Guest Blog: American Board of Adolescent Psychiatry

As part of PRMS’ ongoing efforts to support the behavioral healthcare community and to promote the organizations that work towards this mission, we are pleased to highlight our partner the American Society for Adolescent Psychiatry, which hosts the American Board of Adolescent Psychiatry. We invited Dr. Gregory P. Barclay, DLFAPA, President of the American Board of Adolescent Psychiatry and Behavioral Health Medical Director at the Delaware Medicaid/Highmark Health Options to be our featured guest blogger this month. Dr. Barclay addresses the need for psychiatrists who specialize in Adolescent and Young Adult Psychiatry.

It is widely known that the United States needs many more psychiatrists. Where we need them urgently is in the evolving specialty of Adolescent and Young Adult Psychiatry. Why? Because we know from National Institute of Mental Health (NIMH) data that 60-75% of all major mental illnesses have their onset by age 25, with suicide being the third leading cause of death in the 18-25 age group. Older adolescents and young adults have the highest prevalence rates of mental illness of all age groups in the country, and their rates of co-occurring mental illness and substance use disorders continue to escalate, requiring more sophisticated and individualized treatment approaches. The opioid epidemic has ravaged the adolescent and young adult population along with their families, pointing to a desperate lack of specialized teen and young adult addiction treatment that is evidence-based and led by psychiatrists with expertise in the mental health and substance use disorder needs unique to this age group. In addition, 70% of teens in juvenile justice facilities suffer from (often undiagnosed and untreated) mental disorders, and it is widely believed that the recent global pandemic has affected teens and young adult mental health most severely out of all age groups.

Given that only 8,300 child and adolescent psychiatrists currently practice in the U.S. and more retire than can be trained via the traditional fellowship route, there is a growing need to train general psychiatrists to confidently treat teens and young adults. I am a psychiatrist who has had a longstanding and ongoing passion for the health of teenagers and young adults and am currently the President of The American Board of Adolescent Psychiatry (ABAP), which exists as the alternative route for training and recognizing general psychiatrists who are interested in working with teens and young adults. ABAP has been in existence since 1989, began certifying psychiatrists in this specialty in 1992, and has, to date, certified more than 700 psychiatrists in Adolescent and Young Adult Psychiatry. ABAP is currently hosted by The American Society for Adolescent Psychiatry (ASAP), which supports ABAP with relevant targeted continuing education, administrative support, and other resources to accomplish its mission to expand clinical services to this vulnerable population with expanding mental health services needs. ABAP Certification appeals to general psychiatrists who find themselves seeing more teens and young adults in their practices, psychiatrists working in military or college settings, and psychiatrists working as school and residential program consultants.

Also, there are situations where general psychiatrists may have always had an interest in adolescents and young adults but may not want to treat children or for other reasons may not have been able to do a post-residency Child/Adolescent Psychiatry fellowship. For example, I did my residency in the United States Navy (USN) in the mid-1980’s where many of my patients were older teens and young adults, so I was already interested in the field. The needs of the Navy then were for general psychiatrists, so a fellowship in child and adolescent psychiatry was not an option. By the time I left the USN, I was too far out of residency to consider going back for more fellowship training and was the father of three children with a spouse who wanted to resume her career after a USN-required hiatus. Yet, my work in a community mental health center required that I treat many troubled teens and young adults, and I wanted to feel more confident and better trained to do so.

Therefore, when The American Board of Adolescent Psychiatry announced its new certification opportunity in 1992, I jumped at it. The preparation allowed me to do specific, yet self-directed training without having to leave my job, and after a few years I was accepted and passed the examinations in 1994. This Board Certification provided me the additional skills and training to subsequently develop a school-based mental health program, develop an inpatient adolescent program, consult at a juvenile detention center and a residential youth rehabilitation facility, provide services to college students, and treat many adolescents in traditional outpatient settings. It also gave me the confidence in later years to move into public health where I am currently involved in assuring youth and young adults in the Delaware Medicaid Program have access to quality and evidence-based mental health and substance use services.

So, in conclusion, I encourage any general psychiatrist or resident to consider a rewarding career working with teenagers and young adults. The American Society for Adolescent Psychiatry (ASAP) exists to provide continuing education, networking, career opportunities, mentoring, and networking support to any psychiatrist who is interested in what we have to offer – and the American Board of Adolescent Psychiatry, which is hosted by ASAP, exists as a route to Board Certification in Adolescent and Young Adult Psychiatry for any general psychiatrist who meets its credentialing and educational criteria. Please join us in addressing this great need!

Gregory P. Barclay, MD, DLFAPA

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