I am a counselor, and we do diagnose. We don't prescribe medications though. And even when your struggles are because of the environment and how you were brought up, medications might still be helpful. Your counselor might want you to have a boost from meds to make it easier for you to overcome depression, anxiety, etc.

Another possibility might be that the psychiatrist can help with additional documentation or referrals to get appropriate assistance. If you are ever not sure of why your therapist recommends or suggests anything, you can ask them and they should be willing to explain it to you.