Psychiatric practice

Dr Justine Dreyer

I am a George-based general psychiatrist. I mainly work with adults and older adolescents. I treat most psychiatric conditions, focussing on mood and anxiety disorders, substance use, and ADHD. I also have an interest in the integration of lifestyle, neuromodulation, and faith into mental health care.

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Practice Update

Thank you for visiting this website.

The practice is currently unable to accommodate new patient bookings.
In the meantime, please feel free to browse the website for other helpful information, or visit my resources page.

Thank you for your understanding and support.

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Get started

Reaching out for mental health support often comes with questions, uncertainty, and even fear. These are some of the questions I hear most often:

Most people benefit from starting with the most accessible level of care, i.e. where you don’t have to wait too long for an appointment, and where the rates are less expensive. In the private sector, this is often a GP, counsellor, or psychologist. In the public sector, a local primary health care clinic – where a nurse or mental health nurse can assess and guide care – is an appropriate and important first step. If symptoms are complex, severe, or not responding to initial support, referral to a psychiatrist may then be recommended.

You may not need to see a psychiatrist first. Many people begin with a trusted GP, counsellor, psychologist, or a primary healthcare clinic, where mental health nurses can offer assessment and support. If there are concerns about diagnosis, medication complexity, risk, or lack of improvement, a referral to a psychiatrist can help guide the next stage of care.

Psychiatric treatment can help by bringing clarity when symptoms are persistent, complex, or not improving despite other forms of support. Many people receive help through counselling, psychological therapy, primary health care clinics, faith or community support, and complementary approaches, all of which can be meaningful and important. When needed, psychiatric care focuses on understanding patterns of symptoms over time, assessing risk and complexity, and guiding treatment when medication, closer monitoring, or specialist input may be helpful, alongside the care you’re already receiving.

Each plays a different role in mental health care. GP’s (general practitioners) are often a good starting point for initial assessment and basic treatment, especially when physical and emotional symptoms overlap, and also for ongoing care after psychiatric consultation. Psychologists and counsellors focus on therapy, coping skills, and emotional processing. Psychiatrists are medical specialists who assess complex mental health conditions, clarify diagnoses, provide therapy and lifestyle support, and change medication when needed, such as when symptoms are severe, persistent, or not improving with other care. Many people receive multidisciplinary care from more than one practitioner, depending on specific needs.

Since psychiatry is a scarce resource in South Africa, there are usually waiting times. In the private sector, this can range from a few weeks to several months; in the public sector, waits may be longer depending on availability and urgency. While waiting, it’s important not to delay care – support from a GP, psychologist, counsellor, or a primary health care clinic (where a nurse or mental health nurse can assist) can provide assessment, treatment, and ongoing support. If symptoms worsen or safety becomes a concern, seek urgent help through your nearest clinic, emergency department, or online crisis service.

The first consultation is a structured, clinician-led conversation to understand what you’re experiencing and how it’s affecting your life. In my first consultations, we usually talk about your main concerns and what you’re hoping for, and I ask questions about your life, your health, your symptoms, and your functioning, to build a clear picture of the different factors shaping your mental health. This assessment is often spread over two or more appointments to allow time for understanding rather than trying to cover everything at once. We’ll also talk about how your symptoms fit together, whether a diagnosis is appropriate and explore treatment options.

Not always. Sometimes a diagnosis can be made in an initial consultation, but often more than one appointment is needed to fully understand what’s going on. Psychiatric diagnosis is based on patterns over time, not just a single conversation, and it’s important to get this right. If a diagnosis is considered, it will be discussed with you openly and carefully, in order to guide understanding and treatment.

Psychiatric treatment is tailored to the individual and may involve one or more approaches over time. This can include regular follow-up appointments, talking through patterns and stressors, addressing lifestyle factors, support with coping and functioning, providing different kinds of therapy, collaboration with therapists or other healthcare providers, and, where appropriate, medication. The aim is not simply to reduce symptoms, but to support recovery, stability, and quality of life in a way that fits your needs and circumstances.

Psychiatric treatment sits at the intersection of medical, psychological, and contextual care. Purely medical approaches focus mainly on physical causes and medication. Psychological treatments focus on therapy and coping patterns. Natural or complementary approaches often support wellbeing through lifestyle, nutritional, or holistic methods. Psychiatry brings these perspectives together when symptoms are complex or persistent, helping to understand how biology, emotional patterns, life circumstances, and treatment responses interact over time. When indicated, psychiatric care adds specialist assessment, careful use of medication, and coordination with other forms of support rather than replacing them.

Services

Psychiatric Assessments

Comprehensive diagnostic assessments informed by clinical interviews, evidence-based scales, special investigations, and neurocognitive testing.

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Approach

A multimodal, multidisciplinary approach grounded in nuanced diagnosis, biopsychosocial formulation, and collaborative care planning.

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Treatment Modalities

Psychotherapy-based consultations, psychoeducation, evidence-based lifestyle guidance, and medication management where indicated.

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Conditions

Most psychiatric conditions, with a focus on mood and anxiety disorders, substance use, and ADHD.

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Appointment Information

The practice is contracted to selected medical aids. Appointments and hospital admissions are booked by contacting the practice directly.

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Resources

A curated directory of local and international mental health services and organisations.

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Find out more

Psychiatric care is not about labels or quick fixes.

It is about understanding your story, your nervous system, and what healing might realistically look like for you – with care that is thoughtful, evidence-based, and respectful of your dignity.

Read about my approach