My Last Column

This is my last president’s column for Psychiatric News. The past year has been an incredibly busy but an amazing year—and a great and humbling privilege.

I can summarize my feelings in three words—gratitude, pride, and contentedness.

My gratitude extends to all APA members for their trust and faith in my ability to lead this wonderful organization representing 33,000 psychiatrists—the largest psychiatric society in the world. For someone born, raised, and educated thousands of miles away, even belonging to APA seemed like a fantasy, let alone the ability to become its president. I still have a sense of disbelief at how lucky I have been. APA is a microcosm of our country. “E pluribus unum” (out of many, one), the phrase on the seal of the United States, reflects both diversity and unity and symbolizes APA just at it does for the nation. APA members differ in age, gender, ethnicity, subspecialty, political views, geography, and what have you; yet we all are united around the common goal of promoting highest-quality health care for people with mental illnesses.

I am indebted to the invaluable help given by members of the Board of Trustees, the Assembly, the district branches, and the various councils, committees, and work groups. Since last May, I have traveled extensively across the country and internationally and have had an unbelievable opportunity to see the many great things our members have accomplished for their patients, colleagues, and communities at large. Equally importantly, I want to express my heartfelt appreciation to all the APA staff for their service, commitment, and hard work. I also want to thank my family and my colleagues, trainees, and staff at the University of California, San Diego, for allowing me to spend countless hours working on APA-related issues.

I feel proud to be a psychiatrist. We would not have seen mental health parity without long-term vigorous efforts on the part of thousands of psychiatrists, along with other groups. I am also proud that during the past year, two major tasks of historic proportion were accomplished: completion, approval, and publication of DSM-5 and selection of a new medical director/CEO.

The work on DSM-5 has been going on for at least a decade, involving mental health experts all over the world. My task, as president, was to ensure finalization of the criteria and text, which were approved by the Board of Trustees in December 2012. This required tremendous amount of coordination and collaboration involving the DSM-5 Task Force (led by David Kupfer, M.D.), 13 work groups, Scientific Advisory Committee, Clinical and Public Health Committee, Assembly Committee, and Forensic Review Group, along with experts in criteria, coding, and field trials—and most importantly, the public at large. There were 23,000 public comments sent to APA! Last May, I formed a new Summit Group to ensure that the various groups worked together in a democratic yet timely and efficient manner. DSM-5, reflecting unprecedented collaborative work, will be published by the time you read this. (If you are reading this column at APA’s 2013 annual meeting, you may purchase your copy in advance of the public at the APP Bookstore in the Exhibit Hall.)

The task of choosing APA’s next medical director/CEO was not simple. Jay Scully, M.D., will be stepping down at the end of 2013 after a decade of incredible service to the organization and to the mental health field as a whole. How can you find a successor who will fill Dr. Scully’s big shoes? I formed a search committee composed of several major leaders in psychiatry and chaired by Paul Appelbaum, M.D., a distinguished past president of APA. I am happy to report that the selection process has progressed smoothly and effectively, and we will announce the new leader at the annual meeting.

APA’s other challenges during the last year ranged from continually fighting discrimination against people with mental illnesses by insurance companies, to advocating for better Medicare and Medicaid reimbursements for psychiatric care. APA and the district branches stepped forward to provide critical help during the crises sparked by brutal mass murders in Aurora, Newtown, and Boston. We planned strategies for the future in areas such as international membership and mentoring next-generation psychiatrists. This APA year will end on a high note, with the history-making annual meeting. Not only are we celebrating the publication of DSM-5, but also, for the first time ever, a president of the United States (President Bill Clinton) is our keynote speaker, signifying the rising stature of our organization and our field. Three Nobel laureates and many other outstanding scientists, clinicians, and educators are gracing the conference as well.

I feel contended that, as APA president, I have tried to do my best during the past year by working as hard as possible and focusing on what was in APA’s best interest rather than mine.

I want to add a special note about these Psychiatric News president’s columns. I have thoroughly enjoyed the regular dialogue with APA members through these biweekly columns. I sought to use them to explore different topics relevant to psychiatry—from positive psychiatry and successful aging to child psychiatry and diversity, from international activities and psychosocial interventions to new technology and advocacy, to name a few. I am sincerely appreciative of the many inspiring conversations I have had with readers and for the involvement of invited guest writers who took time out of their busy schedules to contribute to these columns. I also want to thank the wonderful staff at Psychiatric News, led by Jeff Borenstein, M.D.

I would not trade this past year as APA president for anything else, even though it included countless hours of work and my share of sleepless nights! Sometimes people ask me what is the best part of the APA presidency. Is it the honor of being invited to the White House to join President Obama for the announcement of the BRAIN initiative? Is it introducing Bill Clinton at the annual meeting? While those certainly are unforgettable moments, the most rewarding part for an APA president is to hear a member say “Thanks for what APA is doing”—that is simply priceless.

Moving forward, the future of psychiatry and of APA is bright. Sure, we will go through some difficult times, but we will come out ahead. We have succeeded in the past, and we will succeed again. APA will continue to be the voice and conscience of modern psychiatry. I wish all the best to our incoming President Jeff Lieberman, M.D., a long-time friend and distinguished colleague.

Thank you for giving me the opportunity to lead our charge this past year. Robert Baden-Powell told the Boy Scouts: “Leave this world a little better than you found it.” This should apply to presidents too. Am I leaving APA a little better than I found it? This will be for others to judge. However, I do know that APA and all of you have left me much better than before. For that, I will be eternally grateful. ■