Approved by Council, October 1991
To be reviewed

This statement explains the unique role of child and adolescent psychiatrists in providing psychiatric assessment, management and treatment in organized systems of care.

In order to properly balance issues of accessibility to treatment and quality of treatment with the need for cost containment, there are critical points that require the involvement of the most comprehensively trained professional, the psychiatrist, in the assessment, management and treatment of the patient. These points include at least the:

• Initial triage of patients presenting with symptoms of psychiatric illness. This should be done either by a psychiatrist or by a trained, experienced mental health professional working under the direct supervision of a psychiatrist. 
• Subsequent assessment of patients with complex biopsychosocial diagnostic issues. 
• Assessment and treatment of patients who may benefit from psychotropic medication. 
• Decision to admit to all levels of treatment more intense than outpatient therapy.

In the case of children 14 years of age and younger, the appropriate individual is a physician fully qualified as a child and adolescent psychiatrist, i.e. one who has completed training in both general psychiatry and child and adolescent psychiatry in programs accredited by the Accreditation Council on Graduate Medical Education. The special training of fully-qualified child and adolescent psychiatrists equips them to provide the most effective comprehensive assessment, management and treatment for adolescents through age 18.

This standard of care must be tempered by the availability of a child and adolescent psychiatrist but can be implemented in most metropolitan areas.