Schizophrenia Daily News Blog

Child Psychiatrist Shortage in US

The Los Angeles Times had a good article this past week on the shortage of child psychiatrists (especially in rural areas) in the US.

The story stated:

About 15 million U.S. children ages 9 to 17 are thought to have a serious mental or addictive disorder -- such as depression, anxiety, attention deficit hyperactivity disorder (ADHD), eating disorders, early onset schizophrenia or bipolar disorder. Psychiatry has long focused on adults, but knowledge about children's mental health has grown over the last two decades. New studies have helped clarify what is normal and abnormal behavior in children, while genetics research has revealed strong family patterns for mental illnesses, many of which can first appear in childhood or adolescence.

Such knowledge has led to diagnosis at earlier ages than ever before, says Dr. Greg Fritz, medical director of Bradley Hospital in East Providence, R.I., and a spokesman on the issue for the American Academy of Child and Adolescent Psychiatry. Parents today are also less bothered by the stigma of mental illness, he adds, and are more likely to seek treatment -- especially medication -- that can help their children. From 1987 through 1996, psychotropic drug use among children and teens nearly tripled to more than 2 million children, according to a study published in 2003 in the Journal of the American Academy of Child and Adolescent Psychiatry.

Similarly, visits by children, ages 12 to 17, for mental health treatment or counseling increased by almost 900,000 visits from 2002 through 2004, a federal government survey found.

But only about 7,500 child psychiatrists are currently practicing in the United States -- and only 300 new child and adolescent psychiatrists complete training each year. The profession -- the only board-certified medical specialty that trains physicians to treat mental disorders in children and teens -- is experiencing one of the most severe labor shortages among all medical specialties.

Those doctors who are available are often concentrated in urban areas, leaving some rural counties without a single child psychiatrist.

"Every child psychiatrist in the country has a waiting list," says Fritz, an expert on the workforce shortage. "I've never talked to one who didn't. Many will not even put people on a waiting list because it's too long and ridiculous."

The paper suggests that people are developing programs to deal with the shortage.

Child psychiatrists at UC Davis, for example, have turned to telemedicine, relying on high-speed video hookups to communicate with primary care doctors in underserved pockets of California, such as rural Northern California and the Central Valley. Together, they devise treatment plans for children with serious mental illnesses who might otherwise lack specialist care.

And in Kern County -- which until recently had only two child psychiatrists for a population of 730,000 people -- county health officials have launched the first new psychiatry residency program in California in 33 years.

The UCLA-Kern Residency Program now has 10 young doctors in training, several of whom will probably specialize in child psychiatry, says Dr. Tai P. Yoo, director of the program and joint chairman of psychiatry for the Kern County Mental Health department....

The 2004 passage of Prop. 63, the Mental Health Services Act, should also help ease the workforce shortage in California somewhat, experts say, by providing money for training and educating mental health professionals, including psychiatrists.

Source LA Times, February 27, 2006. Young and alone;
With only 7,500 child psychiatrists in the U.S., millions who need treatment are left desperate for care.