Dr. Debora Barney is a child, adolescent and adult psychiatrist. She earned her medical degree from the University of California, Irvine, School of Medicine. She completed residency training in psychiatry at the VA Sepulveda UCLA Medical Center, and received a fellowship in child and adolescent psychiatry at Harbor-UCLA Medical Center.
Barney has been practicing for 25 years, the last 23 in Las Vegas. Her expertise is in treating children and adolescents with ADHD, depression, anxiety and high-functioning autism.
Barney shares her thoughts on helping kids cope, the state of child psychiatry, and the uniqueness of her chosen profession. Here are the highlights of her recent interview with Lisa Stark.
As far back as I can remember, I wanted to help people in some direct way. In medical school I was drawn to psychiatry because of the intimate communication and relationship with patients. Working with children and adolescents is especially rewarding. Being able to intervene during childhood gives the child a chance to return to their developmental trajectory. Treatment intervention at this stage can truly make a significant difference.
In the two and a half decades that I have been practicing, I have seen a steady escalation of children being diagnosed with more complicated psychiatric conditions. It is possible that part of the reason for the latter is that society has become more complex and stressful with the advent of technology. Diagnosing children and adolescents can be extremely challenging, especially when several conditions are present and different developmental stages are involved, which means that the conditions present may not manifest the way one would expect in adults. In addition, ADHD can look like anxiety and vice versa, making it that much more critical to verify which diagnosis is present.
Child psychiatry practice requires a comprehensive assessment that includes both the child’s and the entire family’s history. It is also important to get input from the parents, teachers, pediatrician and anyone else who has regular interaction with the child. A diagnosis should only be made after gathering all of the necessary history and clinical information.
One of the main challenges of treating children is also working with their parents, educating them about the diagnoses present and explaining treatment alternatives. My advice to parents is to make sure that the physician treating their child has the required training and expertise. Parents should also feel comfortable asking questions and making sure that they understand the implications of the diagnosis and treatment plan.
It has been an incredibly gratifying experience to contribute to changing the trajectory of children’s lives by treating their symptoms early, helping them stay on track developmentally and allowing them to fulfill their potential. Some children can outgrow certain conditions such as ADHD in either adolescence or early adulthood, and therefore, ongoing assessment is a necessary part of treatment.
Like many other specialties, Nevada ranks quite low in terms of the number of practicing psychiatrists. With only six per 100,000 people, the Silver State ranks 50th out of 50 states. The problem is especially acute in child psychiatry. Very often a child with a mental health condition may be treated initially by other practitioners who may not have the specific expertise, time or the resources to do a comprehensive enough assessment. Needless to say, my colleagues and I are very busy. Hopefully with the opening of the UNLV School of Medicine and the child psychiatry fellowship program at the University of Nevada School of Medicine, that dynamic will eventually change. Treating children requires a specific skill set and training, which is accomplished during a two-year fellowship. Not every psychiatrist has the training to treat children; it requires additional caution in making diagnoses and using medication interventions while treating the young patient with a developing brain.
I cannot stress enough the importance of having child psychiatrists involved as child advocates in many different aspects of society, including school districts, the community in general and the legislature. In order to best help a child, we need to be part of the team that includes parents, the school and anyone else involved directly in a child’s life. It is through the lens of this multidimensional approach that we can educate the public about mental health causes in general and more specifically, the importance of intervention early enough to reach children and adolescents in need.
Editor’s Correction: We initially stated that Dr. Debora Barney is involved with Camp Make Believe Kids, but she is not. We have since corrected this information.