Trustees Tackle Wide Range of Controversial Issues

At its meeting last month at APA headquarters in Arlington, Va., the Board of Trustees debated several topics that are much discussed in the media as well as in mental health circles.

The Board voted, for example, to address the high level of violence that has long plagued the United States and the piece of the puzzle to which psychiatrists may contribute some expertise. It agreed to appoint a new task force to address the complex issue of assessing violence risk and update a report APA issued on the subject in 1974. The task force will have three years to do its work and is to have members with expertise in child psychiatry and minority mental health issues. Among its charges is to summarize contexts in which psychiatrists may be called upon to assess violence risk, review literature on risk assessment, and explore related ethical dilemmas.

The use of electroconvulsive therapy (ECT) was also on the Board's agenda, with the Trustees voting to form an eight-member task force to revise the 2003 APA publication The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging in light of recently published National Institutes of Health studies on this treatment modality. The Trustees also approved a position statement on ECT.

The Trustees also voted to revise APA's position statement on the insanity defense, which will replace one issued in 1982 that was heavily influenced by the public debate over insanity acquittals after John Hinckley's 1981 attempted assassination of President Reagan. Many citations to court decisions in the earlier document are out of date as are empirical studies done prior to 1982, according to Paul Appelbaum, M.D., chair of the Council on Psychiatry and Law. The new statement says that while APA “strongly supports the insanity defense... [it] does not favor any particular legal standard for the insanity defense... so long as the standard is broad enough to allow meaningful consideration of the impact of serious mental disorders on individual culpability.”

Several membership items were also approved by the Board. The Trustees agreed, for example, to require that APA dues be paid by October 31 of each calendar year or the membership will be terminated. There will still be a three-month “administration reinstatement period” that will go through January 31 of the following year.

Also passed was a proposal to require that members pay their annual dues by the start of the annual meeting (usually in May) or be in the automatic monthly dues payment program if they want to qualify for the reduced member registration fee.

The Board also voted to reduce from three to two the number of recommendations a member needs as part of an application to become an APA fellow.

In other actions the Board voted to approve