The U.S. Army Surgeon General Patricia Horoho recently testified before the Senate Appropriations Committee: "Psychological health problems are the second leading cause of evacuation during prolonged or repeated deployments." The popular media reports that suicides among military members, on average of one per day, are the highest rate so far during a decade of war in Iraq andAfghanistan – and this year higher than the number of troops killed in combat. This clearly demonstrates an appreciation for the need for psychological services in a timely fashion. Reflecting upon my tenure on the U.S. Senate staff, I recall an August 2, 1978 memo from the then-Principal Deputy Assistant Secretary of the Department of Defense titled: Utilization of Psychologists in the Military Health Care System. VernonMcKenzie: "I have had my staff explore this question in some detail. We have concluded that there are utilization problems with respect to this group that require further consideration. We have tentatively concluded that there are several steps which might be taken which would improve the utilization of this professional group. Among these are the following…. Grant psychology departmental autonomy where the size and staffing of the hospital would justify…. Allow a psychologist, when he is senior and capable, to be the head of a mental health department…. Improve the promotion opportunities for senior psychologists…." SG Horoho is the first female and first nurse to be appointed to that critical position since the creation of Army Medicine in 1775.
Bob McGrath, a staunch supporter of psychology obtaining prescriptive authority from the beginning, estimates that currently there are 1600-1700 colleagues who have completed their advanced psychopharmacology training. This is an impressive figure. What I consider even more so, however, is the increasing interdisciplinary training efforts being developed by our academic colleagues as the nation evolves towards integrated care. For example, clinical psychology graduate student LT Chantal Meloscia, USN is enrolled/embedded in a Graduate School of Nursing Advanced Physiology course. This core course for advanced nurse practitioners provides an in-depth understanding of the function and regulation of the body system to maintain homeostasis, with an emphasis on the integration of the structure and functional systems within the human body. The course content ranges from cellular mechanisms to the major body organ systems, providing the basis for understanding physiologic derangements. On average, nine USUHS psychology students will take the required course annually serving as a foundation for a Pharmacology class the following year taken through the MedicalSchool.
Visionary Cynthia Belar announced a new APA Primary Care Fellowship which will develop an overall framework and strategy for promoting the engagement of psychologists in providing integrated mental and behavioral health services in primary care settings. This will involve outreach to physician specialty associations, interdisciplinary primary care organizations, and disease-specific groups to enhance collaboration and partnerships on programmatic and policy initiatives related to integrated health care. Exciting opportunities. For the times they are a-changin'. Aloha,
Pat DeLeon, former APA President – Division 31 – June, 2012
