Limited access to mental health care has far-reaching implications for children and adolescents with psychiatric illnesses or family dysfunction. Left untreated, mental illness in young people can lead to problems at school, at home and with peers, as well as changes in appetite or sleep and social withdrawal or self-destructive behavior.
PRMS recognizes this problem and as part of its continued investment in the future of psychiatry, recently teamed up with the Group for Advancement of Psychiatry (GAP), a think tank of leading psychiatric minds, to endow its first named child psychiatry fellowship, the PRMS GAP Fellowship in Child Psychiatry.
GAP was founded in 1946. Over the years, its thoughtful analysis and recommendations have served to influence and advance modern psychiatric theory and practice. The organization is comprised of more than 300 members from across the United States and Canada. More than 30 working committees meet twice a year to focus on major issues and fields in psychiatry and publish content and research findings on pressing issues.
The work of GAP’s outstanding residents and fellows collaborating with leaders in the field also encourages discussion about the profession and promotes a public appreciation for the role of psychiatry within society. Because psychiatry is a multifaceted specialty encompassing the biopsychosocial paradigm, committees consider everything from psychopharmacology to addictions, the military, natural disasters and ethical and moral issues inherent in the field.
“We are proud to work with such a prestigious group as GAP to fund this fellowship,” said Stephen Sills, Executive Chairman and Chief Executive Officer for PRMS. “The research and collaboration of GAP members and fellows who are leaders in their fields are substantive. We hope that this fellowship in child psychiatry will help produce a growing body of knowledge and innovative perspectives to help psychiatrists continue supporting the mental health needs of our country’s children and adolescents.”
Mental disorders are common among children in the U.S. and nearly five million have some type of serious mental illness that significantly interferes with daily life. According to the National Institute of Health, more than 20% of children either currently, or at some point during their life, have had a seriously debilitating mental disorder.
Not surprisingly, many psychiatric issues affecting children and adolescents often stem from abuse and neglect, as well as situations where parents or primary caregivers are using alcohol and other drugs, whether the children are suffering from abuse or neglect or not, according to GAP President John G. Looney, MD, MBA, a child psychiatrist of national stature and Professor Emeritus of Psychiatry and Behavioral Sciences at Duke University Medical Center.
Looney, who developed the first alcohol and substance abuse program for young people in a U.S. academic division of child psychiatry, said more focus is being put on earlier identification of children with “poor” psychological development who may end up being on the Autism spectrum or have another disorder. “The more we can focus on those things, the more we can help those kids,” Looney said.
GAP’s Fellowships cover everything from administrative psychiatry to psychiatry in the workplace. The GAP Fellowship is a two-year experience during which the Fellow attends four semi-annual meetings and works with a GAP committee on its current project. Fellows contribute to the writing projects of their committees and develop a plenary presentation on a topic of their choice, presented to the general GAP membership at the Fellows’ final meeting.
Every two years, GAP asks training directors at all Departments of Psychiatry in the U.S. and Canada to submit letters and CVs of potential fellows. The application process is competitive. GAP offers about 15 fellowships per class and typically gets more than 50 applicants for each fellowship.
According to GAP Immediate Past President Steven S. Sharfstein MD, MPA, a practicing psychiatrist for more than 35 years and a GAP fellow in 1970, what makes GAP stand out is its ability to look at cutting-edge issues, the relationship of the profession to the rest of medicine and society by pulling together clinicians and academics to probe subject areas and produce independent studies and “a thoughtful product that’s the best thinking in the field on any particular issue,” said Sharfstein. Results can be anything from a book to a paper, a monograph, an op-ed piece, a professional article or even something for the general public.
Sharfstein, former president and CEO of the Sheppard Pratt Health System, Clinical Professor and Vice Chair of Psychiatry at the University of Maryland and a past president of the American Psychiatric Association, said the fellowship helped him develop relationships with mentors and peers that shaped his career. Many leaders in American psychiatry in their subspecialty or in general have had a GAP fellowship and the majority of GAP fellows go on to have esteemed careers in psychiatry. Membership in GAP is invitation-only, but many members have been fellows and leaders in the American Psychiatric Association and the American College of Psychiatrists.
“It’s part of the developmental process and something they remember as being critical in their career,” said Sharfstein, who’s best known for his research and writing on the economics of practice and public mental health policy.
Looney said one reason the PRMS-endowed fellowship is so important is because child psychiatry remains one of the most underrepresented subspecialties in medicine. “Children are our future, that is self-evident,” said Looney. “But for children that we serve, the shortage of child psychiatrists gets pretty frightening.” One way to help deal with the shortage and increase access to quality mental health services is the use of telemedicine, or interactive, real-time videoconferencing, to deliver health care typically delivered in person. Telemedicine or telepsychiatry is not new but can be particularly useful when delivering psychiatric, mental health or behavioral health services to youth and their families over geographic distance and in certain settings, such as with children in rural areas whose parents may be addicted to drugs or in prison.
“Our committee on child psychiatry tries to look at things like that – how we can improve service delivery as well as improvements in diagnostics and accuracy,” added Looney, whose primary interest is the mental health of college students and helping them develop management skills to succeed in college.
Looney said he is excited about the PRMS-endowed fellowship: “PRMS is such a trusted partner with us in GAP and in the psychiatric field, and for many of us personally as our insurer. Our purposes and goals are so similar, and I just think this is a wonderful partnership.”
Sharfstein agreed: “I think it’s wonderful that PRMS is looking to the future of the field by engaging in this way with GAP. We’re only as good as our progeny, and what we pass on through our organizations and institutions is absolutely critical. And we’re very grateful for their help.”
In addition to support from PRMS, unrestricted grants from The Cotswold Foundation (Cotswold Looney Fellows), the Phillips Van-Buren Foundation (Dear Abby Fellow), Beacon Health Options (Beacon Health Options Fellow) and Ginsburg Fellowship also support individual GAP Fellowships. GAP encourages individuals, families, foundations and carefully selected corporate entities to provide support to help ensure the future of the fellowships.
“GAP fellowships are the lifeline of the organization, continuously bringing in new blood, fresh ideas and the energy of training,” said Frances Bell, GAP Executive Director. GAP is a 501(c)3 non-profit organization. Donations are tax deductible to the extent allowed by law. Anyone interested in supporting GAP should contact Bell at firstname.lastname@example.org, by calling (972) 754-2107 or visiting https://www.ourgap.org/donate.