Binder Highlights Five Areas Where Psychiatrists Must Remain Committed


Let’s claim our future.

That’s the message outgoing APA President Renée Binder, M.D., delivered to APA members today at the Annual Meeting’s Opening Session.

Binder emphasized the moral obligations of a professional medical association. “We must assume our responsibility to help our neediest patients, decrease stigma, improve diagnoses, advocate for research funding, continue to strengthen parity enforcement, work to improve access to care, continue to educate our members, and be responsible for the quality of care provided by our profession,” she said.

She outlined the achievements of a busy presidential year, especially highlighting the inauguration of the American Psychiatric Excellence (APEX) Awards in April. The event focused on drawing national attention to the tragedy of incarcerating people with mental illness, an issue of special concern to Binder, who is a leader in forensic psychiatry. Legislators including Sen. Al Franken (D-Minn.) and Florida State Sen. Miguel Díaz de la Portilla (R-Miami-Dade) were honored at the event, as were the stars of the popular television drama “Orange Is the New Black.”

Binder specified five areas of responsibility for psychiatrists:

• Caring for citizens who are most in need. “As psychiatrists, we need to apply our knowledge and political clout to help people who suffer from serious mental illness. This includes individuals who are incarcerated and who need mental health care rather than imprisonment,” Binder said. “Although our nation’s jails are ill suited to treat people with mental illness, in many locales they have become the de facto mental health facilities. There are solutions. We need to advocate for better training of police officers; for better community treatment; for diversion programs including mental health courts, drug courts, and veterans courts; and for better treatment and follow-up for people with mental illness who do wind up in jails and prisons.”


• Decreasing stigma. Binder said people who live with mental illness and substance use disorders still experience discrimination in housing, employment, and relationships. “As psychiatrists, we must lead the fight to decrease stigma. Mental illness is ubiquitous. Most families are affected. We need to talk about it and normalize it so that people feel freer to seek treatment.”
  
  She highlighted APA’s campaign last year to remove a billboard posted by the fashion icon Kenneth Cole over the Westside Highway in New York that said, “Over 40 million Americans suffer from mental illness. Some can access care…All can access guns.” Binder reminded psychiatrists at the meeting that the implication of the billboard was that people with mental illness are violent and should not possess guns.
  
  “Of course, most people with most types of psychiatric diagnoses are not violent, and the billboard contributed greatly to the fear of anyone with a mental illness, including anxiety, depression, adjustment disorders, obsessive-compulsive disorders, or neurocognitive disorders,” she said. “APA brought together two dozen other professional and advocacy groups to demand that Kenneth Cole remove the billboard. This is an example of what APA has done and must continue to do to fight stigma.”


• Increasing funding for research and delineating diagnoses and treatment. “We must continue to advocate for more research funding for NIMH and other NIH institutes so that we can explore the underlying causes of mental illness and develop better strategies for prevention, early intervention, and treatment,” Binder said. “We also need to play our part in evaluating our current treatments, and we have made some headway in this direction. In March 2016, the Board of Trustees voted to develop an APA registry so that de-identified information about our patients, in the real world, can be collected to better determine what treatments work and for which patients.”


• Advocating for our leadership role in new models of care and increasing access to mental health care. “We must advocate for seeing that mental health services are available to everyone,” Binder said. “There is no health care without mental health care. Mental health care is a right and not a privilege. Providing access to mental health care is also fiscally wise. There is solid evidence that mental health care brings down the costs of general health care.”


• Assuming responsibility for measures of quality, competence, and advocacy. “We are being constantly regulated by various outside groups,” Binder said. “For example, third-party payers, including Medicare, are telling us that payment for services will be linked to value and quality. State medical boards and the American Board of Medical Specialties are telling us that there needs to be evidence that we are continuing to practice competently after we are no longer residents and are many years into our practice and that this will need to be demonstrated as a condition of licensure and certification. I don’t think that anyone disputes that physicians need to keep up with new treatments and with advances in our fields of practice. Many of the facts that we learned in medical school and residency training are no longer thought to be true. The issue is that we must regulate ourselves and not have others do it for us.”