AACP Newsletter, Volume 7,
Number 2, Spring 1993
Board of Directors' Report
February, 1993
Various proposals to reform the United States healthcare system have recently been put forth, and in considering their merits, it is essential that issues concerning adequate and equal provision of mental health services be addressed. As an organization, the American Association of Community Psychiatrists has long been concerned about both the personal and social costs of inadequate attention to mental health issues in this country. We believe that if we are to eliminate these costs in the future, the reforms that are eventually adopted must emphasize the following principles:
Universal Access: Services must be available to all persons without regard to age, race, gender, health or socioeconomic status.Parity/Nondiscrimination: Treatment of psychiatric illnesses, including substance use disorders, must be available on the same terms and conditions as other health care.
Service Equity: Services to be provided under any health care plan must be prioritized in a rational way determined by medical/psychiatric necessity.
Comprehensiveness: The system must include a broad array of mental health service types, delivered within diverse settings.
Resource Management: The new system must be efficient and effective in the utilization of limited resources and eliminate bureaucratic waste. It must balance concerns for cost equity, efficiency, quality, research, and regional service planning needs.
Human Resource Development: Provisions must be made to insure the training of an adequate number of qualified mental health providers to implement the proposed system.
Consumer Choice/Participation: The system must maximize consumer choice of service providers and participation in service planning, delivery, monitoring, and evaluation of quality of care.
We believe that these principles must be considered within the context of a healthcare system that rationally integrates mental health services with appropriate social services and community supports. In adopting a comprehensive and long term perspective for reform of healthcare and provision of mental health services, we will create a system which is more just as well as more economic.
Some of the other major topics discussed at January’s meeting are included below.
Membership: Dr. Crandall reported that membership at the end of January, still early in the renewal period, stood at 339. The renewal rate this year was running at 76%, the highest the organization has ever had. Dr. Crandall felt that this success was due in part to the implementation of many elements of the recruitment and retention plan adopted during the May 1992 meeting of the Board of Directors - see Community Psychiatrist 6(4):4. She felt that consistency in publication of the newsletter and our recent affiliation with the Community Mental Health Journal have also contributed. The organization’s commitment to expanding its base was reaffirmed, and additional efforts will be made to recruit state hospital psychiatrists to our membership. A meeting will be arranged in May 1993 at the APA meeting, in coordination with the National Association of State Mental Health Program Directors, ( NASMHPD) to speak with state hospital psychiatrists and to encourage their participation.
Psychiatric Participation in State Plans: There has long been concern in the AACP and the APA, that psychiatry often has limited input into the development of state mental health plans. There are currently no mandates for doing so, and the Center of Mental Health Services at SAMHSA is apparently not empowered to initiate new mandates, at this time for how states develop their plans. The Board discussed alternative methods for achieving broader representation on state planning boards. A plan was developed to address this issue with NASMHPD and to explore the possibility of developing a task force to determine what factors determine both inclusion and exclusion of psychiatrists in this process. Efforts will also be made to join with local AMI (Alliance for the Mentally Ill) chapters to advocate for greater psychiatric representation on planning commissions. As part of that effort, a letter will be developed for members to use in contacting their local AMI chapters.
Programming: The programming committee gave an update on programs being developed for upcoming meetings. In San Francisco this coming spring, the AACP will sponsor a program entitled “Thirty Years in the Public Eye - Lessons from Community Psychiatry”. The program will be chaired by Ken Thompson, MD and will feature a number of nationally prominent speakers. Jeffrey Geller, MD, Lenard Stein, MD, Ezra Griffith, MD, and Charles Goldman, MD will examine how issues addressed by community psychiatry for many years may now have a broader application as we enter the era of managed care.
Another program is being developed for the Institute of Hospital and Community Psychiatry in October entitled “Controversial Issues in the Use of Neuroleptics”.
"Psychiatric Services to Special Populations” will be the topic at the annual meeting of the National Council of Community Mental Health Centers this June in San Francisco.
Plans are also moving ahead for the 1994 Winter Conference, which will be held in Pittsburgh early next year.
Training:
Since completing work on a model curriculum for training residents in community psychiatry (to be
published soon in the Community Mental Health Journal),
the Training Committee has continued to be active and will be consulting for the Center for Mental Health Services as that agency prepares a training resource clearinghouse. Ways to provide support and, recognition to programs involved in the training of community psychiatrists were discussed at this meeting and several ideas emerged. Community Psychiatrist will periodically feature program descriptions,
beginning with the Spring 1993 issue
(
see page 5). Information will be gathered from programs around the country currently noted for their community psychiatry training programs to be used in our organizations consultative role. Extending annual awards to include recognition of training initiatives was also proposed. Further expansion of the AACP’s consultative role will be discussed at future meetings.
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