Actions on Access Issues Follow Senator's Address

The opening session of the May meeting of the APA Assembly in Washington, D.C., just prior to the opening of the APA annual meeting, turned out to be something of a family affair. A surprise addition to the agenda was a speech by U.S. Sen. Daniel Akaka (D-Hawaii), whose nephew, Jeffrey Akaka, M.D., was presiding at his last meeting as Assembly speaker.

Sen. Akaka, long a mental health care advocate, stressed that“ psychiatrists are a vital part of our health care system” and said he shares a commitment with psychiatrists to making sure that all people have access to mental health care. He also expressed his concern about the psychiatric issues and “invisible wounds” that will follow combat veterans home from the wars in Iraq and Afghanistan, citing the recent finding that 1 in 5 Iraq war veterans is likely to develop posttraumatic stress disorder during or after returning from combat. Akaka chairs the Senate Veterans Affairs Committee. He noted that he has introduced a bill that would ensure that veterans get high-quality mental health care at VA facilities and in their communities.

Sen. Akaka also emphasized that it is crucial that psychiatrists take the time to communicate with their senators and representatives to help them understand the need for action on improving access to treatment and other key mental health issues. “Legislators want to know what their constituents think,” he said.

Beginning its regular agenda, the Assembly took action on several access-to-care issues including encouraging district branches (DBs) “to facilitate consultation to primary care physicians.” It was hoped that such an effort, if made a DB priority, could improve patient care, since many people turn to their primary care physicians for help with mental health issues. There was opposition to the measure, however, from several Assembly members who pointed out that existing APA components are already working on such efforts.

Members also voted to have APA appoint a task force whose mission would be to review health care systems in other countries, as well as alternatives proposed for the U.S. system, and to address the pros and cons of these alternatives and the impact that each system has on psychiatric care.

The Assembly also took a step toward recruiting more psychiatrists to public-sector jobs by voting to develop strategies “to increase awareness of psychiatric careers in the public sector, with special attention paid to attracting residents and early career psychiatrists to these positions.” The intent is also to create standards that would recommend“ adequate professional compensation” for psychiatrists working in these positions, in which salaries are often too low to attract psychiatrists in sufficient numbers.

On membership-related issues, the Assembly decided that to help increase the number of psychiatry residents who join APA, all graduating medical school students matching into psychiatry should be contacted about the benefits of APA membership. This effort would be coordinated by the Assembly Committee of Area Member-in-Training Representatives, the Committee of Residents and Fellows, and the APA Membership Committee.

The Assembly also voted to have its Committee of Minority/Underrepresented Groups weigh in on the issue of whether APA members who identify with more than one minority group should be allowed to enroll in more than one minority-group caucus. Currently they are allowed to register with only one caucus each year.

On an issue relating to education and career development, Assembly delegates voted to address residency programs' often widely varying policies regarding pregnancy and parental leave, a particularly timely issue since women now make up about half of residents and medical students. Issues that need to be addressed are the burden of coverage when a resident is on maternity leave and achieving a balance between parenting and residency, among others. The Assembly voted to have APA develop a position statement accompanied by a “model policy and procedure that supports psychiatry residents during pregnancy, parental leave, and after they return to work.”

Among other actions the Assembly took was to urge appointment of an APA task force on men's mental health issues. Supporters of the proposal said this is an overlooked area in which unique mental health concerns arise.

The Assembly also agreed to amend the APA Bylaws to separate the Board's secretary-treasurer position into two positions, as had been the case until 2005, when the Board downsized by combining these positions and eliminating one of the two vice-president positions. The Board had voted to separate the positions at its December 2007 meeting, acknowledging that the workload for the combined position had expanded considerably over the last two years.

Assembly members rejected a proposal to adopt a new APA mission statement that would read, “American Psychiatric Association...helping psychiatrists provide the highest quality care.” APA's current mission statement is too long, and few members can quote it, contended supporters of the new wording. Many members, however, insisted that the proposed statement sounded more like a slogan or advertising tag line than a statement of APA's mission.

A summary of actions taken by the Assembly is posted in the“ Members Corner” of APA's Web site at<www.psych.org> under “Assembly.” ▪