Congress Addresses Child Psychiatrist Shortage

APA and the American Academy of Child and Adolescent Psychiatry (AACAP) are backing a new bill in Congress designed to increase the number of trainees in designated subspecialties, which is expected to include child and adolescent psychiatry.

The proposed legislation, introduced in May by Rep. Pete Stark (D-Calif.), allows the Secretary of Health and Human Services to determine which specialties or subspecialties have professional shortages and fully fund their training programs.

Child and adolescent psychiatry training programs were among the casualties of the 1997 Balanced Budget Act, which halved Medicare graduate medical education funding for subspecialty residency programs.

APA President Richard Harding, M.D., told Psychiatric News, “Everyone from the Surgeon General to medical directors of adolescent treatment programs knows there is a severe shortage of child psychiatrists.”

The 1999 Surgeon General’s Report on Mental Health noted the dearth of child psychiatrists to care for an estimated 15 million children with diagnosable psychiatric disorders.

“We know that untreated mental illness in children has long-term negative consequences and increases health care costs later on,” Harding continued.

There are only about 6,300 child and adolescent psychiatrists practicing in the United States, according to a draft AACAP report. Meanwhile, the number of residents being trained in child and adolescent psychiatry has decreased in the past decade from 712 in 1990 to 669 last year. The number of child and adolescent training programs has decreased in the last decade from 120 to 115, according to the AACAP report.

The government relations staffs of APA and AACAP have been meeting with leaders of key congressional committees that will be voting on the bill, titled the Medicare Critical Need GME Protection Act of 2001. The bill (HR 1928) had 21 cosponsors at press time and was before the House Ways and Means Subcommittee on Health, which oversees Medicare issues. A companion bill is expected to be introduced in the Senate and referred to the Finance Committee, which oversees Medicare in the Senate.

“This bill is crucial to increasing the supply of child and adolescent psychiatrists in the United States. We need to do everything we can to support this valuable subspecialty,” said Harding.

The summary, status, and text of the bill can be accessed on the Web at thomas.loc.gov by searching on the bill number, HR 1928. APA’s Division of Government Relations posted an Action Alert on the bill on APA’s Web site at www.psych.org/pub_pol_adv/Action_alerts.cfm. ▪