CDRP Annual Symposium Speaker: Karam Radwan, MD, DFAACAP

The Center for Chronic Disease Research and Policy is proud to feature a talk by Karam Radwan at our 11th Annual Symposium: Strengthening Adolescent Health and Health Policy on October 30. Dr. Radwan will deliver the talk, “Resilience Across Time: Navigating Adolescents and Families in Crises, Reflecting on the Past and Envisioning the Future.” REGISTER HERE.

Dr. Radwan is the division chief for the child and adolescent psychiatry program at the University of Chicago. Board certified in Adult Psychiatry, Child and Adolescent Psychiatry and Hospice and Palliative Medicine by the American Board of Psychiatry and Neurology, Dr. Radwan has been the director of training for child and adolescent psychiatry fellowship for the past 15 years. He is a distinguished fellow of the American Academy of Child and Adolescent Psychiatry. His interests include promoting family assessment and interventions, studying the effect of play on cognitive flexibility, and promoting evidence-based treatment in child and adolescent psychiatry.

“The number of adolescents and children needing mental health services in the last 20 or 30 years has overwhelmed all the infrastructure and the systems that we have,” says Radwan. “There are not enough child psychiatrists or therapists to see children and adolescents, and we can see the rise of mental health problems within that group as a result. The suicide rate has now surpassed the peak of the 1990s.”

According to Radwan, mental health fatalities exceed deaths by cancer, heart conditions, and other diseases pediatricians and primary care physicians are trained to diagnose and treat. “The three leading causes of death for children and adolescents nationwide are accidents of all sorts–which are often related to impulsivity–suicide, and homicide,” he says. The social and economic stress of the COVID-19 pandemic has only made an existing downward trend worse. “Many of my patients have said, ‘I wish I was born in a different time.’ That’s powerful.”

Naming suicide, substance use, violence, behavioral problems, delinquency, and school refusal among some of the major mental health problems adolescents face, Radwan notes, “Adolescence is a critical developmental period. It is a time of vulnerability but also a time of great opportunity for intervention. If you can prevent some of these problems early on in life, you can make a huge impact in the trajectory of someone’s life.”

According to Radwan, treating children and adolescents often requires taking a holistic perspective and a collaborative approach. “You cannot treat the patient in isolation of their environment, so you have to understand the context of their symptoms in their school, their culture, and their family,” he says. The work is thus often interdisciplinary and team-based, involving psychologists, psychotherapists, pediatricians, school counselors, as well as patients’ families.

However, the need for treatment far outpaces the number of mental health care workers and facilities available to handle the problem. “We graduate about 340 child and adolescent psychiatrists in the country a year,” he says. “We need about 7,000.” As a result of this massive shortage, often care shifts to other providers, such as nurse practitioners, pediatricians, family physicians. “But they were trained to treat things like ear infections, not to deal with adolescents who are cutting themselves, planning to kill themselves, adolescents who are vaping cannabis and hallucinating, kids who are not going to school or who have fear of going to school. So they find themselves struggling to take care of these kids.” Radwan also mentions the decline in the number of inpatient units for pediatric psychiatry.

Finding mental health providers who accept insurance and insurance that adequately covers care pose additional challenges. “If you have good insurance, it’s very hard to find care–can you imagine if you have Medicaid?” he says. “For a long time, insurance discriminated against mental health problems by having two different systems [for coverage].” Though the Mental Health Parity and Addiction Equity Act of 2008 is a federal law intended to prevent group health plans and health insurance issuers from imposing less favorable benefits for mental health and substance use disorders, according to Radwan, “it has not been implemented fully–many are finding ways around it.” These failures reflect structural inequities, ultimately leaving the most vulnerable least able to get help: “Adolescents of color and people who live in low socioeconomic conditions tend to have more mental health problems,” he says, but “there’s discrimination from policy all the way to access of care.”

In his talk on October 30, Radwan will highlight risk factors for mental health and why adolescence–defined in neuroscientific terms as extending to the age of 25–can be such a crucial period for intervention and prevention. He will also share statistical data on specific topics, including suicide, eating disorders, and substance use, and information on treatments that have shown to be successful.

Radwan expresses hope that the symposium will generate more coordinated advocacy for mental health, as well as more commitment to invest resources. “[Keynote speaker] Sameer Vohra is probably the IDPH director who has paid the most attention to mental health–he has been a great advocate. But we cannot do this work on our own. We are family psychiatrists and systems providers.”

CDRP 11th Annual Symposium: Strengthening Adolescent Mental Health and Health Policy

October 30, 8:30AM-3PM

Gordon Center for Integrative Sciences 3rd Floor Atrium

Read more about the symposium on UChicago BSD News

Register to attend

Submit a poster for the poster session