Advocacy Can Reap Big Rewards For Your Patients—and You

Few would argue that direct patient care is the most important contribution psychiatrists can make. However, despite providing high-quality care, we often encounter challenges, such as insufficient placement opportunities, lack of insurance coverage for specialized treatments, and stigma attached to mental illness, all of which hinder clinical improvement in our patients. Dealing with these realities unfortunately remains among the experiences we must confront during residency.

Those of us in training can play a very critical role in addressing these and other problems. Vigor and enthusiasm are often associated with residents and fellows and can be invaluable assets as we advocate on behalf of our patients and our profession. We also have fewer life commitments, which gives us more opportunity for these tasks.

There are several ways residents can get involved to improve patient care and the practice of psychiatry, some of which may not be apparent. These include involvement in legislative advocacy, in which we can help promote bills that are beneficial to our field and patients, such as those that fund psychiatric services or mandate insurance parity. We can also work to oppose bills that could harm our patients, such as those attempting to grant prescribing privileges to some nonphysicians.

You can support a particular bill by writing or calling your state or national legislators. Visiting legislators and lobbying, either alone or with others, through your psychiatric society can also be effective. Lawmakers at all levels really do listen to what their constituents have to say. Information on legislative issues and how to communicate with members of Congress is posted in the Advocacy Action Center on the APA Web site at<http://capwiz.com/psych/home/>. You can also contact your district branch's legislative committee to find out the best way to contribute. In the past, residents have testified in Congress, helped draft bills, and taken part in rallies on behalf of key legislation.

Public education, improving the understanding of mental illness, and providing the public with information on psychiatric care can also be extremely rewarding to residents. This can be accomplished by contacting local media to offer your expertise on topics relating to mental illness and health care. There may also be a need for a mental health column in a local newspaper or a speaker at a school or mental health event. APA's Office of Communications and Public Affairs can be reached by e-mail at<[email protected]> for information on media-related questions and how you can become listed as a media speaker. The public affairs committee of your district branch may provide additional information on opportunities for involvement in public education efforts.

You may choose to participate in providing psychiatric information to other professionals in your area. Residents have been instrumental in preparing the newsletters and Web sites of their local psychiatric societies. This usually involved gathering information on mental health resources, psychiatric facilities, state and federal bills, and research studies. You can also consider writing articles that would be useful to the mental health community in general. If your district branch does not have a newsletter or Web site, you can offer your help to establish one.

APA district branches usually have several other committees through which residents can be officially active. For example, involvement in a medical education committee may provide experiences in planning continuing medical education programs for area psychiatrists. You may also be able to help organize resident workshops or provide resources for various types of extracurricular training of interest to your colleagues. Activities through a public mental health committee may involve reviewing the effectiveness and funding of mental health services by public agencies and working on their improvement.

Much can be achieved through participation in other committees, such as those dealing with forensic, child, or addiction psychiatry or ethics or women's issues. In addition, most district branches have a member-in-training committee that provides a forum for residents and fellows to share concerns and ideas. To get involved in a committee, contact one of its members or officers of your district branch.

Nonpsychiatric societies may also provide opportunities for residents to contribute to mental health care. The AMA, for example, may require specialists from diverse fields in lobbying efforts, such as for tort reform. The National Alliance for the Mentally Ill often needs physician support during public-awareness rallies.

Our field already benefits from how we advocate during our residency training. By educating medical students about the advantages of a psychiatry career, we help ensure that psychiatry gains more good clinicians. By educating other medical specialists about managing mental illness, we ensure that more patients get quality care.

Although not always apparent, your contributions are much appreciated by those needing mental health services and by your colleagues and will continue to be in the years to come. ▪