Is It Time to Rethink Psychiatry Residency Training? Part I: Overview

Aggarwal, Rashi; Balon, Richard; Morreale, Mary K.; Guerrero, Anthony P. S.; Beresin, Eugene V.; Louie, Alan K.; Coverdale, John; Brenner, Adam M.

doi:10.1007/s40596-023-01741-5

Cited by 10 publications

(3 citation statements)

References 13 publications

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“…41 Other potential interventions include expanding training for counselors and social workers to better serve patients with serious mental illness and training of psychiatrists in consultation and collaborative roles. 42 This analysis has several limitations. First, this is an analysis of a US sample, that may not generalize to international settings.…”

Section: Discussionmentioning

confidence: 98%

The Distribution of US Adult Mental Health Patients Across Provider Groups

Gao,

Olfson

2024

Preprint

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Objective To describe the distribution of US adult mental health outpatients across provider groups. Methods We examined a nationally representative sample of US adults from the 2018–2021 Medical Expenditure Panel Surveys. We classified psychological distress using the Kessler-6, and by acute mental healthcare episode (inpatient or emergency department) in the survey year. We report outpatient mental health use rates, visit share by provider group (counselors, social workers, psychologists, psychiatrists, nurse practitioners/physician associates, primary care physicians, other physicians, and other) and by service sector including mental health, medical, both, or neither. Results Of adults with ≥ 1 outpatient mental health visit, 58.2% (95%CI 56.4–60.0%) received mental health visits in the mental health sector alone, 24.3% (95%CI 22.8–25.7%) were seen in the medical sector alone, and 15.2% (95%CI 14.1-16.25%) were seen in both. The largest differences in mental health care were seen for patients who had recent acute mental healthcare episodes who were more likely to receive care in both medical and mental health sectors, 35.5% (95%CI 29.1–41.9) versus 14.5% (95%CI 13.4–15.5%) among those who did not have acute mental healthcare episodes. Of the 8 provider groups, only psychiatrists were more likely to have seen patients with higher than lower levels of distress. Conclusion Adult mental health patients with episodes of acute mental healthcare were more likely than those without to have received mental health visits in both mental health and medical sectors. Among the provider groups, only psychiatrists saw a greater share of patients with higher than lower levels of psychological distress.

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Section: Discussionmentioning

confidence: 98%

The Distribution of US Adult Mental Health Patients Across Provider Groups

Gao,

Olfson

2024

Preprint

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“…One participant opined that psychiatry training needed to be updated to include being able to identify and help address unmet needs of consumers. Opinions on the need for a review of psychiatry training have started emerging ( 73 , 74 ). However, they do not necessarily focus on identifying and addressing unmet needs of consumers, which when met, lead to better overall outcomes ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

Shortcomings of services for persons with severe and persistent mental health challenges: a qualitative study of service users and family carers

Isaacs,

Lambert,

Lawn

et al. 2024

Front. Psychiatry

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IntroductionThe opinions of service users and carers are crucial to identifying ways to innovate and implement system change. This study aims to explore the views and experiences of service users and carerson the services they have used for their mental health challenges and their suggestions for service reform.MethodsTwenty participants (15 carers and 5 service users) were interviewed for the study.ResultsEight categories emerged from the data. They were: Several gaps in the system, Barriers to accessing services, Services are not fit for purpose, Services operate in isolation, System is not person focused, Service users and carers are treated poorly, Services are overloaded and under resourced and Recommendations for service reform. Respondents reported that a persistent lack of funding and resources for mental health services was a main cause of these shortcomings. Respondents also noted that innovations were needed to re-orient services to enable continuity of care, and training of mental health professionals was needed for a better understanding of the needs of service users and their carers.DiscussionAdditional research is needed with larger and more diverse samples to further explore these findings.

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“…Some minority and disadvantaged groups of young people (e.g., groups disadvantaged as a result of their ethnicity, sexuality, gender or economic circumstances) are at particularly high risk and suffer even more from inequity in access to service provision [3]. It is becoming very clear that the increased prevalence of CYP with mental health di culties is unlikely to be matched by a similar increase in trained child and adolescent psychiatrists to address current and future needs [4].…”

Section: Introductionmentioning

confidence: 99%

Rethinking how to deal with demand and supply in CAP: a European training perspective

Deschamps,

Dubicka,

Hansen

et al. 2024

Preprint

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Background Mental health care is suffering from a substantial gap between current service provision capacity and demand. For the generation of young doctors in psychiatry training programs today, this means they face substantial and potentially overwhelming challenges in their clinical practice. This situation calls for creative solutions in psychiatry training to prepare them best for these challenges. Methods Perspectives of European trainers in child and adolescent psychiatry (CAP) were collected and analysed following an iterative procedure in three rounds using thematic analysis of focus groups. Results The three iterative rounds resulted in five proposed strategies for meeting the challenges of current and future demand in CAP specifically addressing implications for CAP training. Examples were provided illustrating how these strategies could be put into daily training practices. Four strategies aimed mainly at increasing capacity: efficiency (making best use of the existing CAP workforce); consultation (task-sharing); innovation (practicing differently); and wellbeing of the CAP workforce. An additional strategy focusing on prevention and early intervention was identified to decrease demand upstream. Conclusion Rethinking CAP training practices through a European perspective on the balance between capacity and demand yielded strategies for aspects of training that are not yet universally applied. Implementation is partly dependent on the larger service provision system of care while training has leverage for future capacity and quality of care.

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Is It Time to Rethink Psychiatry Residency Training? Part I: Overview

Cited by 10 publications

References 13 publications

The Distribution of US Adult Mental Health Patients Across Provider Groups

The Distribution of US Adult Mental Health Patients Across Provider Groups

Shortcomings of services for persons with severe and persistent mental health challenges: a qualitative study of service users and family carers

Rethinking how to deal with demand and supply in CAP: a European training perspective

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