Lack of child psychiatrists felt locally
Mike Quinn, CEO at Chestnut Ridge Counseling Services Inc. located in the Fayette County Health Center in Uniontown explains the importance of mental health services in the area.
Psychiatrist Dr. Muruga Logan Anthan shows where he meets with children and adolescents inside his office at Chestnut Ridge Counseling Services Inc. located in the Fayette Health Center in Uniontown.
Dr. Muruga Logan Anthan, a psychiatrist at Chestnut Ridge Counseling Services, working primarily with children, discusses his point of view regarding the need for more psychiatric doctors for the youth.
Mike Quinn, CEO of Chestnut Ridge Counseling Services presents a map illustrating the lacking number of psychiatrists’ specifically for children and adolescents.
When looking at a workforce data map from the American Academy of Child Adolescent Psychiatrists, one might see red.
The national map from 2015 data depicts nearly the entire U.S. in red, which is indicative of a severe shortage of practicing child psychiatrists.
A closer look at the area shows a mix of gray and red — red still indicating a severe shortage, gray indicating that there are none at all. Fayette and Greene counties are among those in gray, while Washington and Westmoreland counties fall in the red.
“There is truly a deficit in child psychiatrists. We’re lucky enough to have three here, but there’s many counties that don’t have any,” said Mike Quinn, CEO of Chestnut Ridge Counseling Services Inc.
At their New Salem Road location, Quinn said there are nine psychiatrists on staff, with only three of them specializing in adolescents, one of whom is Muruga Loganathan, M.D., who has practiced with them for more than two years now.
Another staffed child psychiatrist works with roughly 65 to 70 children a day at the New Directions partial hospitalization/private academic school.
In Loganathan’s office, a sign reads: “It’s easier to build strong children than it is to repair a broken man.”
“There is so much importance placed on going to school and becoming successful, and preparing children for the future,” he said. “But when they come back home, before they sleep, what do they do? How do they react? How do they play with others, make relationships, build friendships, etc. If they’re struggling, where do they go? How do they cope? That’s where we come in, whether it’s with therapy or medication, or a combination.”
Between Loganathan and another Child and Adolescent psychiatrist, more than 1,500 children were treated in 2016 at CRCS.
Quinn said 15,506 services were provided for 1,528 children, totaling 14,508 service hours. The children ranged in age from 3 to 18, with the largest percentage of treated adolescents being between 15 and 16 years of age. More than half of the children were between ages 13 and 18, Quinn said.
“We do everything we can to schedule children to be seen as soon as possible, but it can take a few weeks for an appointment unless the family can take advantage of a cancellation and come in on short notice,” Quinn said.
“We do the best we can,” he said.
Loganathan said mental illness is best treatable when understood from its origins.
Over a lifespan, symptoms can start as early as separation anxiety in infants and toddlers.
Throughout childhood years, anxiety can grow into depression, and worsen as a child becomes a teenager with bipolar or schizophrenia diagnoses. Loganathan referred to it as a “slippery slope.”
“Everyone tries to chase happiness, but how do you react or cope when other emotions come through? That’s what we’re not teaching the children at a young age,” Loganathan said. “But it we can give appropriate support to them, when they become teenagers and adults, they’ll use these coping skills.”
Substance abuse and self-medication are common coping skills among those who don’t have other means to do so.
“There’s no education. And if there is, there’s a stigma. And then there’s no money,” Loganathan said. “I need two bucks for alcohol, and two hundred to see a psychiatrist.”
Hope
“If there’s any good news here, it’s that nationally, I think there’s a real emphasis and recognition that mental health illnesses are a major, major problem,” Quinn said. “Unfortunately, it took some very significant tragedies for that to come to light. Just about everything you hear afterwards, politically, is about gun control and mental illness.”
“It’s a very dynamic time in healthcare field of psychiatry and addiction, for sometimes the wrong reasons, but for the better. There’s now some attention being paid to the fact that this is a hidden epidemic,” Quinn added.
Quinn said studies show that those with mental illnesses are likely to die 25 years sooner than the average life expectancy.
“If people with psoriasis died 25 years earlier, there would be a public outcry. There would be funding, and the CCD would be all over the place,” Quinn said. “Mental illness — it’s a silent killer.”
Legislation was recently approved for mental illness funding across the nation. Quinn said mental illness accounts for more medical costs than any other illness in the U.S.
“As a practicing psychologist, I have seen firsthand how difficult it is for families to navigate our broken mental health system. Outdated laws prevent the families and caregivers from being a part of the treatment team — too often this has fatal consequences. We need treatment before tragedy and care before crisis,” said Congressman Tim Murphy, who has spent much of his time in office advocating for mental health options, particularly those for adolescents.
“With this new law, we are finally breaking down the wall between physical health and mental health. Now federal agencies will be moving from vague feel-good programs to ones that emphasize evidence-based care for those at the highest risk,” he said.
Recently, President Obama signed the final version of the bill with his 21st Century Cures Act efforts. Funding will now be provided for mental health and substance use education positions, outpatient programs and the workforce in general.
Quinn also noted the system’s “underfunded and understaffed” state of affairs.
“There’s really going to be a workforce shortage starting at the top with psychiatrists, but working its way down with nurses, nurse practitioners, social workers, communal health care system professionals, etc.,” Quinn said. “Psychiatrists are one of the lower-paid medical professionals as opposed to other specializations.”
Quinn added that only 4 percent of medical students enter the psychiatry field.
“There’s a stigma in the medical community,” Loganathan said, referring to the psychiatry field. “It’s a tough choice. You hear sad stories all day. You have to be cut out for it.”
“It’s going to be a struggle,” he said. “But we’re also ripe with opportunities to integrate with primary care and hopefully get some more legislation.”
“They’re not going to get better on their own. It gets harder and harder in the long run,” said Murphy. “That’s why early access is crucial.”
In order to offer timely treatment and guidance to adolescents and their parents, Murphy said the wave of the future is to have staffed psychiatrists in primary care practices available in person or more likely via Skype or another video call service.
“If there’s a consult with them in a doctor’s office, there’s a 90 percent chance they’ll follow up. But there’s only a 45 percent chance they’ll do so if you just give them a card,” Murphy said.
“Telemental health is extremely valuable,” Murphy said.