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Telepsychiatry and Collaborative Care: Solutions to the Chronic Shortage of Child Psychiatrists

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We know that chronic shortages of qualified mental health professionals increase the costs for all concerned, from providers to patients.  This is especially true of the chronic shortage of child psychiatrists.   

To combat the shortage, some are turning to technology and new models of care. 

The bulk of mental health services for people with depression are provided in primary care settings. Primary care providers prescribe 79 percent of antidepressant medications and see 60 percent of people being treated for depression in the United States, and they do that with little support from specialist services. The collaborative care model is a specific type of integrated care developed at the University of Washington that treats common mental health conditions such as depression and anxiety that require systematic follow-up due to their persistent nature.

Essentially, the primary care doctor functions as the quarterback for services while the psychiatrist acts as a consultant and care is largely driven by a licensed mental health professional.  Extending resources in a resource deplete field is essential. 

The National Alliance of mental illness estimates that four million children and adolescents suffer, not just from mental illness, but from serious mental disorders that cause “significant functional impairment at home, at school, and with peers.  Of children ages 9 to 17, 21% have a diagnosable mental or addictive disorder that causes at least minimal impairment.  In any given year, only 20 percent of children with mental disorders are identified and receive mental health services.”

The consequences of leaving mental illness – half of all lifetime causes of which begin by age 14 – are serious.  Among these are suicides, the third leading cause of death for young people in the United States. The overwhelming majority of children who commit suicide suffer from mental illness. Less serious, but no less problematic are those issues that are not lethal, but social and emotionally crippling, leaving victims unable to adjust through childhood and increasingly marginalized as adults.

According to the CDC, Suicide rates among those aged 10-19 years rose 56 percent between 2007 and 2016, with greater increases for females than males. There has been an increase in nonfatal, self harm visits to the emergency departments throughout the United States. The CDC reports that this is a precursor to suicidal behavior.

According to the AACAP, there are approximately 8300 practicing child and adolescent psychiatrists in the United States – and over 15 Million youths in need of one. It’s estimated we need about 12600 child and adolescent psychiatrists for the demand.   

Since telemental healthcare can reach anywhere an internet connection can go, and because mental health professionals who are so equipped can serve multiple locations more quickly, costs are reduced and more patients, overall, can be seen.  This makes telepsychiatry a major step in combating the shortage of child  psychiatrists, nationally.  By enabling psychiatrists to eliminate physical and financial barriers to access, telepsychiatry is poised to become a very real, and increasingly prevalent, means of addressing mental health needs.

Together telepsychiatry and collaborative care can impact overall care and move the needle on addressing the shortage of providers.

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