The Workforce Shortage of Child and Adolescent Psychiatrists: Is It Time for a Different Approach?

Psychiatric disorders affect a large number of children around the world. Recent data have reported that approximately 10% to 13% of children have a serious emotional disturbance with significant functional impairment, suggesting that at least 1 in 10 children require mental health services.^1,2 Approximately half the adults with mental illness received their diagnosis before 15 years of age³ and close to three fourths of mental health disorders start by the mid-20s.⁴ Mental illnesses are associated with a large disease burden because these conditions lead to increases in morbidity, mortality, and financial costs. For example, in high-income countries such as the United States, 3 of the leading illnesses associated with pediatric disease burden are psychiatric (depression, bipolar disorder, and schizophrenia) and psychiatric illness in children and adolescents is a key risk factor for completed suicide.⁵ In the United States, suicide is the second leading cause of death in people 15 to 24 years of age,⁶ with rural areas having particularly high suicide rates.⁷ What is even more disconcerting is the fact that most youngsters who might benefit from psychiatric or behavioral health treatment do not receive it. For example, only 45% of adolescents with mental illness received psychiatric services in 2013. This number is even smaller for children and adolescents with internalizing disorders and for minorities.⁸