Addressing the Mental Health Gap: How Pediatricians are Stepping Up Amid Child Psychiatrist Shortage
Dr. Marc Lashley trained as a pediatrician but received little preparedness for children’s mental health issues. In practice, he saw a significant need due to a shortage of child and adolescent psychiatrists. With training from a Long Island psychiatrist, he began prescribing medications for anxiety and depression. Over ten years, prescriptions for such issues rose from 2% to 20% of his practice.
Lashley’s experience is part of a larger trend. Many pediatricians are stepping in to treat mental health problems like anxiety, depression, and ADHD due to the shortage of specialists. Families struggle to find child psychiatrists, often facing long waiting lists or high costs for visits, as many do not accept insurance. Pediatricians like Lashley offer a trusted alternative.
Dr. Victor Fornari, a child psychiatry vice chair at Northwell Health, emphasizes that pediatricians can handle mild to moderate mental health issues. He helped create Project Teach, which has trained over 2,000 pediatricians in New York State in prescribing mental health medications. This program gains recognition as a solution to the psychiatrist shortage.
Critics, however, raise concerns about pediatricians’ training for mental health treatment. Dr. Meena Ramani argues that pediatricians should not treat mental disorders without proper expertise. Others worry pediatricians might make mistakes due to limited experience in psychotropic medications.
Despite these concerns, pediatricians play a critical role in addressing mental health issues among children. Dr. David Kaye from the University at Buffalo notes that families increasingly trust their primary care providers. Stigma and barriers to seeing psychiatrists further push families towards pediatricians for help.
How can pediatricians effectively recognize and address mental health concerns in their young patients?
News Directory 3 Exclusive Interview: Addressing the Mental Health Crisis Among Children
In this insightful interview, we speak with Dr. Marc Lashley, a pediatrician who has adapted his practice to include the treatment of children’s mental health issues amid a significant shortage of child psychiatrists. Through his experiences, we explore the evolving role of pediatricians in addressing mental health concerns in children and adolescents.
Interviewer: Thank you for joining us today, Dr. Lashley. To start, can you share a bit about your journey from pediatrician to treating mental health issues in children?
Dr. Marc Lashley: Thank you for having me. Originally, I trained as a pediatrician and felt reasonably equipped to handle physical health issues. However, when it came to children’s mental health, I realized there was a significant gap in my training. Over time, I began to see a higher demand for addressing issues like anxiety, depression, and ADHD in my young patients. With a shortage of child and adolescent psychiatrists in my area, I knew I had to step in.
Interviewer: How did you prepare yourself for this new challenge?
Dr. Lashley: I sought additional training under a psychiatrist from Long Island. This education allowed me to start prescribing medications to help manage mental health issues. I saw a dramatic increase in the number of patients with such concerns—over ten years, these prescriptions rose from 2% to 20% of my practice. This change underscored the growing need for mental health support in pediatric care.
Interviewer: That statistic is striking. Can you speak to the broader trend you’re observing among pediatricians taking on mental health care?
Dr. Lashley: Yes, it’s a growing trend. Many pediatricians are realizing that they can provide vital support for mild to moderate mental health issues. Families often struggle to find child psychiatrists, frequently confronted with long waiting times or exorbitant costs—many specialists do not accept insurance. Pediatricians are stepping up to fill this gap, offering a familiar and trusted alternative for families in need.
Interviewer: Dr. Victor Fornari from Northwell Health supports this trend as well. Can you elaborate on Project Teach and its impact?
Dr. Lashley: Absolutely. Project Teach is a fantastic initiative that aims to train pediatricians in New York State to effectively manage mental health issues. Dr. Fornari played a key role in its creation, and it has already trained over 2,000 pediatricians. Training programs like this empower us to identify and treat mental health conditions while providing families with accessible care options.
Interviewer: There are critics who argue that pediatricians may not be adequately equipped to handle more severe mental health issues. What are your thoughts on this?
Dr. Lashley: That’s a valid concern. Pediatricians are indeed trained to handle mild to moderate conditions, and we must recognize the limits of our expertise. Complex cases should still be referred to specialists. However, the training programs are designed to build a strong foundation for pediatricians, enabling us to recognize when a case is too serious and requires a different level of care. Collaboration with mental health specialists is crucial, and I strive to maintain open channels with my colleagues in psychiatry.
Interviewer: How do you foresee the future of this interdisciplinary approach in pediatric medicine?
Dr. Lashley: I believe it will only grow. As the mental health crisis among children continues to escalate, collaboration between pediatricians and mental health professionals will become increasingly vital. Together, we can create a more integrated system of care that ensures our children receive comprehensive support for both their physical and mental health.
Interviewer: Dr. Lashley, thank you for sharing your valuable insights with us today. Your perspective sheds light on an important shift in pediatric care.
Dr. Marc Lashley: Thank you for having me. I hope that by addressing these issues, we can better meet the needs of our children and families.
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The shortage of child psychiatrists remains severe. In New York, there are 1,247 child psychiatrists, while the state has 8,800 pediatricians. Nationwide, 11,422 child psychiatrists exist compared to 147,860 pediatricians. Residency training remains a barrier. Only a limited number of child psychiatrists complete their training each year, and many do not choose this specialty due to longer training periods and debt from medical school.
Mental health issues have risen among American children, partly due to the COVID-19 pandemic and increased screen time. Project Teach provides pediatricians with resources and a “warmline” to consult child psychiatrists. This program has expanded into other states and even overseas.
Pediatricians like Lashley have found success treating children with mental health challenges. Training programs equip them with the skills needed to manage cases, alleviating the burden on child psychiatrists. The rise in medication prescriptions for mental health issues among children reflects this growing responsibility pediatricians are taking on.
The results show fulfillment for both doctors and families. Pediatricians are now helping more families while ensuring that child psychiatrists can focus on more complex cases.