Binder Highlights Five Areas Where Psychiatrists Must Remain Committed

Caring for citizens who are most in need. “As psychiatrists, we need to apply our knowledge and political clout to help people who suffer from serious mental illness. This includes individuals who are incarcerated and who need mental health care rather than imprisonment,” Binder said. “Although our nation’s jails are ill suited to treat people with mental illness, in many locales they have become the de facto mental health facilities. There are solutions. We need to advocate for better training of police officers; for better community treatment; for diversion programs including mental health courts, drug courts, and veterans courts; and for better treatment and follow-up for people with mental illness who do wind up in jails and prisons.”

Decreasing stigma. Binder said people who live with mental illness and substance use disorders still experience discrimination in housing, employment, and relationships. “As psychiatrists, we must lead the fight to decrease stigma. Mental illness is ubiquitous. Most families are affected. We need to talk about it and normalize it so that people feel freer to seek treatment.”

Increasing funding for research and delineating diagnoses and treatment. “We must continue to advocate for more research funding for NIMH and other NIH institutes so that we can explore the underlying causes of mental illness and develop better strategies for prevention, early intervention, and treatment,” Binder said. “We also need to play our part in evaluating our current treatments, and we have made some headway in this direction. In March 2016, the Board of Trustees voted to develop an APA registry so that de-identified information about our patients, in the real world, can be collected to better determine what treatments work and for which patients.”

Advocating for our leadership role in new models of care and increasing access to mental health care. “We must advocate for seeing that mental health services are available to everyone,” Binder said. “There is no health care without mental health care. Mental health care is a right and not a privilege. Providing access to mental health care is also fiscally wise. There is solid evidence that mental health care brings down the costs of general health care.”

Assuming responsibility for measures of quality, competence, and advocacy. “We are being constantly regulated by various outside groups,” Binder said. “For example, third-party payers, including Medicare, are telling us that payment for services will be linked to value and quality. State medical boards and the American Board of Medical Specialties are telling us that there needs to be evidence that we are continuing to practice competently after we are no longer residents and are many years into our practice and that this will need to be demonstrated as a condition of licensure and certification. I don’t think that anyone disputes that physicians need to keep up with new treatments and with advances in our fields of practice. Many of the facts that we learned in medical school and residency training are no longer thought to be true. The issue is that we must regulate ourselves and not have others do it for us.”