Pediatricians frequently have difficulty arranging mental health services for patients. This is a consequence of an extreme shortage of Child and Adolescent Psychiatrists. According to the American Academy of Child and Adolescent Psychiatry (AACAP) website, the current need for Child and Adolescent Psychiatrists (CAPs) is 30,000 providers, but only 8300 are practicing, and this pool is shrinking. Because of this shortage of child psychiatrists, 75% of all mental health services are provided by pediatricians.
I recently co-authored an article on improving access to mental health services, that will be published in the August 2018 issue of Contemporary Pediatrics. There are several striking statistics that emphasize the need for improving mental health access.
- 20% of all children in the US have a mental health problem- but only 20% of them receive treatment
- 13% of children 8-15 years of age have a mental illness that impair daily living- in the 13-18 age group the percentage rises to 21%
- 50% of lifelong mental illness begins by 14 years of age- 75% by age 24
- The average delay between symptom onset and intervention is between 8 and 10 years
So how can pediatricians and family physicians facilitate mental health access for our patients, young and old?
One way of improving access to mental health services is by improving our skill set, by taking courses or being mentored by a dedicated Child and Adolescent Psychiatrist – so we become more proficient in diagnosing and managing patients on our own. Another approach is to embed a psychologist or psychiatrist in your practice.
The quickest and easiest way to facilitate access to mental health services is to consider providing telepsychiatry access in your office! The video describes how this can be accomplished and discusses the E-Psychiatry web site and service. As discussed in the video, E-Psychiatry provides services in all 50 states. Many insurances will pay for telepsychiatry if you access in your office. Self pay patients should expect to pay about $175 per hour for Telepsychiatry visits with a psychiatrist, less for visits with a nurse practitioner.