APA annual conventions are always inspiring, and Honolulu was exceptionally so. Our next generation of colleagues clearly understands that the nation's health care environment is undergoing unprecedented change and, as former APA President Suzanne Bennett Johnson has noted: Medicine's recent paradigm shift from the biomedical to the biopsychosocial model is occurring with significant implications for psychology… providing opportunities and challenges. President Obama's landmark Patient Protection and Affordable Care Act envisions patient-centered, interdisciplinary primary caresystems, capitalizing upon the tremendous potential for data-based measures of quality health care, inherent in the communications and technology fields. Prevention, wellness, and holistic care will become the expected norm by educated consumers (i.e., patients) – with necessary modifications to our current reimbursement models.
One policy development that has particularly impressed me has been the increasing commitment by our sister professions' educational institutions to actively engage local communities in their own health care. This Fall, I visited our College of Pharmacy's annual health fair, held in a popular shopping mall on the Big Island of Hawaii. 152 Pharmacy students (in their white coats) with four faculty/community pharmacist volunteers, along with 68 community volunteers, served 372 participants; 159 receiving free health screenings and 133 entries in the "children's poster contest." This was an exciting community event – all ages, entertainment, music, etc. Psychology's graduate students could have made a significant contribution, addressing biopsychosocial issues such as smoking and substance-use cessation, relaxation techniques, and preventing the spread of HIV/AIDS. This is the future! NPR/ Kaiser Health News: "The state of Oregon is trying some experiments to bring different kinds of medical professionals under the same roof… in a primary care setting, where doctors often have to deal with stomach aches and migraines that end up stemming from mental, rather than physical, problems" – the vision of Robin Henderson, St. Charles Health System.
Under the leadership of Kimber Bogard, the Institute of Medicine (IOM) Board on Children, Youth, and Families has proffered a number of meaningful agendas for colleagues to pursue that would make a real difference. Following the recommendations of the 2009 IOM report on Preventing Mental, Emotional, and Behavioral Disorders Among Young People, the Board launched a Forum to advance an agenda on integrating prevention and treatment services that address children's cognitive, affective, and behavioral health in settings where they are seen and cared for. These places include schools, community based organizations, primary care offices, and child welfare settings. How to implement and scale up evidence-informed practices will be a focus of the activities of the Forum. Professor Emeritus Michael Murphy, with his lifelong passion for public policy, undoubtedly would urge IPA to engage in implementing effective programs targeting child abuse and neglect. Each year child protection services receive reports involving six million children, while many incidents go unreported. The IOM notes since its last report two decades ago, there has been great progress in child abuse and neglect research; yet, a coordinated, national research infrastructure with high-level federal support still needs to be established. Clearly there are significant long-term developmental and biological effects. Adverse outcomes include depression, PTSD, poor physical health, and attention difficulties and delinquency. Children age three and under are more likely to experience abuse and neglect. Every experience is unique. Almost half of all Americans will meet one or more clinical criteria for mental and behavioral health or substance abuse disorders in their life; the first onset usually in childhood or adolescence. Lifetime prevalence may be as high as 37% by age 16. Expenditures on mental and behavioral health and substance use treatment for children and adolescents approximate $12 billion annually. Throughout the convention, there were numerous symposia highlighting effective family-based initiatives. What will be the role of State Associations in furthering this important policy agenda? Aloha,
Pat DeLeon, former APA President – Indiana Psychological Association – October, 2013
