How to Beat the Advocacy Blues

I realized two things recently.

First, the political situation in the United States has made me want to be a better advocate for my patients. Second, I have no idea how to do that.

I was used to calming distress with therapy, medication, a helping hand. But this seemed so different. There was no Stahl’s, no NICE guidelines to show me the way.

So first I tried the Internet. A quick search offered a definition of advocacy: “Public support for or recommendation of a particular cause or policy.” Then I spent half an hour (OK, an hour) in a rabbit hole about famous marches throughout history. Not so productive.

Then I remembered an advocacy talk I’d heard last year at APA’s September Components meeting, where councils and committees gather to develop ideas and work with the APA leadership. This seemed like a better bet. To my surprise, I found quite a few resources on the APA website. More importantly, I found pathways to action. Here’s an admittedly abridged list, with some lessons I took away from my search.

Open your browser and type in https://www.psychiatry.org/psychiatrists/advocacy. You’ll find the main APA advocacy page and a link to APAPAC, APA’s political action committee. This group works to ensure that psychiatrists have a say in legislation that will affect our work (think parity, health care reform, Medicare, and research). Working with APA’s staff, APAPAC members know how to navigate the legislative system and campaign for policies that will help our patients. Your voice is needed!

An important resource on the APA advocacy page is the Congressional Advocacy Network Guide. This 22-page guide offers a wide range of advocacy advice. It ranges from the basics (for example, how federal advocacy works and how to call your members of Congress) to more advanced ways to get involved (for example, conducting tours and hosting candidate fundraisers). It can help demystify the world of federal advocacy, which to me seemed totally overwhelming.

And don’t stop there. Consider going a step further and joining APA’s Congressional Action Network, APA’s political grassroots network. Advocates serve as “key contacts” for their members of Congress so that when an important issue comes up before the U.S. Congress (like Medicare and Medicaid reimbursement for physicians and comprehensive mental health reform), APA can quickly get its message to members of Congress. Learn more here.

The Federal Affairs page links to APA resources on a number of major mental health topics, including mental health reform, parity, public health, and military and veterans affairs. Why does this matter? Well, in my case deciding what I wanted to focus on was part of my problem. Here I found a bird’s-eye view of a number of topics important to psychiatry and our patients. Each topic heading includes APA position statements, fact sheets, and more, and helped me narrow my focus.

The State Affairs page addresses matters affecting your town, county, and state. Although the legislative agenda in each state varies widely, some topics (for example, Medicare and the Affordable Care Act) are relevant regardless of your location.

Another place to find out what’s going on in your state is to become involved in your local district branch. (Contact information for district branches can be accessed on APA’s website.) My branch, the Connecticut Psychiatric Society, has monthly meetings at which we discuss the current legislative session or events or bills that affect our patients. Much of the legislation up for debate this year has concerned the opioid epidemic. These meetings have been a great way to meet other psychiatrists in my area who want to get involved.

So what’s actually keeping us from getting involved? One concern I’ve had is that some of our colleagues may not have a complete understanding of the Goldwater Rule. (The latest ethics opinion on the rule is available here.) The bottom line is that psychiatrists should not diagnose people they haven’t evaluated. But following the Goldwater Rule doesn’t mean you can’t get involved in politics. There’s nothing preventing psychiatrists from contacting lawmakers about legislation, educating the public about mental illness, or getting involved in political campaigns.

Here’s what I’ve learned. Avoid search-engine rabbit holes by relying on APA’s website for the advocacy information you need to know. If you find you have questions, don’t hesitate to contact the staff of APA’s Department of Government Relations. Use the advocacy guide to learn how to contact legislators and get involved. And finally, talk to people! Most of my tips have come from friends and colleagues finding their way along a new advocacy path.

Being an active advocate can feel overwhelming, but we need informed practitioners to speak up about what needs to happen. Your opinion matters.

Now get out there and advocate! ■