Our 121st Annual APA Convention in Honolulu, Hawaii was truly exciting andprovided a timely glimpse into the future of psychology. The energy and enthusiasm of the next generation was palpable, as was their appreciation for the critical importance of becoming actively engaged within our nation's healthcare arena. The community mental health center movement had its beginning with the inspirational vision of President John F. Kennedy; the community health center movement was a feature of President Lyndon Johnson's Great Society, when psychologist John Gardner served as Secretary of the then-Department of Health, Education, and Welfare. Over the years, almost all training and service delivery programs treated mental health and substance-use as fundamentally separate and distinct from physical health care. Increasingly, however, enlightened clinicians and health policy experts (including the Institute of Medicine) have called for active integration, with the development of holistic, patient-centered clinical initiatives recognizing the critical importance of the psychosocial-economic-cultural gradient of care.
The Times They Are A-Changin': President Obama's signature Patient Protection and Affordable Care Act (ACA) will provide for the largest expansion of mental health and substance-use coverage in a generation, with 32.1 million Americans gaining access to these services, while another 30.4 million currently with some coverage gaining federal parity protection. Under ACA insurance offered in the new marketplace must cover a core set of "essential health benefits," including mental health and substance-use disorder services. The coverage for behavioral health services must be generally comparable with coverage for medical and surgical care. Ken Pope recently shared a similar perspective, noting that in 2009 public and private mental health spending totaled approximately $150 billion, more than double its level in inflation-adjusted terms in 1986. Perhaps most telling – listening to the Washington Redskins this weekend, two of their former quarterback commentators talked about the efforts of The Purple Heart Foundation to make readily available services for veterans suffering from PTSD and/or considering suicide. They were talking to a mainstream audience, not to the professional journal readership.
Visionaries: Oregon's health leaders have long been in the forefront of shaping our nation's evolving healthcare environment. In 2002 the State requested a Section 1115 Medicaid waiver to develop an effective "safety net" for your most needy citizens, recognizing the need for holistic and "wrap-around" care. Your 2009-2010 efforts to enact prescriptive authority (RxP) legislation, although not yet successful, places future generations in an enviable position to demonstrate their "value-add" in health care; at the St. Charles Health System Robin Henderson is demonstrating what psychology can contribute. In 2011 the State established the Oregon Health Insurance Exchange Corporation which is increasingly becoming the implementing vehicle for ACA. Earlier this summer representatives from the 16 states that have elected to run state exchanges met with officials from the Administration. According to Hawaii's Coral Andrews, they were very pleasantly surprised to hear President Obama himself join their conference call, requesting a personal briefing on the progress (and tribulations) they were experiencing. With expected retirements, the next Chairman of the Senate Finance Committee, which has jurisdiction over Medicare and Medicaid (i.e., major components of ACA), will most likely be Senator Ron Wyden, a longtime friend of psychology and professional nursing. Colleagues James Werth, Jr.; Greg Hinrichsen, and Mary Polce-Lynch served with him as APA Congressional Fellows. We would suggest, therefore, that those who does not appreciate the President's personal commitment to having all Americans have access to quality healthcare or who hope for Obama Care to be "defunded," simply have not been paying attention to the monumental importance of this national vision.
Having retired from the U.S. Senate staff after 38+ years with Senator Daniel K. Inouye, I have become quite interested in what "senior colleagues" are doing. This fall my wife and I will be visiting Oregon simply because we have never been there before together. Oregon is the home of former APA President and health psychologist extraordinaire Joe Matarazzo. It was a distinct pleasure to work closely with Joe as a member of the APA Board of Directors and over the years on behalf of health psychology. Today, whenever I go to the Uniformed Services University of the Health Sciences (USUHS) (DoD) in my part-time capacity as Distinguished Professor, I particularly appreciate his vision in establishing their Department of Medical Psychology. The local folklore is that four decades ago, while on the founding Board of Regents, Joe successfully convinced each of his fellow Regents to vote to establish the department, losing only the USUHS President's vote. Oregon's vision has, and will continue to, serve the nation admirably. Aloha,
Pat DeLeon, former APA President – Oregon Psychological Association – September, 2013
