It’s any parent’s worst nightmare: imagining your child sitting in an emergency room after they’ve done the unthinkable and made an attempt to take their own life. Everything about a suicide case, especially when it comes to children, demands a sense of urgency. How would you feel, then, if you were told you’d have to wait a whopping three weeks for your child to have an intake with a child psychiatrist in an outpatient setting?
What if I told you the wait was three more hours for the emergency physician? Let’s face it , it’s amazingly difficult to get the children of New York the mental health care they need. If you’re a parent reading this, I’ll bet you now want to book that appointment for your child, even if they don’t necessarily need it right now.
Bureaucracy and barriers: when red tape thwarts mental wellness
The sad reality is that New York is failing some of its most vulnerable residents. What should be an urgent, swift, and efficient protocol to match suicidal minors with the care they desperately need is instead a drawn-out confusing process that can end up costing countless hours, resources and, sadly, lives. The problem starts with the state’s one-size-fits-all approach towards physicians with DEA licenses to prescribe controlled substances. The catch? Virtually all child psychiatrists fall into this category because first line treatments are considered controlled substances. In turn, the state mandates that every doctor receive three hours of training in proper pain management and combating the opioid epidemic.
Of course, this training is crucially important for physicians who routinely prescribe opiate medication; doctors in palliative care, internal medicine, surgery and family practices. This is crucially important training for specialties who routinely prescribe opiate medication. Child psychiatrists, however, never prescribe these medications but are still required to take attend training designed specifically for pain management doctors. And while three hours may seem negligible to most people, in the world of child psychiatry three hours can often make all the difference.
Oversimplified solutions for complex mental health care issues
For some specialists who are stretched unbelievably thin already, mandated and uncompensated time is not just time taken from the physician and their family, it adds hours to emergency room wait times for you and your child, not to mention contributes to the scarcity of available intake appointments. With just over 1,000 child psychiatrists in NYS, this mandating training alone translates to over 3,000 hours of lost time providing crucial mental health care for the children of New York.
It’s not just these training sessions being mandated to your child’s psychiatrist. As the saying goes, there are no free lunches and these mandates represent three fewer hours child psychiatrists could spend learning how to treat opioid addiction, and each time a physician prescribes a life saving medication, such as Soboxone, to treat opioid addiction, chances are good that the clinician and practice staff will now be forced to devote more valuable time spent fighting the insurance company to get that elusive “prior authorization.”
For good measure, throw in meaningless “maintenance of certification” requirements, time spent navigating a seemingly endless number of documentation requirements and more. Every bureaucratic snag represents time the clinician cannot spend with your child. Well-meaning as they may seem, these requirements of physicians, particularly child psychiatrists, lack the necessary thoughtfulness and efficiency required of child-facing mental healthcare. We can, and must, do better.
