The American Psychiatric Association speaks the challenges and needs of psychiatric care to the nation and the world.  As the leading medical organization for mental health care, the responsibility of the APA stems from the patients we represent.  Our members provide scientifically based, evidenced informed, compassionate care to millions of those in need.  The strength of the APA must be maintained in order to provide the best care for our patients.

I have been a member of the APA since residency when I was selected a Falk Fellow.  Since that time I have been continuously active in the APA, primarily in the areas of disaster psychiatry, research, education and quality care.  In those capacities I have advised nearly every APA president in the past 20 years. Having served in advisory capacities to numerous private, public, federal, state and corporate organizations, I know the importance of the members of an organization. They carry on the work and create the directions for the future.

First, in the responsibilities of the APA President, representing the members and their medical care practices, is to ensure the protection, care and future of our patients, many of whom have no voice in their communities and need our help to obtain the care they need.  This is even more critical as the nation addresses the needs for health care and its expense.  This advocacy requires our support of individual treatment needs, public health care and furthering the opportunity for psychiatry to join collaboratively in primary care.  The broad perspective of behavioral risk to health- from alcohol and smoking behaviors, to family violence, depression, schizophrenia and bipolar disorder- all have morbidity and sadly mortality associated with them. The disorders we care for are often complicated comorbid disorders with complex health problems.  Suicide is now the leading cause of morbidity from self-injury- surpassing motor vehicle accidents. 

To address these mental health care tasks – in psychiatric care and primary care- requires addressing important access to care issues for our patients,

providing appropriate reimbursement for care to sustain the psychiatric workforce and training sufficient numbers of psychiatrists to meet the future needs.

Psychiatry is part of the house of medicine and must maintain its strong ties to medicine, particularly primary care.  Further development of our treatment guidelines and guidelines for primary care physicians can help our patients through direct care as well as referral to specialty care.  Psychiatric illness is part of everyday life.  Psychiatric disorders span a broad range from medical bruises (a simple adjustment disorder) to the equivalent of broken bones (depression that responds to treatment) to disorders with high morbidity and mortality (schizophrenia, bipolar disorder).  The extent of these disorders is important for non-psychiatric physicians and the public to recognize in order to decrease the stigma associated with mental illness and end the assumption that “once ill always ill”.

The future of our field depends on the education of our medical students, residents and fellows.  Fostering their early involvement in the APA is important to the APA’s future and to bringing new knowledge and skills to the APA. Most importantly, the APA needs its assembly, its leaders and its members to be strong and ready to define the future of psychiatric health care.