Shortage of child psychiatrists decried

NEW YORK — In state after state, bleak statistics and grim anecdotes lead to the same diagnosis: America suffers from a serious, long-term shortage of child psychiatrists that is taking a toll on young people, their parents and their doctors.

Wyoming is down to two child psychiatrists; another left last year. In Augusta, Ga., Dr. Sarah Sexton tells would-be new patients she might be able to see them in July. Elsewhere, doctors take no new patients at all.

"There is no state where it is not a problem — none," said Dr. Gregory Fritz, director of child psychiatry at Brown Medical School in Providence, R.I. "We see it in the emergency ward every night, where problems have gotten out of hand over time due to lack of intervention, and progress to a point where a kid is suicidal or dangerous."

The shortage has been noticed within the profession for years, but psychiatrists say the consequences are worsening as the stigma of mental-health problems recedes and more families seek help for their children, including prescriptions for psychiatric drugs.

Demand for such drugs is intense, and the shortage of psychiatrists "forces kids to see other practitioners for medication management who might not have the training or experience to appropriately treat them," the National Conference of State Legislatures warned in a report last month.

The shortage is attributed to two main factors: the extra two years of training required for child psychiatrists, on top of four years of medical school and three years of general psychiatry; and a reimbursement rate that doesn't reflect the extra time required for a psychiatrist to interview parents, teachers and others familiar with a child's behavior.

"You always have to deal with a parent or caretaker — it doubles the interview time," Fritz said. "But the reimbursement rate is the same as if you're evaluating an adult."

The main organization representing the profession is the American Academy of Child and Adolescent Psychiatrists (AACAP), which gauges the number of practitioners in the field at about 7,000. The U.S. Bureau of Health Professions projects there will be about 8,300 child psychiatrists in 2020, only two-thirds of the estimated 12,600 needed.

The shortage already is staggering. The Center for Mental Health Services estimates that at least 5 percent of America's children and adolescents have acute mental health disorders.