Message from the Director

Recent reports show an alarming disconnect between supply and demand for psychiatric services in the United States. According to a 2017 report by the National Council for Behavioral Health, the ratio of psychiatrists to population in the U.S. declined by 10 percent between 2003 and 2013. Nearly half the nation’s psychiatrists are private practitioners who operate on a cash-only basis. Fifty-five percent of counties in the continental U.S. have no psychiatrists, and 77 percent have a severe shortage.

Meanwhile, demand for mental health and substance use disorder services is on the rise. Depression is now a leading cause of disability in the U.S. and worldwide. Estimates indicate one in four families are struggling with some aspect of mental illness. A recent Milbank Memorial Fund report said among children ages 9 to 17, as many as one in five may have a diagnosable psychiatric disorder.

Primary care practitioners are living with the fallout. An estimated 40 percent of patients seen in a primary care setting on any given day have an active psychiatric problem, while half the patients referred by a primary care provider for psychiatric treatment are unable to access services.

Exacerbating the gap in appropriate care: The vast majority of primary care providers have suboptimal training in prevention, diagnosis and treatment of psychiatric disorders, including those found in children and adolescents. 

Are we creating a replacement for psychiatrists? No. Our fellows are trained in the basics of treating mild to moderate illnesses, including anxiety and depression. Patients with more serious conditions should be referred to a specialist.

Who benefits?

Providers in these specialties could benefit from this fellowship:

• Pediatrics
• Internal medicine
• Family medicine
• Emergency medicine
• Neurology
• Physician assistants
• Nurse practitioners
• Psychiatric nursing

Mental health providers and pharmacists may also benefit from this fellowship and are welcome to apply.

Robert McCarron, DO, DFAPA, FAIHM
Founding Director, Train New Trainers Primary Care Fellowships
Associate Dean, Continuing Medical Education
Director of Education, Susan Samueli Integrative Health Institute