The new specialty of child psychiatry, approved by the government, increases training from four to five years but this will not entail greater expense since Health has chosen to reduce MIR psychiatry places by 23% (children and not children) so that the cost is zero.
This is denounced by the former president of the Spanish Society of Legal Psychiatry (SEPL) and a member of its board of directors, Alfredo Calcedo, and is included in the Regulatory Impact Analysis Report that accompanies the royal decree approving this specialty, with which all professionals agree but not with its repercussions since, they emphasize, the chronic shortage of psychiatrists will continue, 11 per 100,000 inhabitants, at a time when the pandemic has focused on mental health.
In statements to Efe, Calcedo, psychiatrist at the university hospital Gregorio Marañón (Madrid), warns that the SEPL legal advice studies legal actions against “relevant aspects” of the royal decree, explains that the cost of a Psychiatric MIR in its four years of training is 180,486 euros, which if multiplied by the 288 places called in 2020 gives a total of 51.9 million euros of expenditure for the National System of Health.
In the memory, the Government is committed to “reducing the supply of places to 222, so that the budgetary cost is maintained”.
According to this psychiatrist and professor at the Complutense University of Madrid, the cost of a five-year Psychiatric MIR would be 234,338 euros. If this figure is multiplied by 222 summoned places (23% less) the result is 52 million, that is, the expense is maintained at the cost of reducing the number of places.
For Calcedo, the Health proposal is the “parrot chocolate” since “The only advantage is that child psychiatrists will be better prepared” but in return there will be a progressive decrease in the number of non-child psychiatrists.
At the tail in number of psychiatrists
Calcedo recalls that while the numbers of MIR places called for other mental health professionals such as psychologists (PIR) or nurses (EIR) increase notably, that of psychiatrists will decrease and “inexplicably it is done when mental health is in the political debate and the need to increase professional resources “.
According to data from the SEPL, Spain is in third place in the queue in terms of number of psychiatrists with 11 professionals for every one hundred thousand inhabitants, which implies a draw with Romania and Malta.
Behind Spain are only Poland, with 9, and Bulgaria (8) while the ranking is led by Germany, with 27; Greece, with 25; Lithuania, with 24; France, with 23 and the United Kingdom, with 18 professionals per 100,000 inhabitants.
“They sell us that the specialty is created but what really occurs is a reduction in the role of psychiatry in mental health care”
But in addition to this chronic deficiency in psychiatrists, the SEPL considers that the royal decree raises many questions: “Can an adult psychiatrist treat a child or adolescent in the emergency room? Can a child psychiatrist be responsible for all psychiatric emergencies in a hospital? “
In Calcedo’s opinion, the royal decree closes a problem to create others and recalls that the reduction of places (there will be 222 in the next call) returns to Spain to the 2014 figures.
“They sell us that the specialty is created, but what is really produced is a reduction in the role of psychiatry in health care. mental health”, adds this professional.
And he concludes that the effects of the specialty of child psychiatry will begin to be noticed in at least six or seven years: “The call will be for 2022, five years later the MIR will end and in 2027 and 2028 they will be hired. They will be professionals with more training, but no greater number. ”