Incoming President Vows to Lead APA and Psychiatry in ‘Claiming Our Future’
Renée Binder, M.D., says that the Association must claim its future as the leader in psychiatry in five key areas.
Incoming APA President Renée Binder, M.D., vowed to lead psychiatry in claiming its future with regard to the provision of psychiatric care within the overall medical system, care of the disenfranchised and marginalized, advocacy and ethics, and education and research.
Incoming APA President Renée Binder, M.D., has a special passion for the issue of incarcerated people with mental illness and says it will be the subject of a major event during her presidential year.
David Hathcox
In an address at the Opening Session of APA’s 2015 annual meeting in Toronto, Binder outlined the theme of her presidential year—“Claiming Our Future”—and described five areas where she hopes to help lead the field in claiming its future.
Binder is a professor of psychiatry and associate dean in the Office of Academic Affairs at the University of California, San Francisco, School of Medicine and director of the school’s Forensic Psychiatry Fellowship.
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The provision of psychiatric care within the overall, general medical system. “The United States is in the midst of health care reform and the development of new models of care,” she said. “We have fought hard and accomplished our pursuit of parity legislation, but now we must make fair and equal insurance coverage of mental health a reality. There is no health care without mental health care. Say it with me: There is no health care without mental health care. Every consumer, every politician, and every health care provider should agree with that statement.
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The provision of services to people with serious mental illness and to patients who are disenfranchised and marginalized. “It is a national tragedy that so many patients with serious mental illness—some of whom used to be treated in psychiatric settings and others who never received the community-based care that they were promised—are now being incarcerated and treated in prisons and jails,” Binder said. “One of the themes of my presidential year will be to highlight this issue, including having a summit and a major event in April 2016, sponsored by APA and in collaboration with other organizations and political figures who agree that this problem must be ameliorated.”
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Leadership in advocacy and ethics. “Some psychiatrists question the value of APA membership,” Binder said. “I would like them to imagine: What if APA did not exist? Who would speak for us? The American Psychiatric Association is our voice in legislatures and in the U.S. Supreme Court through amicus briefs when mental health issues are involved. This advocacy role will be especially important in the upcoming presidential election year.”
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Determining quality standards and educating the public. “In 1844, 13 superintendents of public and private hospitals for people with mental illness met in Philadelphia to set standards for their institutions and to help each other improve the treatment of their patients,” Binder said. “This was the beginning of the American Psychiatric Association.
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Research and diagnosis. “The most recent DSM is an outstanding accomplishment that involved over a decade of work and input from hundreds of researchers and clinicians who reviewed the world’s literature and decided whether diagnoses are valid and evidence based,” Binder said. “DSM allows consistent and reliable diagnoses to be made whether someone is sitting in San Francisco, New York, Toronto, or any other place in the world. As our discoveries elicit new understandings of mechanisms and treatments, we will incorporate them into DSM. Psychiatrists and the American Psychiatric Association need to continue to be responsible for this document and its revisions. Treatment guidelines are another huge accomplishment of the American Psychiatric Association. Determining the most effective treatments and guiding the practice of psychiatric care is a crucial part of our ongoing role and responsibility as psychiatrists.”
“As part of health care reform, we need to stand together with our other medical colleagues and provide necessary mental health care to patients who access the health care system,” she continued. “New models of care include embedding psychiatric services in medical clinics, collaborative/consultative care including utilizing other mental health disciplines, and use of new technologies such as telepsychiatry. During this next year, one of my presidential initiatives will be to enhance our efforts in telepsychiatry and to develop educational materials and resource documents for our members and governmental agencies.”
One of the nation’s prominent experts in psychiatry and law, Binder expressed a special passion for the issue of incarcerated individuals with mental illness and told psychiatrists at the meeting that this month she would be taking members of the APA Executive Committee to visit San Quentin State Prison.
“This will be a first step in our renewed effort to focus attention on the inappropriate criminalization of people with mental illness,” she said.
Binder said APA has set the bar high when it comes to ethical standards, and she cited as an example the APA position developed in response to the Bush-era practice of “enhanced interrogations.” “APA developed a position statement that prohibited the participation of psychiatrists, whereas the American Psychological Association allowed such practices,” Binder said. “We set the ethical guidelines for how psychiatric care should be provided. During this next year, we will examine our code of ethics and ensure that it is up to date and continues to serves as a standard for practicing psychiatrists.”
“The Affordable Care Act requires quality measurement, and payers for health care are insisting on quality indicators because they want to pay for value and not just service. This determination of quality is a continuation of what APA was set up to do in 1844 when the superintendents first met. In addition, one of the important jobs of the American Psychiatric Association is to provide state-of-the-art information to the American and international communities. This is represented by our publications, our annual meetings in the spring and the fall, and various workshops and webinars that are provided throughout the year.”
She concluded: “It is clear that we have our work cut out for us. … Let us look to the future and claim our roles in the care of our patients and in enhancing the mental health care of our society. Let us begin! If not now, when?” ■
A video interview of Binder commenting on her presidential plans can be accessed here.
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Published online: 11 June 2015
Published in print: June 6, 2015 – June 19, 2015
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