Page numbers printed in boldface type refer to tables, figures, or boxes.
AACAP.
See American Academy of Child and Adolescent Psychiatry
AAMC (Association of American Medical Colleges),152–153
AAP (American Academy of Pediatrics),181
ABPN (American Board of Psychiatry and Neurology),12, 153, 383
ACA (Affordable Care Act).
See Patient Protection and Affordable Care Act
Academic institutionsgeriatric mental health curriculum,251
history of psychiatry training at,350, 351–352
public relations resources at,173–174, 195
research resources at,173
Academy of Consultation-Liaison Psychiatry,366
Academy of Psychosomatic Medicine,366
Accessibility of mental health care,36–37,
50–
51, 92, 324, 390–391
Accessions process (military),325–326,
327Accreditation Council for Graduate Medical Education (ACGME)on advocacy competency,153
on advocacy education,12
on consultation-liaison education,383
on pediatric training requirements,229
on physician burnout,47
on psychotherapy competency as training requirement,38
Active listening,61–64
Activist, definition of,57–58
Addiction.
See People with substance use disorders
Administration for Community Living,241, 247
Adolescents.
See Children and families
Advocacybecoming an advocate,10–14, 57–76
definition of,3–5, 366, 394
ethical considerations,13, 25–27.
See also Ethical issues
historical context and trends,8–10,
11levels of,18–20,
19. for psychiatry profession, 5–8,
7, 12, 13, 31–54.
See also Health care system challenges
as specialization within medicine,27–29
for special populations,13
theoretical aspects of,13, 20–23
Advocacy portfolios,28
Affordable Care Act.
See Patient Protection and Affordable Care
ActAgenda-setting model,21–22
Aging in place,249–250
Akaka, Jeffrey,77–78
Alcohol use disorder,303–304, 392.
See also People with substance use disorders
AMA.
See American Medical Association
American Academy of Child and Adolescent Psychiatry (AACAP),67, 182, 222, 225–226, 271
American Academy of Pediatrics (AAP),181
American Association for the Advancement of Science,182
American Board of Psychiatry and Neurology (ABPN),12, 153, 383
American College of Obstetricians and Gynecologists,181
American Legion,350
American Medical Association (AMA)on advocacy as a professional responsibility,3–4, 10–12, 366
Code of Medical Ethics,147
legislative advocacy by,124, 238
on physician burnout,47
research as advocacy by,181
American Psychiatric Association (APA)on advocacy as a professional responsibility,12
on advocacy training,418
becoming involved with,69–71, 121, 124
Caucus of Gay, Lesbian, and Bisexual Members,259
Congressional Advocacy Network,226criminal justice-involved patient advocacy by,410, 413, 418
educational resources of,222
immigration advocacy by,282
legislative advocacy by,225–226, 237–238
LGBTQ patient advocacy by,259, 269, 270–271
mentorship program,68, 71, 78
on military psychologists’ scope of practice,334
on physician burnout,47
on popular media engagement,205Principles of Medical Ethics,205research as advocacy by,176, 182
structure of,70
veteran advocacy by,356
American Psychoanalytic Association,182, 356
American Psychological Association,182, 271
Arizona State University’s Learning Objectives Builder,159
Army Mental Health Diagnostic Manual,351
“Ask,”111, 130, 139,
140–
141, 173
Association of American Medical Colleges (AAMC),152–153
Association of Gay and Lesbian Psychiatrists,259
Asylum proceedings,293–294
Beers, Clifford,346–347
Biasadvocacy for overcoming,5–6, 82, 83–84, 85–87, 89–90, 279–280,
280cultural competency for addressing,281
decriminalization of addiction and,316
education as advocacy against,151
immigrant status and,279–280,
280mental health care accessibility and,37
socioeconomic factors and,36–37
Bird by Bird (Lamott),208Blank, Arthur S.,352
Bloom’s taxonomy,159,
161Boundary-spanning advocacy,403–405, 411–412
Bridgewater State Hospital,414–415
Burnout.
See Physician burnout syndrome
Call to actionadvocacy as professional responsibility,3–8, 10–12, 154,
155, 219, 366
the “ask,”111, 130, 139,
140–
141, 173
at state level,224–225
Camp, Norman,354
Campaign to Change Direction,356
CAN (Congressional Advocacy Network),226Cannabis use.
See also People with substance use disorders
cannabis use disorder,304
decriminalization of,316
Caregiver advocacy,239–241,
240,
242, 249–250, 371–373
CARE tasks,372
Carreon, David,199–
202Case examplesof advocacy in medical settings,367–368, 370–371, 375, 379, 381–382
of child advocacy,221, 223
of criminal justice advocacy,402, 403–404
of education as advocacy,221, 223
of health care system challenges,46, 47
of legislative advocacy,21–22, 126, 129, 134–135
of LGBTQ advocacy,263, 266
of military service advocacy,322, 336
of patient-level advocacy,4, 84–93
of popular media engagement,199–
202, 205–206
of PWSUD, advocacy for,311, 314–315, 317
of research as advocacy,176–181,
177CBP (Customs and Border Protection),290
CCBHCs (Certified Community Behavioral Health Clinics),413
Centers for Medicare and Medicaid Services (CMS)on maternal screenings,181
Medicare and Medicaid regulation by,237–238,
242on population health,356–357
on prescribing by psychologists,39
Certified Community Behavioral Health Clinics (CCBHCs),413
Charities and foundations, as research funding source,184,
186Children and families,217–231
advocating with patients and families,227–228
case examples,221, 223
clinical-setting advocacy for,371–373
Congressional Advocacy Network,226education as advocacy for,149–151, 221–225
grassroots effort advocacy for,220, 227
immigration advocacy for,291–292
legislative advocacy for,220–226
LGBTQ patients and families,265–266
medical setting advocacy for,372
mental health coalitions for,223, 226, 228
mental illness statistics,217–218
overview of advocacy for,218–220, 229–230
psychiatry advocacy training,228–229
school-level advocacy for,220–222
Children’s Health Insurance Program (CHIP),225–226,
286Chilton, Julie,55–56
Citalopram,180
Citizens Project,388–389, 393–395
Civil Rights Act (1964),369
Civil War veterans,345–346, 350
Class action litigation,35–36, 41, 415
Clay Hunt Suicide Prevention for American Veterans Act (2015),355
Clinical settingsclinical agency, definition of,82
family-level advocacy in,371–373
medical team–level interventions in,373–375
patient-level advocacy in,369–371
Clinician-level advocacyconsultation-liaison psychiatry,247, 366–368, 373–375,
374, 383
for LGBTQ patients,267
for military service members,325, 332
CMS.
See Centers for Medicare and Medicaid Services
Cocaine use disorder,304.
See also People with substance use disorders
Cochrane, Archie,171
Cognitive-behavioral therapy,37–38, 179
Columbus House,396
Communication skillsactive listening,61–64
collaboration skills,24,
24interpersonal skills,416–417
knowledge-based skills,156–157
messaging skills,64–66, 135–138,
158networking and engagement,159oral communication skills,24–25, 139, 142–144,
143, 156,
158overview,24–25,
24sociopolitical context awareness and,24, 25, 60–61,
62–
63storytelling,128, 193–194, 197–198, 224, 227–228, 303
written communication skills,24–25, 138–139,
140–
141, 156,
158, 195–198, 207,
208Community-level advocacy.
See Local-level advocacy
Confidentiality issuesfor criminal justice–involved patients,417
for military service members,328–330,
329,
331, 336–338
storytelling and,27, 204, 279
Confidentiality of Substance Use Disorder Patient Records,417
Conflicts of interest,26
Congressional Advocacy Network (CAN),226Connecticut Mental Health Center,396
Consultation-liaison psychiatry,91–93, 247, 366–368, 373–375,
374, 383
Consumer Reports (CR) Study,178–179
Continuing medical education,32, 152, 228–229
Conversion therapy,263, 271
Criminal justice–involved patients,401–421
barriers to advocacy for,415–418
boundary-spanning advocacy for,403–405, 411–412
case examples,402, 403–404
legislative advocacy for,412–414, 415
LGBTQ advocacy for,269
mental health systems interface,407
model advocacy frameworks,407–411
organization-level advocacy for,403–405
overview,401, 405–407
patient-level advocacy for,402–403
popular media engagement on,412–413, 414
recidivism rates,405–406
resources,419–420
Sequential Intercept Model,408–411,
409, 413
Stepping Up Initiative,410–411
substance use disorder advocacy for,405–407
training opportunities with,418–419
Worcester Initiative for Supported Reentry Program,412
Cultural competencyeducation on,154
for effective communication,136
for immigrant and refugee advocacy,280–281, 290
for patient-level advocacy,82–8491–93, 280–281
Cultural Formulation Interview,91, 92, 281
Customs and Border Protection (CBP),290
DACA (Deferred Action for Childhood Arrivals) program,277–279,
278“Declaration of Professional Responsibility” (AMA),3–4, 10–12
Decriminalization,304, 307–308, 315–317
Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury,354
Deferred Action for Childhood Arrivals (DACA) program,277–279,
278Demedicalization,312
Depressionin caregivers,239
chronic medical conditions and,366–367
immigrant and refugee status and,277–279
in LGBTQ patients,258
maternal depression screenings,181
in older adults,245–246
physician burnout syndrome and,44–45
psychotropic medication warnings and,180
stigma of,55–56
Destigmatization,309–311,
310, 317
Diagnostic and Statistical Manual of Mental DisordersDSM-I,351
DSM-II,259, 270–271
DSM-III,352
DSM-IV,176
DSM-IV-TR,176
DSM-5,176, 177, 259, 309
Diagnostic overshadowing,83–84, 375
Diffusion theory,23
Discrimination.
See also Bias; Social determinants of health; Stigmatization
advocacy against,77–78, 83–87, 91–93, 249, 267–269
ageism,249
cultural competency foraddressing,136, 281
health care accessibility and,36–37, 92
overview,5–6
Draft No. 4 (McPhee),198
Driving safety, for older adults,243–244
Drug overdose deaths,126, 305–307,
306DSM.
SeeDiagnostic and Statistical Manual of Mental DisordersDuckworth, Ken,107, 115–117
Dying in America (IOM),251,
252EBPs (evidence-based policies),33–38,
35, 170–173, 279–280, 281.
See also Research as advocacy
ED (emergency department) boarding,21–22
Education as advocacy,147–167.
See also Training and training opportunities; Popular media engagement
advocacy training programs,149, 152–164
case examples,221, 223
challenges of,149, 153–154
for children and families,149–151, 221–225
for criminal justice-involved patients,414
effective pedagogy,148–149
general public and,151–152.
for LGBTQ population,264, 265–266, 270–271
for older adults,246
overview,147–148
skills for,25, 58–60, 73–74
for veterans,356
Elder abuse,247
Eldercare Locator,239
Elder Justice Act (2010),247
Elevator speech,142,
143E-mail campaigns,224, 225–226, 227
Emergency department (ED) boarding,21–22
End-of-life care,251,
252Engel, Charles,354–355
Equality advancementhistorical trauma and,92
legislative advocacy for,77–78, 249, 269
patient-level advocacy and,83–87, 91–93, 267–269
role model interview,77–78
Ethical issuescommunication of,136–138
conversion therapy and,263, 271
older adult advocacy and,246–248
organization-level advocacy and,110
overview,13, 25–27
popular media engagement and,204,
205Evidence-based policies (EBPs),33–38,
35, 170–173, 279–280, 281.
See also Research as advocacy
Excellence in Mental Health Act (2014),413
Fact Magazine,205Families.
See Children and families
Family-level advocacyfor caregivers of older adults,239–241,
240,
242, 249–250
in clinical settings,371–373
education as advocacy,149–151
for end-of-life care,251
Fat and Blood (Mitchell),345
FDA (U.S. Food and Drug Administration),179–181
Federal-level advocacy.
See also Legislative advocacy
for caregivers,242for children and families,220, 225–226
class action lawsuits,35–36
for criminal justice–involved patients,413
for end-of-life care,252examples,51, 225–226
for immigrants and refugees,290
legislative process,123, 124–125,
125, 127–128
in medical settings,380–382
for older adults,239, 248–249
by professional organizations,225–226,
226by PWSUD,303
for research,172–173, 174
for veterans,357–358
Fellowship training,67–68, 71, 228–229
Firearm safety,246,
247, 330–332
Foreign-born population.
See Immigrants and refugees
The Forest for the Trees (Lerner),208Foundations and charities, as research funding source,184,
186Friedman, Matthew,352
Friedman, Richard,193
Fryer, John,259
GAP (Group for the Advancement of Psychiatry),351, 356
Gender-affirming medical care,269–270
Gender dysphoria,259, 269–270
General public education.
See Popular media engagement
Geriatric mental health advocacy.
See Older adults
Give an Hour,356
Global health reforms.
See Legislative advocacy
Gold, Jessica,199–
202Goldwater Rule,205Gorgas, William,348
Government.
See Legislative advocacy
Grassroots advocacyfor children and families,220, 227
definition of,227
legislative advocacy and,125,
125, 131, 132–133
strategies for,141, 198, 224
for veterans,353
Grief,55–56, 246
Group formation (theory),23
Group for the Advancement of Psychiatry (GAP),351, 356
Hatch Act (1939),26
Health advocacy.
See Advocacy
Health care system challenges,31–59
about,31–33
case examples,46, 47
medically necessary mental health care access,33–40,
35.
See also Medically necessary mental health care
parity of mental health care,33, 38, 40–41
physician burnout,43–49.
See also Physician burnout syndrome
pre-existing condition legislation,136–137
for PWSUD,313
recent trends,31–32
recommendations and conclusions,49
stakeholders for,376–378
stigmatization of psychiatry and,33, 42, 128, 151, 204–205, 207
workforce shortages,33, 40, 250–251, 416
Health Insurance Portability and Accountability Act (HIPAA) of 1996,323, 328–330,
329, 417
Health policy reforms.
See Health care system challenges; Legislative advocacy
Health-system level advocacy.
See Health care system challenges; Organization-level advocacy
Hearing impairment,241–243
Heroin,305–307.
See also People with substance use disorders
Hinckley v. Fair (1990),403
Historical trauma,92
Homeless populationorganization-level advocacy for,98, 100–101, 106, 108–109, 112
services for,388–389, 395–397
Hooker, Evelyn,258–259
Hospital-level advocacy,267–268, 350, 376–378
How to Write for a General Audience (Kendall-Tackett),207,
208Human rights violations,281, 292
IDES (Integrated Disability Evaluation System),327, 333
Immigrants and refugees,275–299
advocacy training and,290–294
asylum proceedings,293–294
bias against,279–280
Immigrants and refugees (continued)categories of,276,
276, 277,
278cultural competency and,280–281, 290
health care services for,283–284,
285–
288, 289–290
human rights violations and,281, 292
immigration status as social determinant of health,277–279
inadmissibility grounds,292
international students,292
naturalization process for,293
overview,275–277, 294
refugee, definition of,293
statistics,275–276,
276Supplemental Security Income (SSI) for,248
undocumented migrants,293
IMPACT strategies,279–280,
280Implicit biasadvocacy efforts for overcoming,279–280,
280cultural competency for addressing,281
definition of,279
immigrant status and,279–280,
280socioeconomic factors and,36–37
Institute of Medicine (IOM),176, 250–251,
252Institute on Aging,245–246
Integrated Disability Evaluation System (IDES),327, 333
Internalized homophobia and transphobia,258, 262, 264–265, 267
International students,292
Internet,198–203
The Invisible War (film),337
IOM (Institute of Medicine),176, 250–251,
252James, William,346–347
Jamison, Kay Redfield,55, 56
Kidd, Jeremy,211–213
Kinsey, Alfred,260
Koffman, Robert,355
Kotter, John P.,99–101,
102–
103Law Enforcement Assisted Diversion (LEAD) programs,316
Learner-centered education methods,159–161
Legalized marijuana,304, 316
Legislative advocacy,119–146
about,19–20
the “ask,”130,
141, 173
barriers to,416, 417–418
for caregivers of older adults,241,
242case examples,21–22, 126, 129, 134–135
challenges to,142–144
for children and families,220–226
for criminal justice-involved patients,412–414, 415
effective advocacy skills and knowledge,24–25,
25, 58–67, 121–135.
See also Communication skills
ethical considerations,25–27
federal-level process,123, 124–125,
125, 127–128
grassroots efforts,125,
125, 132–133
for immigrants and refugees,279–280
legislator relationships and,121, 123,
125, 127–131, 133, 173,
183, 193, 224, 381–382
for LGBTQ population,259–260, 271
local legislative process,123, 124–125,
125, 127–128
medical expert testimony as,132, 138–139,
140, 142,
143in medical settings,380–382
for military service members,324–325
necessity of,120
for older adults,237–239, 243, 244, 251
overview,119, 121–122, 144
policy development as,122, 125–127
policy influences as,171, 172–175
popular media engagement and,133, 225–226
professional organizations and,121, 124, 131, 133–134, 225–226,
226for PWSUD,302–303, 305–307, 312–313, 413–414
research and,172–173
resources,144–145
role model interview,77–78
state legislative process,123, 124–125,
125, 127–128, 132–135
strategies for,224
support and opposition of policies as,131–135
system of government and,122–123
10-state threshold,124
theories of,23
for veterans,352, 355–358
voting as,120
Legislative days,224–225
Letters to the editor,224–226
LGBTQ patientscase examples,263, 266
clinician-level advocacy for,267
education as advocacy for,264, 265–266, 270–271
family issues,265–266
gender-affirming medical care,269–270
gender expression,261,
262gender spectrum,260–261,
262history with psychiatry,258–260
hospitalization issues,267–268
legislative advocacy for,259–260, 271
in military,338
overview,257–258, 260–261, 271–272
public facility issues,269
queer, definition of,260
relationship issues,264–265
religious issues,268–269
role model interview on,211–213
sexual orientation spectrum,260–261,
262therapeutic interventions,261–264
Liaison Committee on Medical Education,47
Lifespan Respite Care Programs,241
Lifton, Robert,352
Lincoln, Abraham,345
Lobbyists,134, 174, 225
Local-level advocacyabout,19–20
for caregivers of older adults,242for children and families,220–223
citizenship, definition of,393
Citizens Project,388–389, 393–395
collaborations and,106, 107
community, definition of,387–388
for criminal justice-involved patients,413–414
for end-of-life care,252ethical considerations,25–27
goals of,388
for the homeless,388–389, 395–397
for immigrants and refugees,282–283,
284initiatives,378–379, 380
legislative process,123, 124–125,
125, 127–128
local government, definition of,122
in medical settings,378–379, 380
for older adults,238–239, 246, 249–250,
252overview,50, 387–389, 397
for PWSUD,303
for social justice,388–395
team building for,66–67
Loneliness,238–239, 246
Marijuana use.
See also People with
substance use disorderscannabis use disorder,304
decriminalization of,304, 316
Massachusetts Correctional Institution at Framingham,403–404, 417
Media advocacy.
See Popular media engagement
Media interviews,194–195
Medical education.
See Medical school training
Medical expertsat community level,221–222
oral testimony,132, 142,
143for popular media engagement,193
written testimony,132, 138–139,
140Medically necessary mental health care,33–40
accessibility challenges,36–37,
50–
51, 92, 324, 390–391
definition of,33–34, 35
insurance company denials,34–36
standards of care and,34,
35, 37–38
Medical retention standards (military),325–326
Medical school trainingadvocacy curriculum,71–74, 152–153, 382–383
physician burnout syndrome during,44–45, 47
Medical setting advocacy,365–386
barriers to,370–371, 372–373
case examples,367–368, 370–371, 375, 379, 381–382
for children and families,372
in clinical settings,82, 369–375
consultation-liaison psychiatry,91–93, 247, 366–368, 373–375,
374health system definition,376
legislative advocacy,380–382
at local level,378–379, 380
at organization level,376–378
overview,365, 368, 383–384
training on,382–383
Medical team-level interventions,373–375
Medicare Access and CHIP Reauthorization Act (2015),225
Medicare and Medicaid advocacyfor caregivers of older adults,242for immigrants and refugees,284,
285,
287–
288, 289–290
for older adults,241–243,
242overview,235–238,
236–
237,
239for PWSUD,312
for veterans,324
Menninger, William,351
Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008,41, 225, 312
Mental Health Parity Compliance Act, introduction of,41
Mental Hygiene Movement,346–347, 352
Mental Illness Research, Education and Clinical Centers (MIRECCs),353
Mentoring,47, 67–68, 71, 78
Men Under Stress (Grinker and Spiegel),352
Methamphetamine,304–305.
See also People with substance use disorders
Meyer, Adolf,346–347, 352
Military Child Education Coalition,355
Military service membersaccessions process,325–326,
327access to mental health care for,324
administrative separation and,333
as advocates,324–325
career impact of psychiatric diagnosis for,332–333
case examples,322, 336
chain of command and,326–330,
331, 332
confidentiality issues,328–330,
329, 336–338
fitness-for-duty assessments,327, 332–333
legislative advocacy for,324–325
means restriction,331–332
medical retention standards,325–326,
327mental illness statistics,323–324
military sexual trauma,336–338
overview,321–322, 338–339
as patients,323–324
referrals to military psychiatrist for,332
resources for,334,
335safety assessments,330–332
scope of practice considerations,334
suicide and,324, 330, 332
transgender service members,338
Military sexual trauma,336–338
“Mind Over Media” curriculum,206
A Mind That Found Itself (Beers),346
Minority stress, in LGBTQ population,258, 264
MIRECCs (Mental Illness Research, Education and Clinical Centers),353
Moral injury,32, 36, 47–48, 354, 355
Nash, William,354
National Academies of Sciences, Engineering, and Medicine,241,
242, 359–360
National Center for PTSD,352–353
National Center on Elder Abuse,247
National Family Caregiver Support Program,240–241
Neuroimaging research,176–178
New York Timeshuman behavior column,193
on popular media engagement,191
on Rikers Island jail,414
Non-quantitative treatment limitations (NQTLs),41
Older adultsadvocacy resources,241,
242aging in place,249–250
caregivers for,239–241,
240,
242, 249–250
case example,234–235, 244–245, 249–250
driving safety,243–244
end-of-life care,251,
252ethical considerations,246–248
geriatric psychiatry workforce shortages,250–251
Medicare and Medicaid advocacy for,241–243,
242Medicare and Medicaid overview,235–238,
236–
237,
239overview,233–235, 252
social determinants of health for,244–246, 248–249
social isolation and loneliness,238–239
stigma of aging,244–246, 249
suicide and,244–246,
247Older Americans Act (1965),238
Older Americans Act Reauthorization Act (2016),238, 240, 243
Online communication,198–203
Only as Good as Your Word (Shapiro),208OpEd Project,197
Op-eds,133,
141, 196–197, 226
Opioid use.
See also People with substance use disorders
decriminalization,405
legislative advocacy and,413
opioid epidemic,126, 305
opioid use disorder,302–303, 305–307, 313, 392
overdose deaths,405
Oral communication skills,139, 142, 143–144,
143, 156,
158Organizational chart,105–106
Organization-level advocacy,97–114.
See also Professional organizations, advocacy by
about,18–19,
19boundary-spanning advocacy,403–405, 411–412
career integration strategies,69–71
case example,98, 100–101, 106, 108–109, 112
collaborations at other levels,106, 107
commitment of leadership for,416
context for,98
credibility and perception,109
definition of,98–99
ethical considerations,27
examples of,4, 21–22, 376–378
framework for,99–104,
102–
103goal-setting,99, 105, 110–111
health systems and,267–268, 350, 376–378
hierarchical organization and,107–109
for homeless population,98, 100–101, 106, 108–109, 112
against implicit bias,279–280,
280initiatives,376–378
internal versus external advocacy,106, 107, 109–110
leadership levels,105–106, 107–109
in medical settings,376–378
for older adults,243, 251
organizational chart for,105–106
overview,50, 97–98, 113
pitfalls of,109–111
role model interviews,77–78, 115–117
scope and,99, 105, 110–111
stakeholders and,106, 107
team building,66–67
theories of,23
urgency and,100, 101–104
for veterans,346–347, 352
Organizing Forums on Children’s Mental Health (AACAP),67
Overdose deaths,126, 305–307,
306Paraclinical agency,82
Parents and Friends of Lesbians and Gays,264–265
Pathways to Independence (PTI) project,396–397
Patient-level advocacy,81–95.
See also Children and families; Military service members; Older adults; Veterans
about,5–8,
7, 18,
19case examples,4, 84–93
in clinical settings,369–371
for criminal justice-involved patients,402–403
cultural competency and,82–84, 91–93, 280–281
definition of,82
for “difficult” patients,89–90
for end-of-life care,251
ethical considerations,25, 27
for ethnic-based treatment equality,85–87
for immigrants and refugees,291–292
for LGBTQ population,262–264
for older adults,243–244, 247–248
for overcoming implicit bias,279–280
overview,50, 81–83, 93
principles of,83–84
for PWSUD,309–310,
310for subtle presentations,87–89
during treatment team disagreements,89–90
for veterans,358, 360
Patient Protection and Affordable Care Act (2010)on elder abuse,247
as federal-level advocacy example,225
for immigrants and refugees,287, 289
Medicaid expansion and,284, 312
psychiatry reimbursement and,324
Peer support programs,284, 352, 377–378
People with substance use disorders (PWSUD),301–320
alcohol use disorder,303–304
cannabis use disorder,304
case examples,311, 314–315, 317
cocaine use disorder,304
criminal justice involvement by,405–407
decriminalization,315–317
destigmatization,309–311, 317
immigrant and refugee status and,277
in LGBTQ population,258
minorities and,307–308
opioid use disorder,305–307, 313
overview,301–303, 317
remedicalization,312–315, 317
resources,317–318
rural settings,307
sedative-hypnotic use disorder,305
stimulant use disorder,304–305
urban settings,307
Perinatal mood and anxiety disorder screenings,181
Pershing, John J. “Blackjack,”348, 350
Pharmacotherapy,38, 179–180
Physician-advocate role.
See also Education as advocacy; Training and training opportunities
activist, definition of,57–58
agent, definition of,57–58
challenges facing psychiatry,33–59.
See also Health care system challenges
definition of,4, 57–58
ethical considerations,13, 25–27.
See also Ethical issues
finding your voice,143–144
health advocacy definition of,3–5
mental health care use by,55–56
practical constraints,143
practice of,10–14
professional responsibility and,3–8, 10–12, 154,
155, 219, 366
recommendations and conclusions,49
role models interviews,55–56, 77–78, 115–117, 211–213
as specialization within medicine,27–29
training and skills for,13, 24–25, 57–76
Physician burnout syndrome,43
causes,32, 36, 43–45,
50–
51education on,154,
155impact of,33, 45–46
management of,33, 46–49
prevention,33, 47–49
symptoms,43, 44–45
PIE model, for combat stress control,348
“Pivot” in media interviews,195
Policy continents,174
Policy makers,172–173
Policy windows model,21–22
Political advocacy,9–10
Political organizations,174
Pop psychology books,198
Popular media engagement,191–210
barriers to,204–205
blogs,141, 202–203
book writing,198, 353
case examples,199–
202, 205–206
conventional writing,195–198, 207,
208for criminal justice advocacy,414–415
destigmatization of substance use disorders through,303, 310
documentaries as,337
as education outlet,152
e-mail campaigns,203, 224, 225–226, 227
ethical considerations,27
examples of,4, 21–22, 205–206
goal of,192–193
legislative advocacy and,120, 133, 225–226
letters to the editor,133,
141, 197
long-form pieces,198
media advocacy, definition of,192
media interviews,194–195
by military service members,325
military sexual trauma and,337
online communication,141, 198–203
op-eds,133,
141, 196–197
overview,191–193
podcasts,142, 199–202
policy influences and,173–174
research advocacy and,183role model interview,211–213
short-form pieces,197–198
social media,120, 203–204
storytelling,193–194, 197–198, 303
talk show call-ins,133
veteran advocacy through,345–346
videos,202
Population health,356–360, 366–367
Population-level advocacy,19–20,
19.
See also Federal-level advocacy; Local-level advocacy; State-level advocacy
Posttraumatic stress disorder (PTSD),348, 352–353
Power politics (elites) theory,22–23
Prescription opioids,305–307.
See also People with substance use disorders
Prevention Point Philadelphia needle exchange program,314
Professional organizations, advocacy by.
See also specific organizationscommunication specialists at,195
for end-of-life care,252legislative advocacy by,121, 124, 131, 133–134, 225–226,
226at mental-health-criminal justice interface,419–420
for older adults,238
physician involvement in,69–71, 121, 124
public relations and,173–174
resources,144–145
for veterans,346–347, 352
Project Ecosystem,184
PsychArmor Institute,356
Psyched! podcast,199–
202Psychiatric Times,202Psychiatry consultation-liaison (CL) team,91–93, 247, 366–368, 373–375,
374, 383
Psychiatry Milestone Project,12, 153
Psychiatry workforce shortage,33, 40, 250–251, 416
Psychodynamic therapy, accessibility of,37–38
PTSD (posttraumatic stress disorder),348, 352–353
Public awareness.
See Popular media engagement
Public opinion,151–152, 173–174,
183.
See also Popular media engagement
Public psychiatry fellowship,71
PWSUD.
See People with substance use disorders
Race and racismhistorical trauma,92
patient-level advocacy and,85–87, 91–93
for PWSUD,307–308,
308, 315–316
RAND Corporation,357–358, 360
RAND Europe,184
Ready to Serve (RAND Corporation),357–358
Redfield Group,55–56
“Red flag” gun laws,246
Refugees.
See Immigrants and refugees
Religious issues, for LGBTQ population,268–269
Remedicalization,312–315, 317
Research as advocacy,169–189
barriers to,182,
183on caregivers,242case examples,21–22, 176–181,
177evidence-based policies,33–38,
35, 170–173, 279–280, 281
funding and,172, 174, 175,
183, 184,
185–
186,
242influences on legislative policies,171, 175,
183by military service members,324–325
neuroimaging research,176–178
overview,184–185
perinatal moods research,181
popular media engagement for,191–193
psychotherapy research,178–179
psychotropic medication research,179–181
research aims,169–170
research consumers, definition of,170
research versus advocacy,170,
171translational science and,176–181,
177for veterans,353–355, 357
written communication skills for,191
Residency training curriculum,155–164
APA opportunities,71
clinical-educator tracts,149
components of,156
core advocacy skills,156–157,
158–
159educational methods,159–161,
161–
162elements of,157–163
evaluations of,163
goals and objectives of,157–159,
160implementation of,163–164
media advocacy programs,205–206
mentorship programs,67–68, 71
overview,153–156,
155Rikers Island jail,23, 414
Ritchie, Elspeth Cameron,354
Role model interviewsadvocacy through self-disclosure,55–56
organization-level advocacy,77–78, 115–117
popular media engagement,211–213
Royal College of Physicians and Surgeons of Canada,12
Rural settings,37, 307,
308Salmon, Thomas,347–350
SBARE communication framework,373,
374School-level advocacy,220–222
Second Chance Act (2007),413
Sedative-hypnotic use disorder,305.
See also People with substance use disorders
Self-advocacy,33, 49,
50, 357
Self-disclosure, advocacy through,55–56
Sequential Intercept Model,408–411,
409, 413, 414
Sertraline,180
Sexual trauma (military),336–338
Shatan, Chaim,352
Shay, Jonathan,355
Shell shock,348
Show Me the Evidence (Cochrane and Haskins),172
Skills, for effective advocacy.
See Communication skills; Training and training opportunities
SOAR (SSI/SSDI Outreach, Access, and Recovery) Technical Assistance Center,396–397
Social determinants of healthfor criminal justice-involved patients,407
cultural competency for addressing,281
definition of,61
education on,153, 154, 164, 383
federal-level advocacy and,380–382
immigrant status,277–279
legislative advocacy and,120
local-level advocacy and,388–393
for older adults,244–246, 248–249
overview,61,
62–
63Social inclusion,393–395
Social isolation,238–239
Social justicebarriers to,415–418
health care access and,36–37, 92, 390–391
local-level advocacy for,388–395
patient-level advocacy and,85–87, 91–93
Social media useas education outlet,152
as federal-level advocacy,226
policy influences of,174
for substance use disorder advocacy,313
voting and,120
written communications for,141Social medicine,8
Social Security,248–249
Society of Uniformed Services Psychiatrists,356
Somers, Howard and Jean,355
Stakeholder organizations.
See Professional organizations, advocacy by
Standardized discharge initiatives,376–378
Stanford University’s “Mind Over Media” curriculum,206
State-level advocacy.
See also Legislative advocacy
for caregivers of older adults,242for children and families,220, 224–225
collaborations at other levels,106, 107
for criminal justice–involved patients,415
for firearm safety,246
for immigrants and refugees,282
initiatives,380
legislative process,123, 124–125,
125, 127–128, 132–135
for LGBTQ population,263, 271
in medical settings,380
mental health care accessibility,37
for older adults,244, 246–247
overview,51for PWSUD,303
for veterans,356, 358
Stepping Up Initiative,410–411
Stigmatizationof aging,244–246, 249
clinician-level advocacy and,375
of criminal justice–involved patients,406
cultural competency and,281
of depression,55–56
education on,154,
155of gender diversity,267–268
immigrant and refugee advocacy and,284internalized homophobia and transphobia,258–259, 262, 264–267
of LGBTQ military service members,337
of mental illness,42–43, 149, 406
of military service members seeking mental health services,323, 334,
335of military sexual trauma,336–337
of opioid epidemic,302–303
overview,5–6,
50–
51patient-level advocacy and,83–84
of psychiatry profession,33, 42, 128, 151, 204–205, 207
of PWSUD,307–311,
310of substance use disorders,315–316
Stimulant use disorder,304–305.
See also People with substance use disorders
Storytellingfor children and families advocacy,227–228
for legislative advocacy,128, 224
for popular media engagement,193–194, 197–198
Storyworthy (Dicks),194,
208Substance use disorders.
See People with substance use disorders
Subtle presentations, patient-level advocacy for,87–89
SuicideLGBTQ patients and,258
military service members and,324, 330, 332
older adults and,244–246,
247physician burnout syndrome and,45
population health model on,358 veterans and, 355
Suicide Prevention Resource Center,245
Supplemental Security Income (SSI),248–249
Tactical theories, of advocacy,23
Team building,66–67, 89–90,
158.
See also Consultation-liaison psychiatry
10-state threshold,124
ThriveNYC,392
Titicut Follies (documentary),414–415
Title VI, of Civil Rights Act (1964),369
Training and training opportunities,57–76
barriers to,58
career integration strategies,68–73
case example,73–74
for child advocacy,228–229
communication skills,24–25,
24, 58–67
on criminal justice advocacy,418–419
on immigration literacy,290–294
implicit bias training,279–280
lifelong advocacy strategies,74–75
for medical providers,152–155
medical school curriculum,71–74, 152–153, 382–383
mentoring,47, 67–68, 78
overview,57–58, 164–165
on patient-level advocacy,85–87
physician-agent, definition of,57–58
residency training curriculum,155–164
resources,75–76
on social determinants of health,153, 154, 164, 383
social position leveraging,66
team building,66–67, 89–90,
158Translational science,176–181,
177, 182
TRICARE,324
21st Century Cures Act (2016),413
Uniformed Services University (USU) School of Medicine,353
United Behavioral Healthcare,36
Universities.
See Academic institutions;
specific universitiesAn Unquiet Mind (Jamison),55
Urban settings,37, 307,
308U.S. Army Psychiatry in the Vietnam War (Camp),354
U.S. Department of Veterans Affairs,242, 345, 350–351, 352–353, 359–360
U.S. Food and Drug Administration (FDA),179–181
U.S. Immigration and Customs Enforcement (ICE),290
USU (Uniformed Services University) School of Medicine,353
VA Mission Act (2018),360
Varenicline,180
Veterans,343–364
access to mental health care,324
advocacy by,357–358
case example,344
current advocacy highlights,353–356
education as advocacy for,356
history of,345–353
legislative advocacy for,352, 355–358
organization advocacy for,346–347, 352
overview,343–344, 359, 360
population health,356–360
research as advocacy for,353–355, 357
resources for,361–362
Veterans Administration,347–348, 350.
See also U.S. Department of Veterans Affairs
Vietnam stress syndrome,353
Vietnam War veterans,352–353, 354
Vietnam Wives (Matsakis),353
Vignettes.
See Case examples; Storytelling
Virchow, Rudolph,8, 389
Visual impairment advocacy,241–243
Voting,120
Walter Reed Army Institute of Research,353–354
Webinars,152
Whistle-blowers,110
Wit v. UBH/Optum (2019),36
Worcester Initiative for Supported Reentry Program,412
Words That Work (Luntz),137–138
Workforce shortages,33, 40, 250–251, 416
World Health Organization,5, 249, 376
World Professional Association for Transgender Health (WPATH),267, 270
World War I veterans,348–351
World War II veterans,351–352
Writing to Change the World (Pipher),208Written testimony,132, 138–139,
140X-license waiver training,313
Yale School of Medicine,205–206, 396
Youth.
See Children and families
Zarit Caregiver Burden Scale,372
