You want to help every family that calls, but your schedule's full and the need keeps growing.

What can you do when you can't take another patient?

In this episode, we'll talk about how to manage referrals, support other providers, and build systems that make a difference even when you have to say no.

I'm Dr. Josh Fader, the editor-chief of the Carlott Child Psychiatry Report, and co-author of

the Child Medication Fact Book for Psychiatric Practice, Second Edition, 2023, and our other book

Prescribing Psychotropics.

And I'm Mara Government, a licensed clinical social worker in Southern California with a private practice and an avid reader of

the Carlet Psychiatry Reports. Today, we're talking about something that almost every mental

health provider in child and adolescent care

runs into too many referrals and not enough capacity. Right now, the number of trained child

psychiatrists in the U.S. sits around 8,300. Meanwhile, more than 15 million kids and teens

meet criteria for a psychiatric diagnosis. That's about one in five.

And the gaps hit hardest in rural areas and communities with fewer resources. It raises a question

providers face constantly, which referrals do you take and what do you do with the ones you can't?

Yeah, so let's start there.

One of the first things clinicians can do is clarify their scope,

what kinds of patients they're set up to see, what treatments they offer,

and what their capacity looks like for new referrals. That kind of clarity can shape what gets

accepted and what's redirected. And that redirection matters. Families are often left hanging

when they hear, I'm not accepting new patients. A better approach is to build a plan.

What do you say? Where do you point them to? What resources can you share? Even if you can't take them

yourself, you can give them an X step. That might be a referral list. Ideally, at least three names,

...