P3.A011: Train New Trainers Child and Adolescent Psychiatry Fellowship: A Mental Health Certificate Program for Primary Care Providers

Background: In 2022, the Train New Trainer's Program (TNT) at UC Irvine, which had an established year-long adult track to provide mental/behavioral health training to primary care providers (PCPs), started a new child and adolescent psychiatry (CAP) track.  This is in part to address the growing crisis for children's mental health, which was declared a national emergency in October 2021 by multiple organizations (including the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry and the Children’s Hospital Association).  Many youths don’t receive care, and many are hopeful about receiving mental health evaluation and treatment from their PCPs, despite most of these providers having not trained in providing this care.  The year-long TNT-CAP fellowship aims to address the mental healthcare needs of youth and family and keep these youth in their medical home by providing education and training to PCPs including 2 in-person conferences, 2x/month virtual lectures, 1x/month case discussion and Q&A small group calls, multiple monthly open office hours and subsequent access to alumni small groups and resources.

Methods: Program evaluation of the fellowship and curriculum includes an overall attitude survey and knowledge assessments administered at three time points: prior to fellowship initiation (pre), the August annual conference (mid), and the end of the fellowship (post). The overall attitude survey assesses confidence in completing a psychiatric interview, diagnosing and treating common psychiatric problems, and in teaching mental health principles to colleagues. The knowledge assessments evaluate whether there is an increase in psychiatric knowledge throughout the fellowship.

Results: PCPs from across the United States have participated in the fellowship in 2022 and 2023. The 2024 cohort includes PCPs from the United States and international locations. The TNT-CAP fellowship consistently grew over the three years of its existence, 40 fellows were trained in 2022, 55 in 2023, and 81 are currently enrolled in the 2024 program. Results from the overall attitude survey from the 2023 cohort demonstrate an increase in the PCPs' comfort with taking care of patients with behavioral/mental health disorders when comparing the pre- and post-fellowship survey results with an effect size of 1.6. Overall scores also increased on the knowledge assessments when comparing the pre- and post-fellowship results, statistical analysis is currently in process for the knowledge assessments.

Conclusion: The goal of TNT-CAP fellowship is to successfully train fellows to: (1) Complete evidence-based and efficient psychiatric interviews in primary care or pediatric settings; (2) Effectively diagnose and treat commonly encountered psychiatric conditions; (3) Navigate boundaries and family dynamics with children and adolescents with behavioral or mental health concerns; (4) Teach these principles to their primary care colleagues. Based on our results, the TNT-CAP fellowship is an effective program to help increase mental health capacity within primary care.