Opportunity to Change Practice, Perception of Psychiatry Is Now

The future is now. That’s what APA President Jeffrey Lieberman, M.D., told APA members today during his presidential address at APA’s 2014 annual meeting. He opened with a recitation of recent APA successes including—among others—the successful publication of the DSM-5, effective lobbying around the Affordable Care Act, the Mental Health Parity and Addiction Equity Act and the Excellence in Mental Health Act, reversal of the proposal by the Centers for Medicare and Medicaid Services to restrict medication formularies for antidepressant and antipsychotic drugs, securing of an increase in reimbursement values for Medicare coverage of psychiatric services, and serving a watchdog role to protect consumers and psychiatrists from insurance companies that were not complying with the Parity Law.

“But if we want to take advantage of the biggest scientific, economic, and legislative changes in mental health care in our lifetime, then we need to seize this opportunity, right now. . . . Our future is now. We have been waiting, many of us our whole lives, for the chance to change the way the world thinks of psychiatry, and the way we think of ourselves as psychiatrists. Let’s use the momentum we have to plunge ahead into the next year with our confidence brimming, our energy renewed, and our sights set high.”

He cited 10 goals, which he posed as landmarks that APA will achieve.

• Public perception of mental illness and psychiatry will change. “We will better educate the public and the media about what mental illness is, what psychiatry does, and what our role in the future of health care in the U.S. will be. As a result, the public will gain a more accurate and respectful understanding of mental illness and psychiatry.”

• Psychiatry will return to its rightful place in the house of medicine. “Driven by scientific advances and economic forces, psychiatry will increasingly become a scientifically based discipline and achieve capabilities to diagnose and treat patients with mental disorders that previously would have been unimaginable and in doing so rejoin the family of medicine.”

• APA will become a strong voice and respected presence in the political arena.

• Psychiatry will benefit from biomedical research. “Mental illness is right in the sweet spot of the Human Brain Initiative that President Obama announced this year, which will support the development of new powerful forms of neuro-technology.”

• DSM will be a living instrument. “As the caretaker of DSM, APA will ensure that it is managed responsibly and by the most rigorous scientific and ethical standards. Toward this end, we have convened a DSM Steering Committee chaired by Paul Appelbaum and co-chaired by Ken Kendler and Ellen Liebenluft, composed of elite clinicians and top researchers to iteratively revise DSM-5 following nosologically significant scientific breakthroughs rather than at decades-long intervals.”

• APA will work with a coalition of mental health stakeholder organizations to ensure that health care legislation, such as the Affordable Care Act and the Mental Health Parity and Addiction Equity Act, are implemented properly so that mental health providers and patients receive all the benefits to which they are entitled.

• Training programs will change to reflect the impact of health care reform and scientific progress.

• Our government, health care policymakers and providers, and nonpsychiatric medical colleagues will finally understand that “there is no health without mental health.”

• Under the leadership of the new CEO/medical director and continued strong elected leadership, APA will more effectively represent the interests of psychiatry and people with mental illness.

• The ambivalent relationship that our society has historically had with psychiatry will be dispelled.

“I believe that psychiatry has reached a point in its evolution where it can break free of the ignorance, mystery, and stigma with which it has been historically associated,” Lieberman said. “And APA must lead the way. Today we celebrate the progress we’ve made, as an organization, as a field of medicine, and the prospect of a better future. This is our opportunity to change the practice and perception of psychiatry for the better and as never before. Last year, standing on the stage in San Francisco, I told you that ‘Our time has come.’ Today I say to you that our future is now!”