Five Questions With: Dr. Gregory Fritz

Dr. Gregory Fritz is academic director at Bradley Hospital, director of the Bradley Hasbro Children’s Research Center, and professor of psychiatry and human behavior at Brown University. He was recently named president of the American Academy of Child and Adolescent Psychiatry.

PBN: How long have you been in the field of child and adolescent psychiatry, and what first got you interested in it?
FRITZ:
I finished my child psychiatry training and a research fellowship in 1977, so it’s been about 38 years. I majored in American literature in college and have always been interested in what makes people tick. When I added in a medical education, the ways that the mind and the body interact in chronic illnesses became my passion. Working with children, adolescents and their families is a joyful privilege.

PBN: In your inaugural address as president, you said the workforce of child and adolescent psychiatry professionals is “minuscule” compared to the number of kids with untreated mental illnesses. Was it always this way, and the profession is becoming more aware of the problem, or are the numbers of children presenting with mental illness trending upwards – or both?
FRITZ:
There has always been a shortage of child mental health professionals, child psychiatrists in particular. As the stigma of mental illness declines, public knowledge about psychological disorders improves, and the effectiveness of available treatment increases, many more children are being brought for treatment. A longstanding problem of access to psychiatric treatment is becoming much more visible and concerning.

PBN: With all the pressure to reduce health care costs, do you find yourself having to push back to ensure that children and adolescents get the care that they actually need?
FRITZ:
There is a tendency for children to be overlooked in all of medicine, since compared to adults they are mostly healthy, pediatric healthcare costs are much smaller than adult expenditures, and the return on investment for pediatric health care reform is long term rather than immediate. Given that about 80 percent of children with psychiatric disorders get no treatment at all, reform can improve efficiency and reduce per capita costs – but not reduce the absolute amount that should be spent. I think vigorous advocacy for children’s mental health is essential.

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PBN: How does integrated care work in the realm of child and adolescent psychiatric care?
FRITZ:
With mental health professionals’ consultation and backup – and appropriate reimbursement – primary care providers are competent and confident to manage many pediatric mental health problems. They thus actually increase the workforce available to treat children for whom access to mental health services is otherwise unavailable. Education of both primary care and mental health professionals is key to making the new system of integrated care work, but the potential for improved care and satisfaction is huge.

PBN: What is the most hopeful development in the profession in the last several years?
FRITZ:
Nothing impedes progress like shame, secrecy and denial. I think that the reduction in stigmatization and the public acknowledgement of the importance and prevalence of pediatric mental health problems are inspiring to those of us in the field. This is an exciting time to be a child and adolescent psychiatrist!

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