APA Assembly: ACROSS Can Help You Find Your Voice

Is any of my treatment making a difference anyways? These patients are just going to be back on the streets and back here in a couple of months.” These are common ruminations for a new inpatient attending at a local urban hospital as she becomes entrenched in the daily grind of inpatient psychiatry practice. These feelings can be all too common throughout the country, where psychiatrists are balancing patient care with the health care systems and regulatory and legislative context in which they work.

How can a young, motivated psychiatrist learn about the field beyond direct clinical practice and impact the larger discussion of mental health and professional issues facing their patients and colleagues? APA’s local district branches pro vide a community for psychiatrists in a range of career stages and offer a forum to help fight local issues and network with local colleagues, while the national APA Assembly consists of local representatives working together to develop and approve new organizational position statements and actions. Both groups can be a useful and productive way for young and experienced psychiatrists to become more involved and attempt to effect change to the field and profession.

The APA Assembly is made up of representatives from APA district branches and state associations, and includes resident-fellows, early career psychiatrists, minority and underrepresented psychiatrists, and a committee of representatives of subspecialties and sections composed of members from psychiatry allied health organizations (known as ACROSS).

Formulating action papers that propose an initiative to the APA Assembly is one way for newer members to become involved and to highlight a particular topic of interest. For example, correctional (carceral) psychiatry has always been underrepresented and under resourced in psychiatry and minimally discussed in training programs. With that in mind—inspired by the upcoming review of Accreditation Council for Graduate Medical Education psychiatry residency program requirements—I proposed an action paper titled “Enhancing the Learning Experience About Jail and Prison Psychiatry in General Psychiatry Residency Programs” that passed the Assembly with support from the American Academy of Psychiatry and the Law (AAPL) and APA’s Council on Psychiatry and Law in the spring of 2022.

My term in the Assembly has provided a key opportunity for me to become more involved in leadership and advocacy in psychiatry. The Correctional/Carceral Education Module is currently being finalized with the Council on Psychiatry and the Law, whose carceral workgroup is excited about highlighting this area of psychiatry, especially as part of its focus on racial and economic inequities and disparities in access to care.

Similarly, Jeffrey Janofsky, M.D., AAPL’s first representative to the Assembly as well as the organization’s immediate past medical director, highlights the importance of developing his ACROSS position in becoming the lead forensic expert consult to the Assembly. Compared with other allied organizations, Janofsky notes that AAPL’s mission as primarily an educational organization without direct advocacy work has helped its representatives maintain this role within the Assembly. Other organizations have used their connections to join with APA lobbying efforts or position statements through their Assembly representative or to bring more attention and members to their particular subspeciality. My action paper supporting carceral education for psychiatry resident trainees, for example, was the first one officially supported by the AAPL Executive Council.

Despite being from various groups with different interests and agendas, ACROSS organizations are united in their mission to diversify the APA Assembly and educate APA leadership and members about their areas of expertise. The Assembly and ACROSS can help you find your voice. Special thanks to ACROSS members current and past, including Richard Ratner, M.D.; Constantine G. Lyketosos, M.D.; Jeffrey Janofsky, M.D.; Stuart Anfang, M.D.; and immediate past chair Margie Sved, M.D. ■