where you are now.

Risk assessment

As part of any thorough psychiatric assessment, the psychiatrist will ask about safety, including, where relevant to your presentation, thoughts of self-harm or suicide. This is a routine and clinically important element of practice, not an indication that the psychiatrist expects a particular answer or is alarmed by your situation.

These questions are asked with care and without judgement. If they feel difficult, you can say so.

Formulation and diagnosis

Towards the end of the clinical conversation, the psychiatrist will share their formulation of your difficulties. This may include a formal diagnosis or, where the picture requires further assessment before a diagnosis can be confirmed responsibly, a clear clinical impression and a recommended next step.

A formulation is more than a label. It is the psychiatrist's working understanding of what is driving your difficulties, the factors that have contributed to them, and the factors that are maintaining them. This is the foundation on which treatment recommendations are built. You will have the opportunity to ask questions and raise anything you are uncertain about before the appointment ends.

What happens after a private psychiatric assessment?

Following your appointment, you will receive a written outcome report. This is one of the most practically valuable elements of a private psychiatric assessment, and it is something that NHS pathways rarely provide with the same speed or clinical detail.

The report will summarise the history discussed, the psychiatrist's formulation and diagnostic conclusions, and their specific recommendations for treatment. If medication is being recommended, the report will explain the rationale and what to expect. If therapy is indicated, it will specify the type and the evidence base for it. If further assessment is needed, this will be set out clearly along with a suggested pathway.

The report is yours to use as you choose. Many patients share it with their GP, which Psyche Clinic will also do as a matter of routine with your permission. Others share it with an employer's occupational health team, an insurer, or keep it entirely private. It can also serve as a reference point for your own understanding as treatment progresses.

If treatment is recommended and you choose to continue at Psyche Clinic, your care will be delivered by the same senior clinical team. There is no handoff between assessment and therapy. Where psychological therapy is indicated alongside or instead of medication, this is available within the same practice, with clinicians who communicate directly with one another. This is what continuity of care in practice actually looks like, and it is meaningfully different from being assessed by one provider and referred elsewhere for treatment.

What conditions does a private psychiatric assessment cover?

A psychiatric assessment can assess for the full range of mental health conditions. The most common presentations seen at Psyche Clinic include anxiety in its various forms, depression including treatment-resistant presentations, trauma and PTSD, ADHD in adults, bipolar disorder, OCD, burnout, and addiction, including alcohol dependency.

It is also worth noting that many presentations are not clean single diagnoses. Anxiety and depression frequently co-occur. ADHD often presents alongside mood difficulties. Trauma can underpin presentations that initially look like other conditions entirely. One of the significant advantages of a thorough private psychiatric assessment is that it takes the whole picture seriously rather than stopping at the most obvious surface-level explanation. Conditions that are identified and treated together tend to respond better than those treated in isolation.

How much does a private psychiatric assessment cost in London?

At Psyche Clinic, an initial psychiatric assessment is priced between £600 and £775 for a one-hour consultation. Adult ADHD assessments are £1,500 to £1,750, reflecting the additional structured tools and clinical time involved. A full breakdown of fees is available on our appointments and pricing page.

Psyche Clinic is recognised by all major private medical insurers, including Bupa, AXA Health, Aviva, Cigna, Vitality, Allianz, and Simplyhealth. If you hold a policy, contact your insurer before booking to confirm your level of cover and any pre-authorisation requirements. For further context on what private psychiatry costs across the UK, our article How Much Does a Private Psychiatrist Cost in the UK? covers the full landscape.

Do I need a GP referral for a private psychiatric assessment?

No. You can contact Psyche Clinic directly and self-refer without a GP referral. Many of our patients come to us having not yet spoken to their GP about their mental health concerns, or having decided to pursue private care while waiting for NHS services.

If you would like your GP to be involved in your care, we will write to them with your permission following your assessment. Shared care arrangements, in which your GP manages prescription oversight following our initial assessment and treatment planning, are also available. The Royal College of Psychiatrists provides guidance on referral pathways and what to expect from psychiatric care in the UK for anyone who wants to understand the broader system before making a decision.

Clinician Spotlight

Dr Az Hakeem, MBBS MSc FRCPsych

Dr Az Hakeem, MBBS MSc FRCPsych

Dr Az Hakeem is a Consultant Psychiatrist and the lead clinician at Psyche Clinic. He was appointed as a Consultant Psychiatrist in 2005 and has held substantive NHS consultant posts in general psychiatry, medical psychotherapy, and forensic psychotherapy at Camden and Islington NHS Trust and The Tavistock and Portman Foundation Trust. He trained in and taught Mentalisation Based Therapy at The Anna Freud Centre, holds an MSc in Group Analysis from Birkbeck University, and is the author of two published clinical books alongside extensive peer-reviewed research.

Dr Hakeem conducts initial psychiatric assessments at Psyche Clinic and offers ongoing care across a range of complex presentations. He is available for appointments in person at 10 Harley Street and via Zoom. Read more about Dr Az Hakeem.

Frequently asked questions

How long does a private psychiatric assessment take?

An initial psychiatric assessment at Psyche Clinic lasts approximately one hour. Adult ADHD assessments are structured differently and involve additional clinical tools; these typically take 90 minutes and may be divided across more than one session. Your appointment length will be confirmed when you book.

Will I definitely receive a diagnosis?

Not necessarily, and this is not a failure of the assessment. Some presentations are complex, or early enough in their development that a responsible clinician will offer a clinical impression and a recommended next step rather than a confirmed diagnosis at the first appointment. A clear formulation of your difficulties and specific recommendations for what to do next will always be provided.

Can I bring someone with me?

Yes. Many patients choose to attend with a partner, family member, or close friend for support. The psychiatrist may ask to speak with you alone for part of the appointment, as certain areas of clinical conversation require a degree of privacy, but having someone present for parts of the session is entirely possible. Let us know at the point of booking.

What if I become distressed during the assessment?

Psychiatric assessments can surface difficult feelings, particularly when discussing painful history or current struggles. This is normal and anticipated. Your psychiatrist is experienced in managing distress within clinical conversations and will pace the session accordingly. You are never obliged to discuss anything you are not ready to share, and you can ask to pause or redirect the conversation at any time.

How quickly can I be seen?

Psyche Clinic does not operate a waiting list. Most patients are seen within one to two weeks of making an enquiry, and same-week appointments are often available for presentations that are time-sensitive. Evening appointments are available as standard for patients who cannot attend during working hours.

What is the difference between a psychiatric assessment and a psychological assessment?

A psychiatric assessment is conducted by a consultant psychiatrist, a fully qualified medical doctor who can diagnose mental health conditions and prescribe medication where appropriate. A psychological assessment is conducted by a clinical psychologist and uses structured psychological tools to understand patterns of thinking, behaviour, and emotion. Both serve important and distinct purposes, and for some presentations both are clinically warranted. Our article on the difference between psychiatrists and psychologists explains this in more detail.

Is everything I discuss confidential?

Yes, with limited and clearly explained exceptions. These concern situations in which there is a serious risk to your safety or the safety of someone else. Your psychiatrist will explain the limits of confidentiality at the outset of your appointment. All clinical records are held securely and in accordance with UK data protection standards and the HCPC Standards of Conduct, Performance and Ethics.

Book a private psychiatric assessment at Psyche Clinic

Psyche Clinic is a specialist private mental health clinic at 10 Harley Street, London. Our team of consultant psychiatrists and clinical psychologists offers thorough, expert-led assessments conducted with complete discretion. No assessment is delegated to junior or trainee staff.

Appointments are available in person at Harley Street and via Zoom. Evening appointments are offered as standard. There is no waiting list, and all major private medical insurers are recognised.

To book an assessment or make an enquiry, visit psycheclinic.co.uk/contact, email contact@psycheclinic.co.uk, or call +44 (0) 20 7467 8527.

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Psyche Clinic  |  10 Harley Street, London W1G 9PF  |  contact@psycheclinic.co.uk  |  +44 (0) 20 7467 8527