Mental Health Issues

Media accounts have highlighted the inadequate number of child psychiatrists available to meet the mental health needs of our communities. The number of available child psychiatrists is significant given both the greater willingness of families to acknowledge mental health needs, as well as a growing number who need and seek treatment. The greater willingness to acknowledge mental health needs is a positive social trend fueled by education and information. Increased mental health needs are most likely related, at least in part, to family dissolution, dysfunction, and substance abuse.

According to the National Institute of Mental Health (NIMH), mental disorders are common in the United States and internationally. An estimated 22 percent of Americans ages 18 and older—about 1 in 5 adults—suffer from a diagnosable mental disorder in a given year. A more recent study by NIMH has reported that approximately half of all Americans at some point will develop some form of emotional disturbance. Those under 18 are also vulnerable to emotional disorders. Adults who have an emotional disorder undoubtedly experienced childhood and/or adolescent precursor conditions, if not full blown emotional conditions.

Considering the prevalence of emotional disorders and the reported scarcity of adolescent psychiatrists, it is worthwhile considering our national preparedness to provide mental health care. Psychiatrists are a component of our mental health system, which also includes psychologists, school psychologists, and social workers. Each type of mental health professional may provide different forms of treatment, for individuals manifesting conditions in differing circumstances. The point is that psychiatrists frequently provide medication for the treatment of emotional conditions, which is an often helpful component of care, while there are other professionals, also in short supply, who provide other forms of effective intervention. Psychologists frequently provide treatment before and after conditions worsen.

Psychologists provide needed diagnostic and treatment services in schools, hospitals, clinics and private settings. There is a shortage of psychologists in the various settings where treatment is provided. Child psychologists working in schools, clinics, hospitals and private settings provide early diagnostic and preventive treatment interventions. Where those services are insufficiently provided children having early developing conditions are neither recognized nor treated. Lack of diagnosis and early intervention/treatment may lead to the disorder worsening, with all the associated side effects of the condition taking their toll on family, school and interpersonal functioning as well as upon physical health.

Some states have addressed the shortage of psychiatrists by providing statutory authority to properly trained licensed psychologists to prescribe medications for emotional conditions. In addition, some states have required hospitals to provide psychologists with admitting and treatment privileges to address under-served mental health needs. These much needed steps are already providing assistance and as such New York should pass similar legislation to better provide for the state’s mental health needs.

Psychologists have, on average, six years of graduate training, including an internship following graduation from a four year college majoring in psychology, leading to a doctoral degree before taking a comprehensive state licensing examination. Highly trained psychologists have approximately ten years of education before licensure. Medication is only one aspect of treatment. Therapy, early intervention and consultative services are crucial. The problem is that mental health is generally not prioritized. While our acceptance of mental health needs has improved, we still have far to go to ensure all health insurance plans provide equal coverage for physical and mental health treatments. “Parity” laws ensure that health plans must provide an equal level of outpatient and inpatient care for physical and emotional disorders. Substance abuse is an emotional disorder, and is best treated early.

Our recognition of the importance of mental health interventions is growing. Support for “parity;” psychologist prescription and hospital privileges; training more psychiatrists and psychologists; and providing more school psychologists to provide early intervention, would lead to better national mental health statistics.

Raymond Havlicek

Lake Placid, NY