Introduction

“We enter this APA election cycle deeply pondering about our organization’s history of strong positives but also of baffling negatives. None has been more disconcerting than the treatment of minority and underrepresented members and staff. A glimmer of hope came out of the March 2015 Board of Trustees meeting with the approval of the APA’s strategic plan, setting forth the four pillars that would guide future initiatives. The fourth pillar, DIVERSITY, calls for ‘Supporting and increasing diversity within APA; serving the needs of evolving, diverse, underrepresented, and underserved patient populations; and working to end disparities in mental health care.’ But a charter is only as good as its implementation and in that the APA has a long road ahead.”

“When I recently received my APA renewal email, I had no reservations to put the payment on my to-do list. Why did I have no qualms? The reality is that, through my significant involvement in APA governance over more than a decade, I have direct knowledge of what the APA is doing for our patients and our profession. But a great portion of our members remain in the dark about the day-to-day work being performed by the APA and are left questioning the value of their membership. It’s time to ACT through Advocacy! Communication! Transparency! We must reengage our members by improving our communication, including about our advocacy efforts, in a fully transparent manner while ensuring we remain accountable to the needs of our membership.”

“The continued encroachment of non-physicians into psychiatric care needs to be better regulated. Unfortunately, we have arrived at this juncture due to, up until recently, a negative balance of career psychiatrists with more Senior psychiatrists exiting our ranks than ECPs entering. Scope of practice issues stem from a targeted effort by non-physicians to fill gaps in our psychiatric workforce. Their lobbying efforts to several state legislatures have been effective in opening the door to unsafe prescribing. Non-standardized educational requirements, unsupervised patient care, and deceptive nomenclatures (i.e. DNP, DMSc) continue to erode the quality of care received by our patients, greatly affecting minorities and those in rural areas.”

“Board Certification is largely required by accrediting bodies and hospital privileging, having become regarded as an objective measure of a physician’s knowledge, experience and skills. The process has nevertheless become increasingly onerous, both procedurally and financially, and does not achieve the goals of MOC purported by the ABMS: for physicians to ‘continue to update their knowledge, participate in ongoing professional development, demonstrate that they are improving the care they provide, and consistently meet standards of professionalism.’ MOC reform is a must.”

“Mental health is health. Yet insurance carriers continue to impose unfair barriers that compromise the mental well-being of our patients. Prior authorizations, step therapy, higher medication co-pays, and reimbursement limitations remain tactics that limit access to quality mental health care. We need mental health parity legislation that is equity-focused, with tight closing of loopholes and strong sanctions for infractions. There is no health without mental health.”

“I was the primary author of the May 2015 action paper titled ‘The Impact of Global Climate Change on Mental Health,’ which was unanimously approved by the APA Assembly and led to the creation and adoption of the March 2017 APA Position Statement on Mental Health and Climate Change. While the position statement pledged support and collaboration ‘with patients, communities, and other healthcare organizations engaged in efforts to mitigate the adverse health and mental health effects of climate change,’ there needs to be a significant infusion of reengagement and re-commitment by the APA towards the fulfillment of these goals. The APA also needs to make climate change and mental health educational resources more readily publicized and available to our membership.”