Our Challenge
In recent years, public health systems across the country have been confronted with a growing challenge: a severe shortage of child and adolescent psychiatrists (CAPs) who play a crucial role in the mental health continuum of care. This shortage poses a significant threat to the mental health and emotional development of a very vulnerable population—children and youth in the child welfare system.
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According to the American Academy of Child and Adolescent Psychiatry, the shortage of CAPs varies widely by state, with ratios ranging from 4 to 65 per 100,000 children. The national average is just 14 CAPs per 100,000—far below the estimated need of 47. In New York State, there are only 29 CAPs per 100,000 children, placing it in the high-shortage category.
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Under- or mis-diagnosed mental health issues in the child welfare population can have detrimental impacts on individuals well into adulthood, negatively affecting productivity and quality of life. The CAP shortage limits our ability to provide timely and effective mental health services to children who have experienced trauma, abuse and neglect, and exacerbates family and caregiver stress. The trends contributing to the CAP shortage include a costly education system that prompts many professionals to pursue private practice, limited academic and practicum training on the unique trauma faced by children involved in child welfare, and a lack of well-paying positions in public health systems.
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In response, we created a unique partnership to design and pilot a comprehensive program aimed at reversing the shortage of CAPs, starting in NYC, that would serve as a model for a larger, potentially national effort: Child and Adolescent Psychiatry for the Underserved – CAP4Us.
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Learn More
Mental and Behavioral Health Needs of Children in Foster Care
American Academy of Pediatrics
"Mental and behavioral health is the largest unmet health need for children and teens in foster care. Mental and behavioral health requires the presence of at least one nurturing, responsive caregiver who is stable in the child’s or teen’s life over time. Children and teens thrive when their families have routines, structure, and reasonable expectations; and parents display warmth and nurturance..."
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Analysis of Barriers in Mental Health Care for Foster Children: Challenges and Solutions
Christine Guidry, Psychiatric Times
"Children in foster care represent one of the most vulnerable sections of the population, as they are at an elevated risk of experiencing mental health challenges. These difficulties may be caused by past traumas, ongoing instability, and the emotional turmoil associated with separation from their biological family..."
Mental Health Services for Children Placed in Foster Care: An Overview of Current Challenges
Peter J Pecora et al., Child Welfare
"Given the evidence from studies indicating that children in care have significant developmental, behavioral, and emotional problems, services for these children are an essential societal investment. Youth in foster care and adults who formerly were placed in care (foster care alumni) have disproportionately high rates of emotional and behavioral disorders..."