Bright Spots on Children's Mental Health Horizon

Initiatives may increase the number of child psychiatrists and improve overall mental health care availability for patients.

After years of complaints from parents, access to child and adolescent mental health care may slowly improve thanks to initiatives by the University of Minnesota Medical School and Fairview Health Systems.

Efforts by faculty and students from the medical school's Department of Psychiatry to boost interest in psychiatry among medical students are working, according to Chuck Schulz, MD, a professor and head of the department.

Psychiatry has a lot to contend with, competing against fascinating and higher-paying specialties such as surgery and cardiology, Schulz said. So faculty member, David Cline, MD, started bringing medical students to psychiatric offices and clinics to see what psychiatrists do. "They really enjoyed it," Schulz said.

About five years ago, some medical students reorganized the school's psychiatry interest group and the department received foundation money to support the group's activities. Faculty member Jon Jensen, MD, worked to increase the number of child and adolescent psychiatry fellowship slots from three to five, leading to five child psychiatrists graduating every year.

That's up from one or two psychiatrists graduating a dozen years ago, Schulz said. Several current students are pursuing child and adolescent psychiatry.

"We find, as with many other specialties, the majority of people who go to the University of Minnesota Medical School end up practicing here," Schulz added. "I am hoping that the trend that has been going on for about five years now will lead to us graduating five new child psychiatrists a year going down the road. We need them."

This sort of "soft hand-off" from the primary care provider to a psychologist or psychiatrist within the primary care clinic should reduce patients' tendency to ignore referrals to mental health providers, while freeing psychiatrists to treat the sickest patients, according to Kathy Knight, vice president of Fairview Behavioral Health Services.

"Over the years of carving out mental health and making it all specialty services, we kind of carved the head off the body, if you will," Knight said.

The change began with the Fairview Hiawatha clinic, where the staff may intervene immediately in mental health situations to reduce stress among patients. Knight hopes this will particularly help adolescents who might consider suicide if treatment is delayed.