Lisa Durette MD, FAPA Program Director Medical Director, Healthy Minds
Agenda What is a CAP? National Shortage Local Shortage Our Partners Our Program 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 - psychiatry is a unique subspecialty with some very formidable .... Child and adolescent 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 ... and adolescent psychiatrist on staff, according to its child website_
U.S. is 20,000 Short on Child and Adolescent Psychiatrists By Guest Writer. May 6, 2014 ia I WT .t tumblr a � I 4 PRINTER FRIENDLY Recommend by Dr. Paramjit Joshi According to the latest at least 1 in American a serious mental disorder—a dramatic numbers 5 youth live with increase from ten years ago. Of that number, only about percent receive evaluation and treatment by a 20 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 sit back and watch vulnerable population suffer in silence. Congress act now to no longer this must renew fund H.R. 'The Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of and 1827, 2013," a critical Public Health Service Act provision. place the growing necessity for CAPs at over 30,000. However, many graduating physicians choose Estimates other specialties because of the staggering debt upon graduation. As a result, there are only practicing 8,300 CAPs available to the needs of more than 75 million children across the nation, a number exacerbated by meet the median age years. rising at 53 average wait of weeks any psychiatric evaluation treatment clearly illustrate the urgent Current times 7.5 for or need expansion. Evaluations suggest these delayed mental health the nation $247 for workforce services cost billion annually lost and of health care such as through productivity, crime the utilization other venues emergency Without action, extensive delays will also prolong assessments, diagnoses, and treatments rooms. that can serious and even threatening consequences. carry life 1827 offers a simple solution: provide loan programs for CAPs working full-time with medically H.R. relief underserved populations. re-authorizes the "Investment in Tomorrow's Pediatric Workforce" program, sponsored H.R. 1827 Health Care by Representative Joe Courtney {D- Conn.), which recommends of $50 million annually appropriations for pediatric subspecialty workforce growth, with up $20 million each year specifically designated to increase to numbers CAPs. of As a and a medical doctor, share the despair every family who searches endlessly answers—only mother I of for to learn that few resources exist to help them and their children. I urge all lawmakers. Demonstrate your commitment to America's youth ensuring access to quality mental health services. Support and by they have 1827 today. fund H.R. 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 years of experience as a child and adolescent psychiatrist 25
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 Nevada 3h1 2.759 million * Clark County 2h1 2.001 million Las Vegas 'F1 596,424 ___--429,908 (2012) Washoe County, Population 1970 � 1980 � 195. O Washoe County 500,000 429,908 400,000 ^^ Reno 231,027 300,000 200..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
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