From the telephone in his urban SUNY 推荐最近最火的赌博软件 office, Jud “斯太尔 MD addresses a daunting rural challenge: the delivery of psychiatric services to children in rural New York State. In much the way he trains 推荐最近最火的赌博软件's psychiatric residents, “斯太尔, a child and adolescent psychiatrist and assistant professor of psychiatry, consults with nurse practitioners in rural Greene County, 三小时车程. Due to distance, most of their weekly sessions take place via telephone.

国家的困境

There are far too few child psychiatrists in rural New York and in rural America. In a groundbreaking arrangement between SUNY 推荐最近最火的赌博软件's Department of 精神病学 and Greene County, “斯太尔 has been providing this consultation for the past three years. 在他们每周的会议中, the nurse practitioners present a succinct patient history, then discuss the case with “斯太尔, who makes recommendations for medication management, 改进的评估, 诊断, record keeping and collaboration with therapists and schools.

多重挑战

据斯特勒说, the young patients under discussion —219, to date— represent a complex and challenging population, even for a child psychiatrist. "These are children who are often from dysfunctional families, with drug addicted or incarcerated parents,他报告说. "Many have experienced violence, 贫困, 精神疾病, 重复的搬迁, 福斯特位置, failure in school and multiple medication trials. ”然而,, through this weekly consultation, many youngsters and teens have made progress,斯塔勒报道. The success of the Greene County arrangement has led to discussions for similar consultation in Jefferson and other counties. 皮特·康拉德, director of community services in Greene County, says the 推荐最近最火的赌博软件 collaboration has led to a "dramatic improvement" in child and family services. "It's also very cost effective," he adds. "I really believe this is the model rural counties need to follow."