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Health & Wellness

Free State Program Helps Fill The Gap Caused By Too Few Child Psychiatrists In Texas

Young, female school psychologist having a serious conversation with a small boy.
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With too few child psychiatrists in Texas, some Texas children take mental health issues to primary care physicians or pediatricians.

State lawmakers funded the Child Psychiatry Access Network (CPAN) in 2019 to help fill the gap between a shortage of child psychiatrists and a growing rate of mental health challenges among children.

KERA’s Sam Baker talked about this with pediatric psychiatrist Dr. Mili Khandheria. She’s the medical director of CPAN, and an assistant professor with UT Southwestern Medical Center.

INTERVIEW HIGHLIGHTS:

Research has found children are experiencing more mental and behavioral health challenges at rates faster than at any time in recent history: A 24% increase for ages 5-11 since April of 2020, and 31% for ages 12-17.

What's Behind The Increase?

There's a multitude of factors:

  • An increase in social media use, which can lead to online bullying.
  • Adverse childhood events — traumatic events such as a family member's death, violence in the home, neglect and abuse — which can lead to long-term health issues, especially mental health problems.
  • COVID-19 has played an enormous role: The social isolation our children and adolescents are experiencing has led to worsening symptoms of depression and anxiety across the board.
  • Children these days have more demands placed on them in an academic setting, which leads to higher rates of mental health issues.
  • And 11% of the state's children are not covered by insurance. One in five children live below poverty level in Texas.

Why Are Children Facing These Challenges Often Taken To Pediatricians Or Primary Care Providers?

The biggest challenge we're facing in Texas is this shortage of child psychiatrists to provide care these children desperately need. They also have a relationship with their primary care provider, so they feel more comfortable going to see them.

But A Primary Care Provider Isn't Necessarily Trained In Mental Health Issues.

This is where the Child Psychiatry Access Network comes in. It's a free program funded by the state of Texas to help get children and adolescents access to mental health care. We offer providers free consultations with child psychiatrists and therapists on behavioral health concerns, diagnoses, prescribing medications and referrals like therapy, or even testing for autism and things like that.

This is about better enabling the pediatrician or primary care provider. There is such a shortage of child psychiatrists. Several counties in Texas have zero child psychiatrists. So we want to teach them how to provide that care.

This is a consultative model where they call and we provide consultations for them about these issues. Additionally, we have educational opportunities to learn more about these issues in a continuing medical education series we have every month.

Why Are There So Few Child Psychiatrists in Texas?

I think it requires additional training after adult psychiatry, residency two additional years and people often find it challenging to work with kids and families. So there's just not enough to go around. And a lot of the child psychiatrists are kind of aging out.

As a result, we actually have another program called this child psychiatry workforce expansion program to train more child psychiatrists. Starting in July of 2021, we’ll have seven spots to train child psychiatrists. Most of the programs in the state of Texas are increasing their number of spots. And they're increasing the number of institutions that have training programs.

RESOURCES:

Child Psychiatry Access Network (CPAN)

Research on Mental Health-Related Emergency Department Visits

Interview highlights were lightly edited for clarity.

Got a tip? Email Sam Baker at sbaker@kera.org. You can follow Sam on Twitter @srbkera.

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