On Monday, Kanye West was admitted to UCLA Medical Center for evaluation. This came on the heels of the sudden cancellation of the remaining dates of his Saint Pablo tour and multiple performances interrupted by monologues from Kanye about the 2016 presidential election and Donald Trump. Those monologues left many fans divided and dejected, simultaneously worried about Kanye, frustrated with him, and also unsurprised, as it seemed like it was consistent with a history of provocative, difficult-to-process declarations. (For instance, in February, he tweeted that Bill Cosby is innocent.)
TMZ reports that Kanye was admitted to UCLA for a psychiatric evaluation. To get a better understanding of that process entails, Complex spoke with Dr. Donya Rhett, a licensed clinical psychologist who has been practicing as a psychotherapist for 14 years.
The following conversation has been edited for clarity and brevity.
Why would someone have a psychiatric evaluation?
Whenever someone’s behavior patterns become erratic, inexplicable, when there are concerns that someone might become a danger to themselves or others, you would like to have a comprehensive evaluation of that person to find out what’s going on. Is there mental illness? Is there substance abuse?
What a comprehensive evaluation entails depends on what the presenting problems are. For example, if someone comes in with a traumatic brain injury, you would administer more neuro-psych types of test to find out what parts of the brain may have been damaged. With a situation like Kanye, I imagine they’ll be looking to more for ruling out a mood disorder, some type of psychosis. They might give him a screening tool called the MMPI. That’s the Minnesota Multiphasic Personality Inventory. That’s a really comprehensive set of questions that can pick up on bipolar disorder, paranoia, psychosis. It can detect if someone is faking their answers to look good, or look particularly sick. It’s the gold standard. It takes about 90-minutes and has been around for almost 90 years; it’s been revised over the years but it’s a pretty accurate tool.
A clinical interview is also a critical part of an evaluation. There are structured clinical interviews with various set questions that a clinician would ask and the response determines what the next question would be. Clinical interviews could be done in an hour, but more likely you would have multiple clinical interviews, with a psychologist and a psychiatrist. They would also want to gather information from those closest to the patient—that’s also very helpful.
What sort of questions would a psychologist ask?
We ask questions about mood, have the patient describe their current mood, and their dominant mood over the past couple of weeks. Length of time for symptoms is critical, so we try to help the patient pinpoint exactly when the symptoms started and how long they lasted. We would ask questions about things like sleep, appetite, and certain high-risk behaviors, like an increase in sexual behavior, or an increase other behaviors that might indicate that someone has deviated from what’s normal for them. We’d also get a history, including family mental illness. Then substance abuse, of course. We’d be assessing for any substance use to determine whether it’s crossed the line into dependence or addiction.
Would a drug test be administered?
I’m pretty sure, yes.
Generally speaking, are evaluations like this more likely to be voluntary or involuntary?
I don’t know percentages, but I’d say there’s a good mix. Usually when someone gets to a point where their behavior or mood is getting in the way of their functioning, they’ll seek out an evaluation on their own. I work with kids, so more often than not I have parents coming to me looking for an evaluation. But you have instances with criminal behavior, and then an evaluation is court ordered.
How long would the patient be required to stay at the hospital following an evaluation?
It depends on the severity of the symptoms. The more concern there is that someone is a danger to himself or others, the longer they will stay. If you’re super rich, you could potentially stay wherever you are for as long as you want. The average person who has insurance that wants to get them out of the hospital quickly, you might be in the hospital for a few days. A week or two. But not much longer than that.
What’s the best-case scenario after a comprehensive evaluation?
You get a good diagnosis with a treatment plan and very specific goals. You want a clear course of action. It’s scary when you don’t know what’s going on, or why this is happening. Once you can figure it out, there’s really great treatment out there, from therapy to medication, or combinations of both. And if substance abuse is involved, that will be treated before they try to treat any mental illness.
What’s the worst-case scenario?
There are definitely mental illnesses that scarier or more severe than others. For example, schizophrenia. There’s no cure for that. There’s good treatment, but it’s something that you’ll struggle with for the rest of your life. If it were a mood disorder, most people are very successful in treating if they’re compliant with the treatment. I don’t see a worst case scenario, really.