Articles in our journal have noted worrisome trends in the growing prevalence of mental health disorders in children and teens. To address these trends, a strong workforce of health care professionals equipped to help families manage mental health concerns is critical. What is the workforce of child psychiatrists? McBain et al (10.1542/peds.2019-1576) in a study being released this week in our journal evaluated a ten-year trend in the number and distribution of child psychiatrists in the US and by state and county between 2007-2016. The good news is that the authors found that the number of child psychiatrists increased by 21%, from 8.01 to 9.75 per 100,000 children. Unfortunately, 70% of counties in the US do not have a child psychiatrist. Sadly, the counties without a psychiatrist include many with low family incomes. The variation across states in the distribution of child psychiatrists varied by as much as 8-fold.
So what are the takeaways from this study? We asked Dr. David Axelson, a child psychiatrist from Nationwide Children’s Hospital, to share his thoughts with us in an accompanying commentary (10.1542/peds.2019-2646). He notes that despite the overall increase in numbers, the prevalence of mental health issues in children and teens has risen at a far greater rate. When it comes to supply meeting demand, he cites data from the American Academy of Child and Adolescent Psychiatry noting a need for 47 child psychiatrists per 100,000 children, four times what McBain et al. found. Dr. Axelson does not believe the answer to helping children and teens with mental health issues lies in simply growing the child psychiatry workforce in numbers. He shares with us a number of great suggestions ranging from retooling how a child psychiatrist is trained to be more of an interprofessional team-leader than an individual specialist as well as the importance of better integration of mental and behavioral health providers in general and specialty practice settings. There is a lot of useful data and discussion in both the study and commentary, so read both and think what can be done in your local setting to better equip your practice to deal with mental health needs, especially if child psychiatry cavalry is not just coming over the hill in numbers to match the demand any time soon.
