Abstract
Child and adolescent mental health care in North American has historically gotten lost somewhere between pediatrics and psychiatry. Although child mental health clinicians share a population of concern with pediatricians and other primary care providers, child psychiatry is not considered a pediatric medicine specialty area but rather a psychiatric one. The bulk of the psychiatric “business”, however, deals with adults and, therefore, has closer ties to internal medicine than to child psychiatry. This creates a no-man’s land organizationally, where service need and responsibility are disconnected (Rae-Grant 1986). Adding to the disconnect are the barriers of stigma (families experiencing shame when their child has a mental illness) and scarcity. (The subspecialty of child psychiatry produces very few doctors compared to other medical specialties, and both the training of psychiatric nurses and that of clinical social workers is focused on adults.)
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Grimes, K.E. (2004). Systems of Care in North America. In: Remschmidt, H., Belfer, M.L., Goodyer, I. (eds) Facilitating Pathways. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18611-0_4
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