American Association of Community Psychiatrists’
Guidelines for Developing and Evaluating Public and Community Psychiatry Training Fellowships May, 2008 Introduction: Development of the psychiatric workforce has become a critical issue in most parts of our country, and the shortage of well-trained psychiatrists is most egregious in publicly funded settings. A number of factors have contributed to the difficulties in attracting talented young psychiatrists to settings that are in greatest need. Over the past several decades, a great deal has been learned about the brain, pharmacology and biological processes contributing to behavioral health disorders and these aspects of treatment have enjoyed great emphasis in the training of future psychiatrists. At the same time, a worldwide movement embracing a recovery paradigm has developed and has been critical in empowering individuals to see themselves as persons of potential as opposed to being hopelessly mentally ill. Most psychiatric training experiences do not formally teach the values of a recovery orientation in working with individuals with a variety of behavioral health issues. A variety of contemporary forces have converged to limit the scope of psychiatric practice, largely constricting its range to medication management and focusing on the biologic contributions to the expression of an illness. Training programs have often reflected this shift in the conceptualization of psychiatry, spending less time on promoting leadership, prevention, health maintenance, and psychosocial interventions than in the past. It is essential that opportunities are created to help our profession redefine itself and to ensure an engaged psychiatric workforce, committed to high quality services and treatment. Purpose: The purpose of this document is to create a framework for the training of psychiatrists that incorporates the elements needed to re-establish psychiatry’s strong position in leadership and collaboration. To realize this vision, psychiatrists must develop a thorough understanding of recovery as a goal and a process and embrace the added value of effective partnerships with consumers, families, other disciplines, and stakeholders in addition to their expertise in managing medication and the biologic aspects of illness. At the same time, systems of care must creatively develop methods to support psychiatrists in this effort. Critical to the training will be a greater understanding of what underlies the health and mental health of people and communities. Many of our country’s neighborhoods are