Resident as Advocate: Extending Your Commitment

As a resident committed to improving the well-being of people with mental illness through local, state, and federal action, I encourage you to consider joining me in this work. Why get involved in advocacy? Mental health services are poorly funded, with low reimbursements to clinicians and financial loss to many outpatient clinics. Even integrated mental health practices with clinical efficacy are difficult to support financially after initial research demonstration funds end. Advocacy is needed to expand mental health access and continue research. Hopefully, sustained advocacy efforts can collectively bring about systemic changes that improve care.

There are several ways to be involved in advocacy, and they are not time consuming. One way is through direct participation in the political process. For example, several of my co-residents and I went to Hartford, Conn., earlier this year to testify at a public hearing against budgetary cuts to our premier community mental health centers in Connecticut. We sent out emails to organize the event and drove about 45 minutes to Hartford. At the event, we waited in a large caucus room until our names were called. We read our prepared statements in front of a camera and members of Congress. Our testimony was broadcast on local television. Afterward, the department featured our advocacy efforts at Grand Rounds.

Similarly, attending conferences can offer insight on current issues in psychiatry. This year, I attended a conference by the National Association of Psychiatric Health Systems, where I met Sen. Chris Murphy (D-Conn.), who is the cosponsor of comprehensive mental health reform legislation in the Senate. The bill allows for patients to partner with providers and their families to gain better access to care. Last year, I went to APA’s Institute on Psychiatric Services, where I first learned about evidence-based integrated care models that improve access to care. These opportunities allow for resident engagement in national discussions on policy ideas and changes.

Just last month, APA launched its Congressional Advocacy Network (CAN), whose goal is to amplify the voice of psychiatry in Congress through an intensive program matching psychiatrists in every state and Congressional district with a member of Congress. You can join in this effort by becoming a Congressional Advocate. Congressional Advocates will serve as key contacts when important issues come before Congress, so that psychiatry can quickly deliver its message to Congress through direct, personal communication. The CAN program will also complement the efforts of the district branches and state associations (DBs/SAs) and be used as a resource for both the DBs/SAs and APA when federal issues arise that require a quick response. If you are interested in the program, contact Ashley Mild at [email protected] or Adam Lotspike at [email protected] of APA’s Division of Government Relations. More information can be accessed here.

Writing can also be a powerful way to participate in the political process. Members of Congress want to hear from constituents (particularly physicians, because they are thought to offer a unique voice as a group). The email addresses of senators and representatives are posted online, and their offices are a phone call away. Either emailing or calling works well. I’ve had responses within 24 hours using both methods. You can often email your message directly or can schedule an appointment to speak to your representative at a time that works for you (for example, an afternoon off from clinic). This can occur at the state or national level. To make it easy for you to contact your federal members of Congress, just visit APA’s advocacy website, where you can send pre-composed letters to members of Congress and learn about new mental health legislation.

You can also become an advocate at your home institution by creating a forum for discussion. I worked with other residents from my program to create a discussion group among those interested to learn more about models for psychiatric services and policy implications for mental health reforms. We were able to recruit faculty mentors to help suggest local experts and discussants who could give brief, informal presentations to facilitate conversation. The monthly group gathering is an opportunity for social engagement that has strengthened participants’ knowledge about parity laws and other reforms in the context of patient struggles. We were fortunate to have our state’s deputy commissioner, Miriam Delphin-Rittmon, who oversees all mental health and substance abuse services in Connecticut, come and talk about state-level approaches to mental health challenges. After making the connection, she invited us to help with active projects such as working on recovery-model patient and family-driven research collaborations and participating in advocacy issues around opiate addiction.

As a trainee, you deserve the opportunity to learn about advocacy and discover innovative strategies for change. There are many ways to be engaged beyond the ones that are listed. Find what works for you. The process can really help you grow as a clinician and provide new opportunities for personal and professional development. I know it has for me. ■