Building on 2022’s Successes in the Year Ahead

It’s hard to believe that I’m writing to you at year’s end and have crossed the halfway point in my term as your president. It has been an honor and a privilege to serve these past six months, and together we have accomplished important work as an organization and as a profession. We find ourselves now in the midst of a national mental health crisis that started long before the COVID-19 pandemic catapulted the need for mental health care in this country front and center into the public eye. We need to build on our accomplishments in 2022 to confront the challenges we are facing as we lead on the path to a more equitable and mentally healthy nation.

Though COVID-19 and its variants remain a serious concern, 2022 saw a return to the face-to-face interactions with colleagues and friends that were sorely missed during the worst of the pandemic. I feel very lucky to have assumed the presidency during the Annual Meeting in New Orleans, our first in-person meeting in two years. The energy and enthusiasm generated there and at our recent in-person meetings at the APA State Advocacy Conference (APA Unveils Prior Authorization Model Legislation) and the Mental Health Services Conference are testament to the preparedness and commitment of APA members and the administration to foster the free and considered exchange of ideas toward meaningful mental health impact, including access, equity, parity, stigma, and eradication of structural and systemic racism and oppression.

In 2022, we also had success advocating to lawmakers on key issues for psychiatrists and those we serve, including mental health parity, telehealth, and safe prescribing. APA was one of the key leaders of the Mental Health Liaison Group, a coalition of organizations that sent a letter to Congress signaling strong support for the Behavioral Health Coverage Transparency Act of 2022. This legislation would provide for increased implementation and enforcement of federal parity laws. We continued our work to support parity enforcement with the Department of Labor with the assistance of our state and federal advocacy teams. During a congressional briefing hosted by the Bipartisan Policy Center in October, I made the case to lawmakers that the restrictions on telehealth relaxed during the pandemic should be made permanent. Also in October, I participated in a policy briefing at the CATO Institute supporting safe prescribing and opposing psychologist prescribing. These issues are key to realizing safe, affordable, accessible, high-quality mental health care for every American.

Within APA, diversity, equity, inclusion, and belonging remain a top priority. We’re taking both top-to-bottom and bottom-up approaches in our work, with the Division of Diversity and Health Equity (DDHE) spearheading external efforts regarding our patients and the psychiatric workforce in general, and internal attention to the APA membership and administration. In September, APA launched the Structural Racism Accountability Dashboard, which notes APA’s progress on the 18 recommendations made by the Presidential Task Force on Structural Racism Throughout Psychiatry in 2021. Last month, the Board of Trustees voted to reconstitute the Structural Racism Accountability Committee with broader membership and staff support from the Membership Department and DDHE not only to advance its work at the leadership level of APA but also to promote extension to district branches and individual members. In addition, a workgroup to assess the definition of minority and underrepresented (M/UR) groups in APA and examine terminology for the future is underway; members will be asked to submit comments later this winter for the Board’s consideration.

Another important achievement in 2022 was the release of the APA report “The Psychiatric Bed Crisis in the U.S.: Understanding the Problem and Moving Toward Solutions.” The Task Force on Assessment of Psychiatric Bed Needs in the United States, convened by then President Jeffrey Geller, M.D., M.P.H., did exceptional work in creating this vital resource. Not only does it paint a clear picture of where we are now in terms of psychiatric bed supply in the United States, but also it offers solutions and a functional model to identify areas with the most need so that resources can be allocated most effectively. Past President Anita Everett, M.D., led the task force.

We must continue to make the most of every opportunity to develop sustainable and scalable models of care delivery. In addition to the model on psychiatric beds and determining community mental health needs, this includes furthering the adoption of the Collaborative Care Model and working in conjunction with other stakeholders in mental health care to rebuild our broken system of care. Our sister organizations are on board, and the Mental Health Services Conference was an important step in bringing leaders and professionals across mental health disciplines together in a forward-looking, solutions-focused endeavor.

In 2022, we saw a 6.7% increase in the number of medical school graduates matching into psychiatry. While this is an important gain, it is still not enough to keep pace with the demand for psychiatric care that exploded during the pandemic and shows no signs of slowing down. Looking ahead, growing the psychiatric workforce with an emphasis on diversity, equity, and inclusion and mitigating the physician shortage by promoting team care and collaboration will remain high on our list of priorities. My workgroup on the Roadmap for the Future of Psychiatry is hard at work identifying the steps APA needs to take now to be prepared for where we need to be in a decade and beyond. Early next year, I’ll report out more about this effort.

Engagement from APA members is especially important as we work to identify priority areas for action and advance our mission in the coming year. One of the best ways every member can have a say in what course our organization charts into the future is by participating in the APA election. I know that APA members are passionate and always ready to share thoughts on issues and goals. Let’s translate that energy and activism into participation at the “ballot box” this election cycle (Meet the Candidates for APA’s 2023 Election). As an APA member, your voice is important and can have tremendous power, but only if you make yourself heard.

As we head into the holiday break, I offer my heartfelt thanks to APA members and to the APA and APA Foundation administration for their work and dedication to advancing psychiatry and mental health. We’ve come a long way, yet the road ahead is still long. I’m excited and hopeful about what we can achieve together in 2023. I wish you all happy and healthy holidays and a joyous new year. In the meantime, as always, please follow me on Twitter @Pres_APA ... and be in touch. We will keep the momentum going next year! ■