Environmental Scan - Government of Nova Scotia

23.3.3 Paediatrics – PsychiatryPhysician Resource PlanningAn Environmental ScanThe child and adolescent psychiatrist works with children, adolescents and their families, in a hospital and in avariety of settings such as schools, courts, universities, private offices, social agencies and other communityorganizations. Some become specialized experts in a particular age group (such as infants or adolescents), aparticular diagnosis (such as anxiety or eating disorders), or a particular treatment modality (such as paediatricpsychopharmacology or custody evaluations).Epidemiological studies suggest the prevalence of childhood emotional and behavioural disorders as 15 -20% 95 . It is recommended that child psychiatry consultation in rural centers be provided through outreachrather than locating one physician for a region (i.e. population < 25,000) 96 .The U.K. Royal College of Psychiatrists recommends 1.5 FTE child psychiatrists per 100,000 total population(equivalent to 1.0 FTE per 13,400 age 0 to 17) under age 18 97 . It also recommends a further 0.75 FTE for fullservices up to the patients’ eighteenth birthday along with the appropriate balanced multidisciplinary team.In 2000 Kim reported to the American Academy of Child and Adolescent Psychiatry (according to the AmericanMedical Association physician master file), had 7.51 child and adolescent psychiatrists per 100,000 under age18 with a range of 1.32 to 17.53 98 . A ratio of 7.51 in Nova Scotia would equate to a count of 12.9 child andadolescent psychiatrists or about one per 14,000 under age 18.Currently there are 14.8 child and adolescent psychiatrist FTE in Nova Scotia or 1.0 FTE per 11,900 under age18.COGME (Specialty Physician Workforce, September 2000) observed a striking inverse relationship between thedensity of psychiatrists and the percentage of children living in poverty. They also noted ‘no easy standardemerges for this analysis’.• A benchmark of 13,400 population under age 18 per child and adolescent psychiatrist FTE wasapplied to the Base Case forecast in the Final Report.23.3.4 Other SpecialtiesThe following specialties will be addressed in the forecast modeling, scenario development, and final reportand recommendations:• Developmental Paediatrics• Paediatric Emergency Medicine• Paediatric Haematology/Oncology95 Breton JJ, Bergeron L, et al. Quebec Child Mental Health Survey: prevalence of DSM III-R Mental Health Disorders. J ChildPsychology and Psychiatry 1999;40(3);375-384.96 Canadian Academy of Child Psychiatry, Child Psychiatry In Canada: Physician Resources Position Statement, CanadianAcademy of Child Psychiatry Physician Resource Committee, January 22, 200297 U.K. DOH, Medical Specialty Workforce Factsheet, Child And Adolescent Psychiatry, Aug/201098 Kim, W.J, Child and Adolescent Psychiatry Workforce: A Critical Shortage and National Challenge, The AmericanAcademy of Child and Adolescent Psychiatry, Task Force on Workforce Needs, Academic Psychiatry, 27:4, Winter 2003219 | Page Social Sector Metrics Inc. & Health Intelligence Inc. | 12/31/2011