Lisa Durette MD, FAPA Program Director Medical Director, Healthy Minds
What is a CAP? National Shortage Local Shortage Our Partners Our Program Agenda Research and Future Training
What is a CAP The CAP is a physician who specializes in the diagnosis and the treatment of disorders of thinking, feeling and/or behavior affecting children, adolescents, and their families. aacap.org The Pathway: college (4 year degree), medical school (MD or DO, 4 years), general psychiatry residency training (3-4 years), THEN CAP fellowship (2 years) = total after high school MINIMUM
History 1899, Mannheimer uses the term child psychiatry in Les Troubles Mentaux de l Enfance 1909, Jane Addams et al created Juvenile Psychopathic Institute (later Institute for Juvenile Research world s first child psych clinic) AND William Healy, MD neurologist studied IQ, behavior and biology of the brain 1930, Leo Kanner, MD founded the first academic child psychiatry department (Johns Hopkins) 1933, Moritz Tramer, MD described the parameters of CAP in terms of diagnosis, treatment and prognosis within the discipline of medicine 1934, Tramer founded the first Journal of Child Psychiatry: Zeitshrift fur Kinderpsychiatrie 1944, first clinical description of autism = Kanner s syndrome ABPN since 1959 (I m 5983)
Shortage Of Child And Adolescent Psychiatrists Reaches... www.medicalnewstoda.y.comireleases/144958.php Iv Medical News Today ****' Rating: 4..5-2 votes Apr 5, 2008 - The shortage of child and adolescent psychiatrists in the United Slates has reached the crisis level with 7418 practicing in a country with 73675 Child and Adolescent Psychiatry: The Next 10 Years... wyeimpsychiatrictimes.comi.jciiiid-and-adoescent-psy._ Psychiatric Times - Child and adolescent psychiatry is a unique subspecialty with some very formidable... This shortage embraces all children's mental health professions and _.. In Iowa, shortage of child psychiatrists reflects national... thegazette.corni..din-iowa-shortage-of-child-psychiatrists-refl... '''r The Gazette Jan 4, 2014 - About one in five children in the United Slates today has a mental health disorder, according to the American Academy of Child and Adolescent Shortage of Psychiatrists plaguing state, region, experts say... the-times-tribune_coml.ishortage-of-psychiatrists-pla... The Times-Tribune Jul 5, 2013 - None has inpatient psychiatric beds for children and adolescents. _._ Association predicts a shortage of about 22,000 child psychiatrists and Shortage of child psychiatrists has families scrambling for help livww nhregister..comf.,../shortage-of-child-ps... New Haven Register lir by Ed Manna rd - in 175 Google+ circles. Jan 1g, 2013 - A national shortage of psychiatrists who treat children, and difficulty in... child and adolescent psychiatrist on staff, according to its website_
U.S. is 20,000 Short on Child and Adolescent Psychiatrists By Guest Writer. May 6, 2014 Recommend by Dr. Paramjit Joshi tumblr a I WT.t 4 I ia PRINTER FRIENDLY According to the latest numbers at least 1 in 5 American youth live with a serious mental disorder a dramatic increase from ten years ago. Of that number, only about 20 percent receive evaluation and treatment by a medical professional, with only a fraction ever having the opportunity to meet with a specialist. Despite three decades of hi-partisan supported policy initiatives, Congress has never funded any provision to address the critical shortage of child and adolescent psychiatrists (CAPs). We can no longer sit back and watch this vulnerable population suffer in silence. Congress must act now to renew and fund H.R. 1827, 'The Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013," a critical Public Health Service Act provision. Estimates place the growing necessity for CAPs at over 30,000. However, many graduating physicians choose other specialties because of the staggering debt upon graduation. As a result, there are only 8,300 practicing CAPs available to meet the needs of more than 75 million children across the nation, a number exacerbated by the rising median age at 53 years. Current average wait times of 7.5 weeks for any psychiatric evaluation or treatment clearly illustrate the urgent need for workforce expansion. Evaluations suggest these delayed mental health services cost the nation $247 billion annually through lost productivity, crime and the utilization of other health care venues such as emergency rooms. Without action, extensive delays will also prolong assessments, diagnoses, and treatments that can carry serious and even life threatening consequences. H.R. 1827 offers a simple solution: provide loan relief programs for CAPs working full-time with medically underserved populations. H.R. 1827 re-authorizes the "Investment in Tomorrow's Pediatric Health Care Workforce" program, sponsored by Representative Joe Courtney {D- Conn.), which recommends appropriations of $50 million annually for pediatric subspecialty workforce growth, with up to $20 million each year specifically designated to increase numbers of CAPs. As a mother and a medical doctor, I share the despair of every family who searches endlessly for answers only to learn that few resources exist to help them and their children. I urge all lawmakers. Demonstrate your commitment to America's youth by ensuring they have access to quality mental health services. Support and fund H.R. 1827 today. Dr. Josh/ is President of the American Academy of Child and Adolescent Psychiatry, as well as Division Chair of Behavioral Medicine, and Director of the Psychiatry and Psychology programs at Children's National Health System. She has more than 25 years of experience as a child and adolescent psychiatrist
Federally-Designated Health Professional Shortage Areas (HP A) for Mental Health' (Legend: Number of Mental Health Professional Shortage Area Designations per State) Mental Health HFSAs FIPSA Legend 1-25 27-48 49-76 79-3.35
2.001 million (2012) Clark County, Population 3h1 Nevada 2.759 million 2h1 * Clark County 2.001 million 'F1 Las Vegas 596,424 --429,908 (2012) 1970 1980 195. Washoe County, Population 500,000 400,000 300,000 O Washoe County 429,908 Reno 231,027 200..000 100,000 1970 1980 1990 2000 2010
Nevada Supply Data derived May 2014 from the American Board of Psychiatry and Neurology verifycert site (all currently Board Certified in a particular specialty) Nevada: 34 BC CAPs 10:34 - active practice in Clark County 6:34 moved away or not practicing in Clark County 18:34 practicing in northern Nevada
The Partnership
The Program April 2014 received accreditation from the ACGME 2 fellows per year Faculty 50/50 MD and PhD Didactics partner with UNSOM Reno and UNLV FY-1: 6 months DJJS, 6 months DWTC, longitudinal clinic for 2 years at HM FY-2: 6 months UMC, 6 months DFS, longitudinal clinic at HM
Other Training Sites Clark County School District school clinics Mental Health care partnership with Healthy Minds Craniofacial Clinic FAS Clinic Administrative Psychiatry Forensic Psychiatry Child Neurology / Autism Clinic Research (requirement for graduation)
Why Healthy Minds? Focus of treatment on evidence based care provided in a collaborative fashion Compliance with ACA: use of EMR, ongoing quality of care measures, ongoing research Relationship with DFS, the Clark County Pilot Project National relationships: presentation at AACAP 2013, FFTA 2014 Dr Durette is appointed to AACAP adoption and foster care committee, liaison with NCVC Multidisciplinary training site: MD, MFT, LCSW, and pending PhD site
Questions? Ldurette@medicine.nevada.edu http://medicine.nevada.edu/las-vegas/ psychiatry www.healthymindslv.com