An article in a recent Mayo Clinic e-newsletter cited Child
Psychiatrists as being in extremely short supply in the US, and
stated that there is little evidence that the shortage will be
remedied in the long term either. The May Clinic article
mentioned, as one example of the problem, that Wyoming has only 2
child psychiatrists. But the shortage is, in fact, a problem in
all fifty states and getting worse. The impact of this shortage
has become even more noticeable in recent decades with less
stigma attached to seeking help for psychiatric illnesses, as
more families seek treatment for children, and as more children
become suicidal or dangerous due to lack of psychiatric
intervention. With few Child Psychiatrists even taking new
patients, long wait times for initial appointments, and the
general lack of available practitioners in many areas of the US,
many parents have few options other than to bring their children
to see doctors without training and experience in treating
psychiatric disorders or in the proper use of psychiatric
drugs.
Several factors likely discourage medical graduates who might
otherwise consider this medical specialty from pursuing it. One
drawback is the additional two years of training beyond the
initial 3 years of Psychiatric residency training that are
required to certify as a Child Psychiatrist. The fact that
insurance and other reimbursement policies do not adequately
reflect the time required for the psychiatrist to obtain a useful
history, when the patient, parents, siblings, and even teachers
might need to be interviewed to accomplish this also lessens
interest in the field. Even assuming a relatively modest
incidence of serious mental illness for this age group, this
still calculates to a staggering number of patients for each
practitioner. The House of Representatives recently passed
legislation that provides loan forgiveness to college students
studying to work in this area, but given the current and
predicted shortfall in producing physicians trained to offer
mental care to children, this is hardly going to solve the
problem.
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