Advocacy Connects Residents to Larger Purpose

See one, do one, teach one. In medical education, this mantra is repeated with reverence. We understand that we learn best by observing, applying our lessons, and then teaching others—this form of experiential learning is at the core of all physician training.

This same focus on experiential learning must be applied to becoming effective advocates for our patients, our profession, and our communities. Residents and fellows gain immeasurably by engaging actively in advocacy during their psychiatry training.

Residency can be challenging: long hours, high patient volume and turnover, and repetitive documentation. We can lose the forest for the trees. Direct clinical work is rewarding, but we can still struggle with the sense that we are but one person with a limited impact. Advocacy provides us with an opportunity to reconnect with a larger purpose—to relieve suffering from mental illness and help the people we serve better live the lives they want.

We can use advocacy as an opportunity to develop our autonomy as psychiatrists. Residents and fellows can organize and lead initiatives, lobby state and national lawmakers, and connect with their communities.

In taking on these efforts during training, we begin to master a skill set that lays a foundation for crucial action for the rest of our careers.

So what specific steps can we take to become effective advocates?

• Stay informed. It is tempting during training to retreat into the bubble of residency and academia, but we must fight this impulse! Take a few moments over coffee to scan the news headlines for articles related to mental health or health-care financing. Several prominent news Web sites allow you to set "alerts" to e-mail you when an article on a topic on which you've expressed interest (for example, "mental health parity") is published.

Similarly, all APA members-in-training can receive APA Headlines, the daily news-clipping service focusing on mental-health-related news (for information about receiving Headlines go to the Members Corner of APA's Web site at <www.psych.org> or call [888] 35-PSYCH). And of course, another great way of keeping informed is by doing exactly what you are doing right now—reading Psychiatric News! Also, Psychiatric News has a new e-newsletter (see News Can't Wait, So Why Should You?) and a daily news blog through which you can read about the latest developments in the legislative, regulatory, and clinical arenas. And APA's Division of Government Relations publishes a valuable resource known as RushNotes that has regular health-policy updates.

• Organize. It's easy to feel alone in our frustration with the mental health system, but know that there are many among your peers who feel the same way! Seek them out! Invite your peers to discuss a particularly challenging issue over lunch. Watch a documentary or host a book club on a memoir focusing on mental health issues. Let this process be the seed for a group of like-minded colleagues who are passionate about mental health advocacy. Get a group together over pizza and see if there are "low-hanging fruit" of mental health issues in your health system or community that the group might want to pick off as an advocacy project. Develop a plan to meet regularly, set goals and review success and strategies, educate each other, and engage!

• Act. Voltaire warned us that "the perfect is the enemy of the good." Sometimes we get frozen in not quite knowing how to do something well. And yet we have a wealth of experience during training of struggling with new skills, practicing them, and eventually mastering them. Advocacy requires the same process. Just take the first step, no matter how small!

There is no substitute for picking up the phone and calling your senator's office to fight for preserving graduate medical education funding or writing a letter to the editor of your local newspaper protesting stigmatizing language used to describe people living with mental illness. Once you have taken that first step, the next is much easier. Before you know it, you will be developing a skill set that can greatly influence the lives of the people you serve and greatly increase your sense of professional self-efficacy and accomplishment.

As psychiatrists, it seems at times that we are asked to do more and more with less and less. In increasingly resource-scarce times, psychiatrists need to engage in collaboration with our communities, work with legislators and regulators to promote parity and access, and use multiple media formats to educate and reduce stigma.

We all have been guilty of assuming that we will engage in advocacy "when I'm an attending." But our lifelong habits as psychiatrists are developed and honed in training. To become effective advocates, we must, during psychiatric training, learn from successful advocates, actively engage in advocacy, and foster advocacy interests in our peers and juniors. As the saying goes, "If not us, who? If not now, when?"