Introduction: Unique Needs and Innovative Opportunities

June 29, 2016

Children in foster care; combat vets; physicians with mental health needs: Dr Koh introduces a series of articles on these and other special patient populations.

When discussing psychiatry as a potential career with medical students, I used to feel defensive about my chosen specialty field. I remember making a case about how fascinating the human brain was, how interesting and dynamic human behavior and relationships were, and how medical knowledge has advanced. While all of these reasons are still true, recently I find myself asking medical students, “Why wouldn’t you go into psychiatry?” In fact, some now come to me trying to figure out what parts of psychiatry I do not like. This is different from being asked to explain why I like my field. There are clearly many reasons why this switch in perspective may be happening.

[[{"type":"media","view_mode":"media_crop","fid":"49454","attributes":{"alt":"© Bruce Rolff/shutterstock.com","class":"media-image media-image-right","id":"media_crop_7265124476751","media_crop_h":"219","media_crop_image_style":"-1","media_crop_instance":"5981","media_crop_rotate":"0","media_crop_scale_h":"124","media_crop_scale_w":"125","media_crop_w":"220","media_crop_x":"130","media_crop_y":"0","style":"font-size: 13.008px; line-height: 1.538em; float: right;","title":"© Bruce Rolff/shutterstock.com","typeof":"foaf:Image"}}]]The changes that the Affordable Care Act has brought to mental health services have been well documented in peer-reviewed journals and in mass media. The Act makes it a requirement for health plans to cover mental illness and substance disorders, and it reinforces mental health parity. Over time, while stigma still exists, mental health issues have become more accepted in general public discourse. However, as demand for mental health treatment increases, the number of psychiatrists is not keeping pace. Furthermore, the attention to mental health care has increased the focus on special populations with unique needs and innovative opportunities to deliver effective care. In this environment, psychiatrists find themselves in demand as never before, and there are ample opportunities to practice in diverse settings and with special populations.

In this Special Report, we offer 5 articles on special patient populations and different potential models of delivering mental health care.

Children in Foster Care: Special Issues and Concerns” gives us an overview of and current data on child maltreatment. The author uses guidelines from the American Academy of Child and Adolescent Psychiatry to give recommendations on how to care for foster and/or welfare children.

The need for more mental health providers has galvanized our interest in special populations.

Combat Veterans: Adaptation to Transition” gives us a convincing perspective on active duty military personnel who are transitioning to civilian life. It presents a personal account to illustrate the topic of transition and adaptation studied by Schlossberg. As we are called on to serve those who served, the importance of transition to psychiatric presentation and needs is emphasized.

Wearable Devices for Mental Health: Knowns and Unknowns” reviews the ways in which new technology can be used to help our patients and allow us to extend our therapeutic reach. It acknowledges that advancements in technology do not mean that wearable devices are used with abandon but instead should be considered as one of many adjunctive tools we can use to help our patients.

Treating Physicians: Special Issues, Sensitivities, and Considerations” deals with working with our colleagues with mental health needs. Unfortunately, physicians bear significant stigma in seeking out and getting help for mental health problems. The article gives valuable advice and recommendations in working with our colleagues in a respectful and meaningful way.

Finally, “Collaborative Opportunities: Working With Nurse Practitioners to Meet the Needs of Underserved Patient Populations” presents a way for psychiatrists to function as collaborative team leaders and to partner with psychiatric nurse practitioners to deliver mental health care to underserved populations. This is one of several ways to extend psychiatric care capacity to underserved areas.

In recent years, psychiatry has become more diverse and exciting to practice. While the need for more mental health providers is real and at a critical point, it also has galvanized our interest in special populations and innovative ways to serve our patients. The articles presented here are just a small sample of the diversity of practice modern psychiatry can serve to meet the needs of our patients.

Disclosures:

Dr. Koh is Assistant Professor in the department of psychiatry at the University of California, San Diego. He reports no conflicts of interest concerning the subject matter of this Special Report.