Get to Know APA’s New President, Rebecca Brendel, M.D., J.D.

Q. What are your goals and objectives for the coming year, and what would you like to see accomplished?

A. As we emerge from the COVID-19 pandemic, APA and psychiatry will face many challenges as we continue to adapt to the “new normal.” These challenges also represent opportunities to take bold action to improve the state of mental health care in America. Americans are struggling with mental health more than ever, so it is critical in the year ahead for APA to take a lead in addressing the nation’s overwhelming mental health needs.

Q. Why did you choose the theme “A Roadmap for the Future”?

A. I chose that theme because psychiatry and mental health are truly at a crossroads. For the first time, mental health is a presidential priority and a major part of the national discourse. As we emerge from the pandemic, the mental health toll of the last two years is just becoming apparent. We already knew we had a shortage of mental health services in this country, and today many people are still unable to access care, especially children and members of underserved communities. We have a lack of beds with patients in need of psychiatric intervention left waiting in emergency rooms. We’re also still confronted with an inadequate payment system that undervalues the lifesaving care our members provide.

I am really looking forward to confronting and overcoming these challenges by working with members to create a road map for how APA can engage the public, help the many psychiatrists who were struggling to keep their practices afloat during the pandemic, train for the future so we can build a well-rounded and diverse workforce, and leverage our policies to help build a mental health infrastructure that increases and facilitates access to high-quality care for all of our patients and the communities we serve.

Q. One of your identities is as a consultation-liaison psychiatrist. How will that identity inform your presidential year?

A. My background in consultation-liaison [C-L] psychiatry has prepared me for leadership at this moment in time. Much of my career was built around caring for people who fell through the cracks, who couldn’t access mental health or general medical care because of what we now call social determinants of health and mental health—lack of insurance, barriers within systems of care, lack of affordable housing, and food insecurity, among others.

In April, I testified before the Health Subcommittee of the U.S. House Energy and Commerce Committee about collaborative care legislation. We are seeing strong evidence for improved outcomes when mental health and general medical care are integrated, and a team approach is taken to the total health of a patient. So, C-L psychiatry is really important to me because it is where I came from, but also because it’s where the profession needs to go. There really is no health without mental health, and we need to use collaborative care and other models of care to work with our medical and surgical colleagues to deliver quality care to everyone.

Q. What problems and challenges do you see in the year ahead, and how do you hope to meet them?

A. Obviously, there is an enormous demand for mental health care services and not enough psychiatrists to meet it. We have to think about ways we can extend what we do to reach as many patients as possible and leverage the expertise of our members, but also that of lawmakers, community leaders, and the general public, because all of us have a stake in mental health.

A persistent challenge that we need to address is stigma—stigma about psychiatry, mental illness, and seeking treatment for mental illness, but also stigma within systems of care that reimburse for psychiatric services less than services in other medical specialties for equivalent work. We can learn a lot from younger generations of medical students, early career psychiatrists and patients who are taking a much more open and honest approach to discussing these issues. We also must do some hard thinking about how to train the psychiatrist of the future: What do they need to know? And how will the psychiatrists of the future work in collaboration with their medical and surgical colleagues?

Q. What else do you want APA members to know about your coming presidential year?

A. As we continue to emerge into the post-COVID era, I urge all members to participate and make their voices heard through their district branch, Assembly representatives, and APA’s councils and components. Every community is unique, and we need members to let us know what issues they are struggling with in their communities. We can’t be effective as an association without knowing what is happening with our members.

I also want to call on our members to be open minded, to try to think outside the box about what would be helpful to psychiatric practice and to be open to new ideas and possibilities. It’s worth recalling that before the pandemic, many of us—myself included—didn’t want to touch telemedicine. We were ambivalent about whether we could provide our best care from behind a computer screen. Well, nothing drives progress and innovation like necessity, and telepsychiatry has since become one of our most indispensable tools. We now know that many of our patients are happier with telemedicine and that we can provide more accessible care. We have to embrace innovation and develop strategic partnerships so that we have a meaningful presence in the areas where technology and mental health intersect. It is important that we develop forward-thinking solutions to address the problems of today and always keep in mind that the psychiatrist of the future may look very different from today. ■