University of Utah celebrates 50 years of child psychiatry

SALT LAKE CITY — In Utah, those with mental illness used to be referred to as "the feeble-minded" or "mentally defective."

Today, the University of Utah's School of Medicine fosters one of the most progressive psychiatric programs in the country.

This year, the U. will celebrate 50 years since the inception of the Department of Psychiatry's child and adolescent residency training program. And when those involved with the program look to the past and celebrate how far they've come, they also look ahead to new challenges.

The U. has one of only 14 schools in the country offering a triple-board program, integrating pediatric medicine, child psychiatry and adult psychiatry. It is one of 108 psychiatric programs in the country, but they all are bound to train only a certain number of students due to a federal cap and decreased funding over the years. The U.'s program has 14 students at the moment, which is all it can train at one time, according to Dr. Douglas Gray, residency training director for child psychiatry at the U.

"We need to de-stigmatize mental illness for the general public, help them to know that it's as much an illness as asthma and high blood pressure," he said.

In a country with more than 73 million children and adolescents, there are about 7,400 practicing child and adolescent psychiatrists. That number is expected to remain stagnant unless medical schools across the country are expanded enough to train more physicians.

As the incidence of mental illness rises among children and adolescents, as well as the general population, the need for qualified professionals becomes more important.

"We've come a long way in the past 50 years, both in diagnosis and treatment for patients and with training for physicians," Gray said. "Children and adolescents suffering with psychiatric conditions remain society's most vulnerable citizens."

Utah's first child psychiatrist, Merritt Egan, arrived in the state in 1949, nearly a hundred years after psychiatry became a formal medical specialty, and the U.'s training program was established 10 years later. Before then, children with psychiatric issues were sent to Utah's "School for the Deaf and Dumb," the "Territorial Reform School" and the "Utah School for the Feeble-Minded."

According to a history of child psychiatry in Utah, written by Utah psychiatric pioneers Egan and Paul Whitehead, there were five major developments in the first decade of the 20th century that led to a more enlightened understanding of children's needs and established a firm foundation for child psychiatry. Those included the juvenile court system, psychoanalysis, psychological testing, the mental hygiene movement and, most importantly, compulsory education.