xxAACP Newsletter, Volume 12,
Number 2, Spring 1998
Guest Column:
Community Psychiatrists in the APA:
Focusing Towards the Future
The Council on Psychiatric Services was reorganized in 1996 to replace several committees. The Council coordiated four subcouncils called consortia designed to address the broad range of psychiatric care. Members are selected for their expertise and serve for limited, overlapping terms. Community psychiatry is represented on the following three consortia: Consortium on Special Delivery Settings; Consortium on Organized Service Systems; and Consortium on Funding. The fourth Consortium is the Consortium of Treatment Issues.
The assembly committee on public and community psychiatry will have its first meeting at the APA Assembly meetings in May. This new committee was formed by merging the Assembly Committee on Community Psychiatry and the Assembly Committee on Public Psychiatry. The merger was an early effort by the Assembly to reorganize and streamline. The merger had the support of both committees, who felt that times had changed since these committees were originally formed and that the needs of the persons served in public/community psychiatry settings could be more effectively addressed by a single committee.
The former Assembly Committee on Community Psychiatry has been the primary liaison committee for the AACP. Cliff Tennison, MD, liaison representative, has made the bridge between the AACP and the APA work very well. Several AACP initiatives have made it from this committee through the Assembly and into APA official policy or structure. For example, several years ago, Dr. Tennison submitted Guidelines for Psychiatric Practice in Organized Settings of Care. They were eventually approved by the APA Board of Trustees and are now part of official APA policy. This past year Dr. Tennison shared Guidelines for Formulary Management and the Level of Care Utilization System ( LOCUS ). They were referred to the Council on Psychiatric Services for further study and for inclusion in a "Toolbox" for APA members and systems to use in managing psychiatric care. Dr. Tennison also reiterated your invitation to share information in newsletters, which is the reason this column is here.
Other APA activities pertinent to community psychiatry include the Ethics committee's recommendation of the " Guidelines for Ethical Practice in Organized Settings," which were recently approved by the Assembly and the Board. The most notable recent concerns shared by the AACP and the APA are being addressed by the APA Committee on Managed Care. This group has been developing guildelines for states and other mental health authorities who purchase managed care services for vulnerable persons with serious and persistent mental illnesses. This document is in its final stages of review.
The liaison relationships with the AACP and others brings depth and focus and effectiveness. Because of its size and its diversity, the APA must be vigilant to coordinate and be efficient. In contrast, the smaller, more focused and more grassroots approaches of the AACP are valuable and bring seasoned understanding and vitality. Both the APA and the AACP benefit from this symbiotic relationship. The APA benefits from the focused knowledge of the AACP and the AACP benefits from the size, diversity and strenth of the APA. There are other meaningful liaison relationshps within the APA which relate to Community Psychiatry. The National Alliance for the Mentally Ill ( NAMI ) and the National Association for State Mental Health Program Directors ( NASMHPD ) are two such liaison relationships which add perspective and focus to the APA.
Psychiatric Services is a monthy APA journal which was established in 1950 and is published for mental health professionals and others concerned with treatment and services for persons with mental illnesses and mental disabilities. About two years ago, to be more current with recent trends, Psychiatric Services changed its name from Hospital and Community Psychiatry. For many years this has been the premier professional journal for professionals working in community and public settings. The APA also sponsors the Institute for Psychiatric Services, an annual meeting attended by about 2,500, many who work in community mental health settings. There is also the Psychiatric Services Resource Center, which offers educational materials such as videotapes for rent.
The organized systems to deliver psychiatric care are changing. Many of the APA structures and relationships to deal with community psychiatry issues have been updated in the past two years. Liaison relationships with the AACP and others help keep the APA grounded and focused. The APA with its diversity, size and organizational structure appears positioned to address and carry forward community psychiatry issues with strenth.
Dale Svendsen, MD
American Psychiatric Association
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