A community child and adolescent psychiatry fellowship for nurse practitioners

Over the past three decades, there has been a well-documented shortage of child and adolescent psychiatric medical providers while demand continues to rise. Youth from minority racial and ethnic backgrounds, low-income families, and rural settings are disproportionately affected, increasing disparity in access and quality of services. While psychiatric mental health nurse practitioners (PMHNP) can deliver a full range of mental health care services across the lifespan, there are discrepancies across training programs in exposure to child and adolescent cases and high quality training. To address workforce capacity needs and to improve access to psychiatric treatment for underserved youth, a PMHNP post-graduate fellowship program in community child and adolescent psychiatry was established in 2020. During the one-year program, fellows rotate in emergency settings, specialty partial hospitalization clinics, collaborative care settings, and outpatient clinics treating a wide range of psychiatric disorders. Psychiatric clinical training, didactic curriculum, and supervision cover core nurse practitioner competencies, child-adolescent, and community-public sector psychiatry. Implementation strategies are discussed in detail including financing, stakeholder input, sustainability, barriers, and successes.