I recently had the opportunity of reviewing a most insightful book Retiring But Not Shy: Feminist Psychologists Create Their Post-Careers, edited by Ellen Cole and Mary Gergen. This generation of colleagues has, over the years, significantly contributed to the impressive maturation of psychology as a discipline, and by their personal involvement within the APA governance helped shape the association into the public policy forum and political force that it has become. They are now entering the twilight of their lives and are beginning to reflect upon what their careers have meant to them, their close friends, and their families. Without question, their next journey can be a very interesting, productive, and creative time -- if they so desire. As public service statesman -- and now author --Rod Baker has opined: "My definition of a 'good retirement'…. Doing what you want, as much as you want, and whenever you want. And, if you are not doing that, you only have one person to talk to." Personal vignettes:
During his 13 years with the Practice Directorate (1992-2005), Mike Sullivansignificantly shaped psychology's State Association presence. "I've long been a big believer in the benefits of volunteering. In my own life volunteering has opened many doors and led to new pathways in my career and my retirement. Volunteering has also afforded me many opportunities to find satisfaction and fulfillment in giving back to others. Three examples may help to convey these points. * My experience as a Peace Corps volunteer right out of college expanded my horizons and gave me profound respect for bilingual and bicultural persons. The challenge of communicating daily in a language as difficult at Korean dwarfed the supposed physical hardships of working in the underdeveloped Korean countryside of the 1960's. * My experiences volunteering for the Coalition of Hospital and Institutional Psychologists and the New York State Psychological Association early in my psychology career were transformative. I learned firsthand the importance of organizational leadership and the power of professional advocacy. I saw how this can produce results in new laws benefitting psychology and the public. My contributions of time were more than rewarded by becoming part of an inspiring network of like-minded colleagues across the country. Ultimately this avocation became my vocation for half of my career, when I had the good fortune to work as Assistant Executive Director for State Advocacy in the APA Practice Directorate. * My experience volunteering in the community during my 'retirement' has given me a wonderfully fulfilling life outside of psychology. Here inColumbia, South Carolina, I deliver Meals on Wheels, exercise special need dogs at Howlmore Animal Sanctuary, and volunteer through my church at the Transitions Centerfor persons who are homeless. Recently I was honored to be nominated for a national volunteer award given by the Meals on Wheels Association of America. In reality, I believe the honor is in serving others. Any day that I spend some time sharing my good fortune with others is a day that would leave me with no regrets if it turned out to be my last. I endorse Marian Wright Edelman's belief that 'Service is the rent we pay for living.' Volunteering is a wonderful vehicle for professional and community service. And the opportunities abound!" Not surprisingly, in recognition the Ohio Psychological Association in 2008 established the Division 31 (State, Provincial and Territorial Psychological Association Affairs) Michael Sullivan Diversity Scholarship Fund. Highlighting the importance of involvement and activism: "Our parents at the Autism Center helped us again – their letters helped us to get a $120,000 state appropriation to develop an online parent training program which we intend to use with parents who cannot access our center-based services. And their efforts with our annual fund raising event helped us raise $190,000 for the Center. They know how to do it! [Mary Beth Kenkel]"
Walter Penk, consultant in VA rehabilitation: "One challenge I hope to hear more about is the Student Veteran. VA psychologists have to do more for the Student Veteran. I'm consulting with the Dean of Students at The University of Texas at Austin, developing support for combat veterans using the GI Bill returning to college. The University already has about 1,000 veterans enrolled, including family members. AustinCommunity College has many more, above 2,000. Texas State University (where President Lyndon Baines Johnson went to college) in San Marcos, 30 miles south ofAustin, has 2,000+. This is a quickly growing population for which we want to make sure that they have the support necessary to complete their educational objectives. Some Student Veterans enter college and then drop out, discontinue, because they do not have as comprehensive an array of support that is needed, at the right time. So we, as psychologists, have a major job ahead of us to ensure Student Veterans get many kinds of support when needed. I'm pleased Secretary Shinseki has established the VITAL (Veterans Integration to Academic Leadership) program, led by Derek Blumke in the VA, assigning clinicians to work on campus. We received one such position for the Austin Outpatient Clinic, hired a clinical psychologist, Jay Morrison, who had trained at the NationalPTSD Center in Boston, and, who is now seeing many veterans on campus at the university. Student Veterans are such a rapidly growing population, marching now in the spirit of U.S. House of Representatives Edith Nourse Rogers – she who wrote the First GI Bill, signed by President Franklin Delano Roosevelt, on June 22, 1944. Nathan Ainspan and I, along with Alexa Smith-Osborne, presented a CE workshop in Orlando. The book Nate and I have written, When the Warrior Returns: Making the Transition at Home, will include these materials in more detail. I hope to hear more about the Student Veterans Manual that Marsha Ellison of The Edith Nourse Rogers Memorial Veterans Hospital is developing and the services VA psychologists will be providing for these students as the VA increasingly collaborates with college campuses and the GI bill."
Those who attended the inspirational Opening Ceremonies at our Orlandoconvention witnessed President Suzanne Bennett Johnson presenting Lifetime Achievement Awards to Kelly Brownell and Rena Wing for their decades of service to our nation and especially their groundbreaking research in effectively addressing obesity. As our President noted, psychologists have developed treatment programs that work and although obesity is a major public health issue, as well as a high priority of the Obama Administration, psychologists are currently not being reimbursed for this clinical care under the provisions of the President's landmarkPatient Protection and Affordable Care Act (PPACA) [P.L. 111-148]. The statutory language and implementing regulations for the Accountable Care Organization (ACO) andPatient Centered Medical Home (PCMH) initiatives of the law also do not recognize psychology's expertise. As a nation we currently spend more on health care than any other advanced country, spending 18% of our GDP vs. the next closest nations spending 12% or 13% of their GDP. And yet, we do not have enviable comparative health outcomes.
The Patient Protection and Affordable Care Act is projected to increase the number of Americans eligible for primary care services by an additional 32 million. This is at a time when, as Morgan Sammons points out, combining nurse practitioners (NPs) and physician assistants (PAs), the numbers of non-physician practitioners are on track to exceed that of primary care physicians in the not too distant future. There are approximately 250,000 NPs and PAs in clinical practice in theUnited States, compared with approximately 306,000 primary care allopathic physicians (medical and osteopathic doctors). This trend is highly consistent with projections made a decade ago. Interestingly, in March 1994 during the Clinton Administration health care reform deliberations, the APA Monitorpublished an article entitled: "Nurses are a model in health reform" quoting then Practice Directorate Executive Director Russ Newman. "Because nurses and psychologists share many of the same issues in regard to practice, the two professions can work together. At the center of both the nurses' issue and our [own]… is the question of collaborative treatment. How do non-physician providers and physicians collaborate to provide necessary treatment that is cost-effective, non-duplicative and uses appropriate resources?" As the current Executive Director for the Practice DirectorateKatherine Nordal strongly urged during this year's State Leadership conference which focused upon primary care, it is imperative that psychologists get personally involved at the local and state level in the ongoing health policy deliberations surrounding the implementation of PPACA. "We know that we can't do it alone. Our advocacy depends on effective collaborations and effective partnerships, and those are the relationships that we have to develop back home if we're going to get the job done." It is at the state and local level that the specifics of health care reform are being determined today.
Timely Changes Are Coming: During his Fiscal Year 2013 testimony before the Senate Appropriations Committee the Surgeon General of the U.S. Navy provided a thoughtful glimpse into the future. "I can report to you Navy Medicine remains strong, capable and mission-ready to deliver world class care, anytime, anywhere. We are operating forward and globally engaged, no matter what the environment and regardless of the challenge…. It is a challenge, but one that we are privileged to undertake." We see tremendous progress in joint medical operations with the Army and Air Force. Health is not simply the absence of infirmity or disease -- it is the complete state of physical, mental, spiritual and social well being. As our wounded warriors return from combat and begin the healing process, they deserve a seamless and comprehensive approach to their recovery. Our focus is integrative, complementary and multidisciplinary, bringing together clinical specialists, behavioral health providers, case managers, and chaplains.
We continue a robust translation research program in wound healing and wound care, moving technologies developed at the bench to deployment in the clinic to enhance the care of the wounded warfighter. We are focused on improving the capability and capacity to provide comprehensive and interdisciplinary pain management from the operational setting to the medical treatment facility to home. This priority includes pain management education and training to providers, patients, and families to prevent over-prescribing, misuse of medications, and promoting alternative therapies. Preserving the psychological health of service members and their families is one of the greatest challenges we face today. We continue to foster a culture of support for psychological health as an essential component to total force fitness and readiness. We address stigma by encouraging prevention, early intervention, and help-seeking behaviors. Navy Medicine has continued to adapt psychological health support across traditional and non-traditional health care systems. Access to psychological health services have increased in venues designed to reduce the effects associated with mental health stigma. We are focused on suicide prevention. We are integrating behavioral health providers in our Medical Home Port (MHP) program to help address the needs of our patients in the primary care setting. Post-Traumatic Stress Disorder (PTSD) is one of many psychological health conditions that adversely impacts operational readiness and quality of life. We have an umbrella of psychological health programs that target multiple, often co-occurring, mental health conditions. These support prevention, diagnosis, mitigation, treatment, and rehabilitation of PTSD. For our Marine Corps and Navy reserve populations, we have developed the Reserve Psychological Health Outreach Program (PHOP) 24/7 for unit leaders, reservists, and their families. Navy Medicine continues to leverage its unique relationships with the Army, Air Force, the VA, as well as other federal and civilian partners. This helps create system-wide synergies and fosters best practices in care, education and training, research, and technology. We share and collaborate with the VA throughout our enterprise. "The lucky old sun. He's got nothing to do. But roll around heaven all day." Aloha,
Pat DeLeon, former APA President – Division 42 – September, 2012
