The high prevalence and significant social burden of mental disorders among children and adolescents underscore the importance of expanding child and adolescent mental health services (CAMHS) resources. To attain this objective, enhancing the knowledge and skills of pediatric residents in child and adolescent psychiatry (CAP) is paramount. Expansion of CAP training among pediatric residents has amassed a solid foundation overseas, offering invaluable experience for its implementation in China. This article systematically reviews the practice and research of the CAP training among pediatric residents on an international scale, and, based on this, proposes actionable implementation pathways on how to expand CAP training among pediatric residents in our country by integrating China's specific contextual needs, foundation, and support. These include conducting systematic investigations, formulating structured training programs, and refining assessment and certification mechanisms, etc. The study aims to promote the systematic development of CAP training programs among pediatric residents in China through the above series of measures. It is expected to provide robust workforce support for expanding CAMHS resources and achieving hierarchical diagnosis and treatment. Ultimately, this effort will contribute to building a comprehensive workforce cultivation system and optimizing the allocation of healthcare resources.
Pan Meirong
,
Tang Ni
,
Qi Jianguang
,
Chen Weiran
,
Zhu Zhengjie
,
Cao Qingjiu
,
Si Tianmei
. Practical values and implementation pathways of expanding child and adolescent psychiatry training among pediatric residents in China[J]. Chinese Journal of Medical Education, 2026
, 46(1)
: 53
-58
.
DOI: 10.3760/cma.j.cn115259-20250217-00157
[1] Pan M, Tang N, Qiu Y, et al. Strategic implementation of child and adolescent psychiatry training in Chinese residency programs: an exploratory survey[J]. BMC Med Educ, 2025,25(1):860. DOI: 10.1186/s12909-025-07471-6.
[2] WHO Teams. Child and adolescent mental and brain health[EB/OL].(2024-08-28)[2024-10-10] . https://www.who.int/activities/Improving-the-mental-and-brain-health-of-children-and-adolescents.
[3] Kieling C, Buchweitz C, Caye A, et al. Worldwide prevalence and disability from mental disorders across childhood and adolescence: evidence from the global burden of disease study[J]. JAMA Psychiatry, 2024, 81(4): 347-356. DOI:10.1001/jamapsychiatry.2023.5051.
[4] Li F, Cui Y, Li Y, et al. Prevalence of mental disorders in school children and adolescents in China: diagnostic data from detailed clinical assessments of 17,524 individuals[J]. J Child Psychol Psychiatry, 2022,63(1):34-46. DOI: 10.1111/jcpp.13445.
[5] Zhang J, Shi C, Liang Z, et al. Burden of noncommunicable diseases among children and adolescents aged 10-24 years in China, 1990-2019: a population-based study[J]. Cell Rep Med, 2023,4(12):101331. DOI: 10.1016/j.xcrm.2023.101331.
[6] 马宁, 陈润滋, 张五芳, 等. 2020年中国精神卫生资源状况分析[J].中华精神科杂志,2022,55(6):459-468. DOI: 10.3760/cma.j.cn113661-20220617-00158.
[7] Wu JL, Pan J. The scarcity of child psychiatrists in China[J]. Lancet Psychiatry, 2019,6(4):286-287. DOI: 10.1016/S2215-0366(19)30099-9.
[8] 国家卫生健康委确定2025—2027年为“儿科和精神卫生服务年”[EB/OL].(2024-12-31)[2025-01-31] .https://www.nhc.gov.cn/xcs/c100122/202412/5a1960ef636e49ed80db1392c1e5feaa.shtml.
[9] WHO Team. Mental Health Atlas 2020[EB/OL].(2021-10-08)[2025-01-31] . https://www.who.int/publications/i/item/9789240036703.
[10] Wang S, Ungvari GS, Xiang YT. The shortage of child and adolescent psychiatrists in China[J]. Asian J Psychiatr, 2023,81:103404. DOI: 10.1016/j.ajp.2022.103404.
[11] Kim WJ, American Academy of Child and Adolescent Psychiatry Task Force on Workforce Needs. Child and adolescent psychiatry workforce: a critical shortage and national challenge[J]. Acad Psychiatry, 2003,27(4):277-282. DOI: 10.1176/appi.ap.27.4.277.
[12] Heneghan A, Garner AS, Storfer-Isser A, et al. Pediatricians' role in providing mental health care for children and adolescents: do pediatricians and child and adolescent psychiatrists agree?[J]. J Dev Behav Pediatr, 2008,29(4):262-269. DOI: 10.1097/DBP.0b013e31817dbd97.
[13] Jones S, Jordan B. Communications between medical referrers and child psychiatry staff[J]. Aust NZJ Psychiatry, 1993,27(4):683-685. DOI: 10.3109/00048679309075831.
[14] 中国住院医师培训精英教学医院联盟. 中国住院医师培训精英教学医院联盟住院医师核心胜任力框架共识[J].协和医学杂志,2022,13(1):17-23. DOI: 10.12290/xhyxzz.2021-0755.
[15] Shaw RJ, Rackley S, Walker A, et al. Core competencies for pediatric consultation-liaison psychiatry in child and adolescent psychiatry fellowship training[J]. Psychosomatics, 2019,60(5):444-448. DOI: 10.1016/j.psym.2019.04.006.
[16] DeMaso DR, Mezzacappa E, Goldman SJ. Recruitment and training of child and adolescent psychiatry residents from pediatrics[J]. J Am Acad Child Adolesc Psychiatry, 1992,31(6):1100-1104. DOI: 10.1097/00004583-199211000-00018.
[17] American Board of Pediatrics. Content outline: general pediatrics[EB/OL].[2024-08-31] . https://www.abp.org/content/about-us.
[18] RCPCH. RCPCH Progress+ core syllabus for paediatric training[EB/OL].[2025-01-31] . https://www.rcpch.ac.uk/sites/default/files/2023-10/ProgressPlus-Generic-Syllabus-Core-v1.pdf.
[19] BC Children's Hospital. Clinical training program[EB/OL]. [2025-01-31] .http://www.bcchildrens.ca/Psychology-site/Documents/CPABROCHURE2023_October17_Final(002).pdf.
[20] Shahidullah JD, Kettlewell PW, Palejwala MH, et al. Behavioral health training in pediatric residency programs: a national survey of training directors[J]. J Dev Behav Pediatr, 2018,39(4):292-302. DOI: 10.1097/DBP.0000000000000548.
[21] Doja A, Pringsheim T, Andrade BF, et al. Implementation and evaluation of a curriculum on the assessment and treatment of disruptive behaviour disorders[J]. Paediatr Child Health, 2021,26(8):458-461. DOI: 10.1093/pch/pxab008.
[22] Green C, Walkup JT, Bostwick S, et al. Advancing the agenda in pediatric mental health education[J]. Pediatrics, 2019,144(3):e20182596. DOI: 10.1542/peds.2018-2596.
[23] 何莹, 罗庆. 深入推进儿科医师继续教育与持续职业发展——国家级继续医学教育基地在卫生人才培养中发挥重要作用[J]. 中华医学信息导报, 2021, 36(20): 5. DOI:10.3760/cma.j.issn.1000-8039.2021.20.106.
[24] 静进, 欧萍, 徐海青, 等. 儿童心理行为专科建设专家共识[J].中国儿童保健杂志,2023,31(9):929-934.
[25] 中国儿童精神卫生精英教学医院联盟成立[EB/OL].(2023-09-20)[2025-02-14] . https://news.cctv.com/2023/09/20/ARTIq9QGvmyif9xBrmDZcjvj230920.shtml.
[26] Rand CM, Goldstein N. Patterns of primary care physician visits for us adolescents in 2014: implications for vaccination[J]. Acad Pediatr, 2018,18(2S):S72-S78. DOI: 10.1016/j.acap.2018.01.002.
[27] Davie M. Doing more for mental health[J]. Arch Dis Child Educ Pract Ed, 2016,101(2):77-81. DOI: 10.1136/archdischild-2015-308344.
[28] Ruedinger E, Carlin K, Inwards-Breland D, et al. Effectiveness of the adolescent medicine rotation in improving pediatric residents self-assessed skill and confidence caring for youth[J]. J Adolesc Health, 2019, 64(4): 530-536. DOI:10.1016/j.jadohealth.2018.10.007.
[29] Colburn MD, Harris E, Lehmann C, et al. Adolescent depression curriculum impact on pediatric residents' knowledge and confidence to diagnose and manage depression[J]. J Adolesc Health, 2020,66(2):240-246. DOI: 10.1016/j.jadohealth.2019.08.022.
[30] Child and Adolescent Psychiatry Milestones Working Group. Child and adolescent psychiatry milestones[EB/OL].[2025-01-31] . https://www.acgme.org/globalassets/pdfs/milestones/childandadolescentpsychiatrymilestones.pdf.
[31] Shaligram D, Bernstein B, DeJong SM, et al. ″Building″ the twenty-first century child and adolescent psychiatrist[J]. Acad Psychiatry, 2022,46(1):75-81. DOI: 10.1007/s40596-022-01594-4.
