Assembly Considers Array of Issues

APA’s Assembly approved action papers and position statements addressing a variety of issues—tracking the psychiatric workforce, the use of neuromodulation for treating psychiatric disorders, text changes to DSM, and telepsychiatry, among them—during its virtual meeting in April.

At the meeting, the Assembly also voted to elect the following candidates as officers of the Assembly from April 2021 to May 2022: for speaker-elect, Adam Nelson, M.D., of Area 6, and for recorder, Vasilis K. Pozios, M.D., of Area 4.

(Position statements and action papers approved by the Assembly are not APA policy until they are approved by the Board of Trustees.)

Assembly members approved an action item calling on the Council on Healthcare Systems and Financing, Council on Quality Care, and the Council on Research to track the number of active mental health practitioners in the United States using accessible databases, such as the APA Health Workforce Mapper. The tally will include psychiatrists, nurse practitioners, physician assistants, prescribing pharmacists, and psychologists for the purpose of understanding and predicting future workforce needs. The Assembly also voted that the data should be analyzed statistically and graphically, projecting out beyond 2032, and be available on the APA website for members’ review.

Among the approximately 15 position statements approved, two were passed in a vote by strength, in which Assembly members’ votes are weighted according to the number of APA members they represent.

A revision of the Position Statement on Substance Use Disorders Among Older Adults was approved by strength; the statement says that psychiatrists and other health care professionals should promote screening for substance use disorders and co-occurring psychiatric disorders in older adults. The statement also asserts five points with regard to treatment:

“Substance abuse in older adults is a growing problem,” said Ilse Wiechers, M.D., a representative from the American Association for Geriatric Psychiatry. “It is imperative that clinicians are aware of this.”

Also approved in a vote by strength was the position statement on Interstate Licensure for Telepsychiatry.

The approved position points out that “state medical licensure requirements requiring a psychiatrist to hold a medical license where a patient is physically located when conducting telepsychiatry represent a significant barrier for patient access, quality, and continuity of mental health care. These challenges have been increased as well as highlighted by the current COVID pandemic.”

APA supports the reduction of barriers to interstate telepsychiatry services. Among the proposed solutions are the following:

Additionally, the Assembly approved an action paper calling on APA’s Joint Reference Committee (JRC) to appoint a task force or work group to consider the development of a component on neuromodulation.

The component might help advance the standards for a range of neuromodulation services (electroconvulsive therapy, transcranial magnetic stimulation, deep brain stimulation, vagus nerve stimulation, among others) and promote research in neuromodulation.

Finally, the Assembly approved several text changes to DSM-5 that had been previously approved by the Board (Psychiatric News). Those changes were approved by the Board first so they could be included in DSM-5-TR, now under development.

The majority of the action papers were referred to the JRC for consideration, and, if approved, they will then be referred to the appropriate APA component. The Assembly-approved position statements that have already been reviewed and approved by the JRC will be submitted for consideration by the Board at its meeting this month. ■

Approved position statements can be found in APA’s Policy Finder here.

The status of governance actions (including action papers and position statements) through the Assembly, Joint Reference Committee, and Board of Trustees can be tracked through the Action Item Tracking System here.