CHERISH YOUR HUMAN CONNECTIONS -- BECOME INVOLVED

The APA and APA Practice Organization annual State Leadership Conference – this year renamed the Practice Leadership Conference (PLC) – is always one of the highlights of my year.  Dan Abrahamson and Susie Lazaroff did an outstanding job.  Over 400 enthusiastic colleagues convened in our nation's Capital for the 34^th conference; highlighted by the Monday evening recognition of Congressman Tim Murphy's landmark efforts on behalf of our nation's mental health and substance abuse initiatives.  APA President Tony Puente and President-Elect Jessica Henderson Daniel were ever-present, with Tony envisioning the Rebirth of APA as he actively engaged with numerous graduate students and Early Career Psychologists.  The Plenary Session, featuring former congressional and administration operatives, entitled "Inside the White House and the 2017 Political Landscape" provided fascinating insights into the current political dynamics and an intimate sense of the perhaps unprecedented changes evolving.

The landscape for professional practice is definitely changing: how one will get reimbursed for providing care, the challenges and opportunities of integrated healthcare, the advent of technology -- social media and telehealth -- with the need for licensure mobility, and addressing the culture of business, law, and medicine.  Katherine Nordal's challenge for psychology "to appreciate the importance of being at the table" was most timely.  She conceptualized promoting psychologists by advancing the trade of professional psychology – truly a new message for a number of our colleagues – and by contributing to our Political Action Committee (PAC).  Today, the psychology PAC ranks 44^th among 129 health professional PACs with dentistry, medicine, optometry, nursing, physical therapy, podiatry, social work, and psychiatry significantly ahead of us.  The key to our long term survival as an autonomous profession is, and alwayshas been, visionary leadership within our State Associations.

            During President Donald Trump's inaugural address at the Joint Session of Congress, he offered a vision for America in which: "(T)he time has come to give Americans the freedom to purchase health insurance across State lines – creating a truly competitive national marketplace that will bring cost way down and provide for better care."  Those who have been involved in earlier state association legislation will recall the heroic efforts of former APA Presidents Nick Cummings and Jack Wiggins in the 1970-80s to enact "Freedom of Choice" legislation which ensured that psychological services would be readily available to patients.  President Trump further noted: "We should help Americans purchase their own coverage… but it must be the plan they want, not the plan forced on them by the Government."  "We should give our great State Governors the resources and flexibility they need with Medicaid to make sure no one is left out."

With flexibility comes the potential for eliminating a wide range of previously mandated health benefits, including those for mental health and substance abuse.  Not surprisingly, the GOP crafted healthcare legislation to "Repeal and Replace Obamacare" proposed that beginning in 2020, their plan would eliminate the mandate that Medicaid cover basic mental health and addiction services in those states that expanded their plan – adversely impacting 1.3 million Americans.  Their initial effort begins with Medicaid with further legislative proposals anticipated later on this Congress.  Theoretically, as psychology becomes more intimately integrated within the nation's overall healthcare system – as has been increasing the case within the public sector especially within the VA and DoD -- there will be little need for mandating our services.  However, if psychology is not at the table as Katherine urges, "we may be on the menu."  "Your relationships with friends and family."  Aloha,

Pat DeLeon, former APA President – Division 31 – March, 2017

 

Sent from my iPhone

Division 31 Spring column

“CHERISH YOUR HUMAN CONNECTIONS” -- BECOME INVOLVED

            The APA and APA Practice Organization annual State Leadership Conference – this year renamed the Practice Leadership Conference (PLC) – is always one of the highlights of my year.  Dan Abrahamson and Susie Lazaroff did an outstanding job.  Over 400 enthusiastic colleagues convened in our nation’s Capital for the 34^th conference; highlighted by the Monday evening recognition of Congressman Tim Murphy’s landmark efforts on behalf of our nation’s mental health and substance abuse initiatives.  APA President Tony Puente and President-Elect Jessica Henderson Daniel were ever-present, with Tony envisioning the Rebirth of APA as he actively engaged with numerous graduate students and Early Career Psychologists.  The Plenary Session, featuring former congressional and administration operatives, entitled “Inside the White House and the 2017 Political Landscape” provided fascinating insights into the current political dynamics and an intimate sense of the perhaps unprecedented changes evolving.

The landscape for professional practice is definitely changing: how one will get reimbursed for providing care, the challenges and opportunities of integrated healthcare, the advent of technology -- social media and telehealth -- with the need for licensure mobility, and addressing the culture of business, law, and medicine.  Katherine Nordal’s challenge for psychology “to appreciate the importance of being at the table” was most timely.  She conceptualized promoting psychologists by advancing the trade of professional psychology – truly a new message for a number of our colleagues – and by contributing to our Political Action Committee (PAC).  Today, the psychology PAC ranks 44^th among 129 health professional PACs with dentistry, medicine, optometry, nursing, physical therapy, podiatry, social work, and psychiatry significantly ahead of us.  The key to our long term survival as an autonomous profession is, and always has been, visionary leadership within our State Associations.

            During President Donald Trump’s inaugural address at the Joint Session of Congress, he offered a vision for America in which: “(T)he time has come to give Americans the freedom to purchase health insurance across State lines – creating a truly competitive national marketplace that will bring cost way down and provide for better care.”  Those who have been involved in earlier state association legislation will recall the heroic efforts of former APA Presidents Nick Cummings and Jack Wiggins in the 1970-80s to enact “Freedom of Choice” legislation which ensured that psychological services would be readily available to patients.  President Trump further noted: “We should help Americans purchase their own coverage… but it must be the plan they want, not the plan forced on them by the Government.”  “We should give our great State Governors the resources and flexibility they need with Medicaid to make sure no one is left out.”

With flexibility comes the potential for eliminating a wide range of previously mandated health benefits, including those for mental health and substance abuse.  Not surprisingly, the GOP crafted healthcare legislation to “Repeal and Replace Obamacare” proposed that beginning in 2020, their plan would eliminate the mandate that Medicaid cover basic mental health and addiction services in those states that expanded their plan – adversely impacting 1.3 million Americans.  Their initial effort begins with Medicaid with further legislative proposals anticipated later on this Congress.  Theoretically, as psychology becomes more intimately integrated within the nation’s overall healthcare system – as has been increasing the case within the public sector especially within the VA and DoD -- there will be little need for mandating our services.  However, if psychology is not at the table as Katherine urges, “we may be on the menu.”  “Your relationships with friends and family.”  Aloha,

Pat DeLeon, former APA President – Division 31 – March, 2017

 

Division 42 February 2017 column

“ALONE WE CAN DO SO LITTLE”

            Visionaries Making A Difference:  One of the most satisfying aspects of being involved in the public policy/political process is having the opportunity to personally interact with psychology’s visionaries, and those of other disciplines.  Steve Tulkin, who was the original architect of the Alliant International University psychopharmacology (RxP) training program, expanded his efforts beyond the Golden State to successfully mentor the pioneering class of Louisiana medical psychologists who became licensed to prescribe in 2004.  Equally important, Steve appreciated the long-term importance of engaging public service psychologists in this legislative quest.  Not only are these colleagues working within integrated systems that frequently utilize psychotropic medications, their patient populations represent those who are most in need of quality psychopharmacological care.  Steve’s previous employment was with Kaiser Permanente and he hosted the only “political gathering” that I had during my campaign for APA President.  Over the years, I have come to appreciate that successful visionaries must possess patience; effectively engage the next generation (i.e., serve as inspirational mentors); rise above themselves for a “greater good”; and understand the critical importance of being present when policy decisions are ultimately made (i.e., “at the table” as Katherine Nordal emphasizes at every APAPO State Leadership conference).

            “I am optimistic about growing opportunities for public service psychologists to obtain postdoctoral training in psychopharmacology.  Public service institutions are becoming more aware of the benefits of integrated care, both in terms of patient outcome and cost-effectiveness.  Expertise in psychopharmacology is critical for success in these settings (Journal of Clinical Psychology in Medical Settings, 2012).  Division 18 (Public Service) has a long history of supporting funding for public service psychologists to be trained in psychopharmacology.  After early grants from the Laszlo N. Tauber Family Foundation and the Irving and Dorothy Rom Foundation, there had been little success – until now.

“Last year the American Psychological Foundation (APF) announced the Walter Katkovsky Scholarships, which are ideally designed for public service psychologists.  These scholarships offer $5,000 to early career licensed psychologists (up to 10 years post-degree) to obtain training in an APA-Designated RxP program.  One of the goals of the scholarships is to encourage opportunities for psychologists to join healthcare teams to benefit patients who have psychological and medical problems.  Furthermore, ‘preference will be given to applicants with current or pending opportunities to work collaboratively with medical professionals in a medical setting (e.g., hospital, clinic, or community health center).’  Seems to me that this defines public service psychologists!  The Katkovsky Scholarships could well be a jump start to increased funding for psychopharmacology training for public service psychologists.  As more of us are trained and demonstrate our value to integrated teams, more public service institutions will allocate funding to train and hire psychologists with this unique expertise.  Your responsibility is to send in those applications, enter programs, and move on to prove our increased value to the patients and institutions we serve in the public sector (Steve Tulkin).”

            In January, Beth Rom-Rymer held her second networking event at her home, generating grass-roots enthusiasm for the implementation of the Illinois Psychological Association (IPA) RxP legislation.  Their landmark law is gradually moving through a careful administrative rules process.  Since the passage of the law in 2014, Beth has been active in cultivating and nurturing relationships with community partners.  Her ultimate goal is to facilitate collaborations with engaged community partners so that, together, significant improvements can be made throughout their statewide health care delivery system.  More than 80 individuals were in attendance that memorable evening, representing a wide range of RxP trainees and faculty; leaders of the Illinois managed care system; CEOs of hospitals and clinics; state government mental health and criminal justice leaders; and IPA governance members.  “As hoped for, we generated tremendous electricity in the air and a certain knowledge that we are creating revolutionary changes in the Illinois health care system, changes that are reverberating throughout the country.  What makes me most proud is the sense of community that we all feel (Beth Rom-Rymer.”  Beth truly appreciates the importance of taking on the role of mentor.  Being personally aware of the extraordinary needs in Indian country, she helped fund scholarships (over a period of five years) for Native American psychologists who were earning their Master’s degrees in clinical psychopharmacology at CCSP/Alliant University, in preparation for becoming prescribing psychologists.

            The Hawaii Psychological Association (HPA) initiated their first legislative effort to study obtaining RxP in 1985.  In 2007, their House and Senate passed RxP authorization bill was vetoed by the Governor.  Jill Oliveira-Gray and her HPA colleagues are committed for the long-haul, however, and have been emphasizing developing broad community support.  This February, Mental Health America of Hawaii (previously the Mental Health Association) alerted their members: “Mental Health at the Hawaii State Capitol.  The 2017 Legislature is in session and we have asked them to again support mental health by taking up the issue of prescriptive authority for psychologists with advanced training with House Bill 767 and Senate Bill 384.  Hawaii’s physician shortage is having a serious negative impact on mental health.  Depending on where you live and what type of insurance you have, it can be next to impossible to see a psychiatrist in a timely manner.  People on our neighbor islands are forced to visit the emergency room in crisis because they cannot get care when they need it.  Authorizing psychologists with advanced training to prescribe from a limited formulary of psychiatric medications will help patients avoid crisis and reach and maintain recovery.  If you would like to get involved in advocacy for prescriptive authority for psychologists or share your story with us, please email.…”  At Beth’s gathering, Bethe Lonning reported that since 2011, it had only been necessary to raise $3,535.50 in support of their Iowa RxP success.  The key to their legislative victory was grassroots campaigning and believing that what they were proposing was important for the citizens of Iowa.  In essence, this is the approach which HPA has taken.

            During her Presidential year, Susan McDaniel personified many of the key attributes of visionary leadership.  “When I ran for APA President, I thought I might have something to contribute to improving our nation’s health by making psychology and psychologists an essential part of our new healthcare system.  Certainly, I never dreamed it would be the experience it has been….  It has been stressful at significant times, but also inspiring and critically important.”  “One of the most useful things I did this year was to engage a group of seven diverse Early Career Psychologists (ECPs) to mentor me and discuss key challenges in front of APA and the APAPO on monthly phone calls.  It seemed like a good idea during the summer of 2015.  Actually enacting it was far more useful than I imagined; I think because this group is supremely talented and diverse in every way – psychology researchers/practitioners/policy makers; demographic diversities, urban and rural, etc.  Thanks to each of these talented psychologists – Le Ondra Clark Harvey, Lindsey Buckman, Sabrina Esbitt, Angela Kuemmel, Shawn McClintock, Innocent Okozi, and Emily Selby-Nelson -- for providing me invaluable perspectives, ideas, suggestions, leaving me with complete conviction that the long-term future of Psychology and the APA is bright because of their current and future leadership.”

            Given the volatile nature of the ongoing health care debates during the national Presidential campaigns, Susan was quite creative in focusing upon the multitude roles psychology could play within the nation’s health care environment regardless of how one might define the most appropriate role for government per se.  One of her impressive initiatives was an Integrated Primary Care Alliance, during which she hosted 83 Presidents, CEOs, and governmental relations staff from 23 different professional associations at the APA headquarters.  Another explored developing a Curriculum for an Interprofessional Seminar on Integrated Primary Care.  Her third focused on Integrated Specialty Care which, although around longer than many appreciate and is especially successful within the VA, is often overlooked.  Finally, she and team researcher Eduardo Salas will be co-editing a special issue of the American Psychologist addressing Interprofessional Team Science and the Science of Teams.

            Each of the colleagues described above continue to make a real difference in the daily lives of our nation’s citizens.  Above all else, they are committed to fulfilling a vision which supersedes themselves as individuals.  They represent the “best of psychology and public service.”  “Together we can do so much.”  Aloha,

Pat DeLeon, former APA President – Division 42 – February, 2017

 

 

ALONE WE CAN DO SO LITTLE

Visionaries Making A Difference:  One of the most satisfying aspects of being involved in the public policy/political process is having the opportunity to personally interact with psychology's visionaries, and those of other disciplines.  Steve Tulkin, who was the original architect of the Alliant International University psychopharmacology (RxP) training program, expanded his efforts beyond the Golden State to successfully mentor the pioneering class of Louisiana medical psychologists who became licensed to prescribe in 2004.  Equally important, Steve appreciated the long-term importance of engaging public service psychologists in this legislative quest.  Not only are these colleagues working within integrated systems that frequently utilize psychotropic medications, their patient populations represent those who are most in need of quality psychopharmacological care.  Steve's previous employment was with Kaiser Permanente and he hosted the only "political gathering" that I had during my campaign for APA President.  Over the years, I have come to appreciate that successful visionaries must possess patience; effectively engage the next generation (i.e., serve as inspirational mentors); rise above themselves for a "greater good"; and understand the critical importance of being present when policy decisions are ultimately made (i.e., "at the table" as Katherine Nordal emphasizes at every APAPO State Leadership conference).

            "I am optimistic about growing opportunities for public service psychologists to obtain postdoctoral training in psychopharmacology.  Public service institutions are becoming more aware of the benefits of integrated care, both in terms of patient outcome and cost-effectiveness.  Expertise in psychopharmacology is critical for success in these settings (Journal of Clinical Psychology in Medical Settings, 2012).  Division 18 (Public Service) has a long history of supporting funding for public service psychologists to be trained in psychopharmacology.  After early grants from the Laszlo N. Tauber Family Foundation and the Irving and Dorothy Rom Foundation, there had been little success – until now.

"Last year the American Psychological Foundation (APF) announced the Walter Katkovsky Scholarships, which are ideally designed for public service psychologists.  These scholarships offer $5,000 to early career licensed psychologists (up to 10 years post-degree) to obtain training in an APA-Designated RxP program.  One of the goals of the scholarships is to encourage opportunities for psychologists to join healthcare teams to benefit patients who have psychological and medical problems.  Furthermore, 'preference will be given to applicants with current or pending opportunities to work collaboratively with medical professionals in a medical setting (e.g., hospital, clinic, or community health center).'  Seems to me that this defines public service psychologists!  The Katkovsky Scholarships could well be a jump start to increased funding for psychopharmacology training for public service psychologists.  As more of us are trained and demonstrate our value to integrated teams, more public service institutions will allocate funding to train and hire psychologists with this unique expertise.  Your responsibility is to send in those applications, enter programs, and move on to prove our increased value to the patients and institutions we serve in the public sector (Steve Tulkin)."

            In January, Beth Rom-Rymer held her second networking event at her home, generating grass-roots enthusiasm for the implementation of the Illinois Psychological Association (IPA) RxP legislation.  Their landmark law is gradually moving through a careful administrative rules process.  Since the passage of the law in 2014, Beth has been active in cultivating and nurturing relationships with community partners.  Her ultimate goal is to facilitate collaborations with engaged community partners so that, together, significant improvements can be made throughout their statewide health care delivery system.  More than 80 individuals were in attendance that memorable evening, representing a wide range of RxP trainees and faculty; leaders of the Illinois managed care system; CEOs of hospitals and clinics; state government mental health and criminal justice leaders; and IPA governance members.  "As hoped for, we generated tremendous electricity in the air and a certain knowledge that we are creating revolutionary changes in the Illinois health care system, changes that are reverberating throughout the country.  What makes me most proud is the sense of community that we all feel (Beth Rom-Rymer."  Beth truly appreciates the importance of taking on the role of mentor.  Being personally aware of the extraordinary needs in Indian country, she helped fund scholarships (over a period of five years) for Native American psychologists who were earning their Master's degrees in clinical psychopharmacology at CCSP/Alliant University, in preparation for becoming prescribing psychologists.

            The Hawaii Psychological Association (HPA) initiated their first legislative effort to studyobtaining RxP in 1985.  In 2007, their House and Senate passed RxP authorization bill was vetoed by the Governor.  Jill Oliveira-Gray and her HPA colleagues are committed for the long-haul, however, and have been emphasizing developing broad community support.  This February, Mental Health America of Hawaii (previously the Mental Health Association) alerted their members: "Mental Health at the Hawaii State Capitol.  The 2017 Legislature is in session and we have asked them to again support mental health by taking up the issue of prescriptive authority for psychologists with advanced training with House Bill 767 and Senate Bill 384.  Hawaii's physician shortage is having a serious negative impact on mental health.  Depending on where you live and what type of insurance you have, it can be next to impossible to see a psychiatrist in a timely manner.  People on our neighbor islands are forced to visit the emergency room in crisis because they cannot get care when they need it.  Authorizing psychologists with advanced training to prescribe from a limited formulary of psychiatric medications will help patients avoid crisis and reach and maintain recovery.  If you would like to get involved in advocacy for prescriptive authority for psychologists or share your story with us, please email.…"  At Beth's gathering, Bethe Lonning reported that since 2011, it had only been necessary to raise $3,535.50 in support of their Iowa RxP success.  The key to their legislative victory was grassroots campaigning and believing that what they were proposing was important for the citizens of Iowa.  In essence, this is the approach which HPA has taken.

            During her Presidential year, Susan McDaniel personified many of the key attributes of visionary leadership.  "When I ran for APA President, I thought I might have something to contribute to improving our nation's health by making psychology and psychologists an essential part of our new healthcare system.  Certainly, I never dreamed it would be the experience it has been….  It has been stressful at significant times, but also inspiring and critically important."  "One of the most useful things I did this year was to engage a group of seven diverse Early Career Psychologists (ECPs) to mentor me and discuss key challenges in front of APA and the APAPO on monthly phone calls.  It seemed like a good idea during the summer of 2015.  Actually enacting it was far more useful than I imagined; I think because this group is supremely talented and diverse in every way – psychology researchers/practitioners/policy makers; demographic diversities, urban and rural, etc.  Thanks to each of these talented psychologists – Le Ondra Clark Harvey, Lindsey Buckman, Sabrina Esbitt, Angela Kuemmel, Shawn McClintock, Innocent Okozi, and Emily Selby-Nelson -- for providing me invaluable perspectives, ideas, suggestions, leaving me with complete conviction that the long-term future of Psychology and the APA is bright because of their current and future leadership."

            Given the volatile nature of the ongoing health care debates during the national Presidential campaigns, Susan was quite creative in focusing upon the multitude roles psychology could play within the nation's health care environment regardless of how one might define the most appropriate role for government per se.  One of her impressive initiatives was an Integrated Primary Care Alliance, during which she hosted 83 Presidents, CEOs, and governmental relations staff from 23 different professional associations at the APA headquarters.  Another explored developing a Curriculum for an Interprofessional Seminar on Integrated Primary Care.  Her third focused on Integrated Specialty Care which, although around longer than many appreciate and is especially successful within the VA, is often overlooked.  Finally, she and team researcher Eduardo Salas will be co-editing a special issue of the American Psychologist addressing Interprofessional Team Science and the Science of Teams.

            Each of the colleagues described above continue to make a real difference in the daily lives of our nation's citizens.  Above all else, they are committed to fulfilling a vision which supersedes themselves as individuals.  They represent the "best of psychology and public service."  "Together we can do so much."  Aloha,

Pat DeLeon, former APA President – Division 42 – February, 2017

 

Sent from my iPhone

Division 19 column

“IF YOU DON’T KNOW WHERE YOU ARE GOING”

            These are “interesting” times.  On January 27, 2017, President Trump issued a National Security Presidential Memorandum: “Policy: To pursue peace through strength, it shall be the policy of the United States to rebuild the U.S. Armed Forces.”   He has continued to reaffirm his commitment to repealing the Affordable Care Act.  Undoubtedly, victory will eventually be proclaimed.  The details, however, will be critical.  Does the Administration appreciate the strategic importance of a robust international humanitarian presence to national security, the long-term benefits of preventive health care, or the effectiveness of integrated behavioral health care?  APA is very fortunate that President Susan McDaniel possessed the vision during her tenure to make a special effort to actively encourage interactions with our international colleagues, as well as to invite Jeff Goodie of the Uniformed Services University of the Health Sciences (USUHS) to co-chair her efforts to establish a curriculum for an Interprofessional Seminar on Integrated Primary Care.  Colleagues within the VA had the opportunity to engage with her during their 2016 VA Psychology Leadership (AVAPL) conference in San Antonio.  Yet, APA still does not have an office of Veterans or Military Affairs.

            The Fiscal Year 2017 National Defense Authorization Act (P.L. 114-328) foreshadows significant change within the military health care system.  The conferees: “After careful study and deliberation, the conferees conclude that a single agency [Defense Health Agency] responsible for the administration of all MTFs [military treatment facilities] would best improve and sustain operational medical force readiness and the medical readiness of the Armed Forces, improve beneficiaries’ access to care and the experience of care, improve health outcomes, and lower the total management cost of the military health system.  The conferees believe that the current organizational structure of the military health system – essentially three separate health systems each managed by one of the three Services – paralyzes rapid decision-making and stifles innovation in producing a modern health care delivery system that would better serve all beneficiaries.  A streamlined military health system management structure would eliminate redundancy and generate greater efficiency, yielding monetary savings to the Department while leading to true reform of the military health system and improving the experience of care for beneficiaries.”

            The law further repealed the statutory specification of general flag officers for various corps specific leadership positions (i.e., two-star rank for the dental and nursing corps and one-star rank for the veterinary corps).  The conferees also removed the statutory general officer grade requirement associated with the military Surgeon Generals.  Of particular interest to mental health, the final agreement included a provision which authorized the Secretary to conduct a pilot program to assess the feasibility and advisability of expanding the use of physician assistants (PAs) specializing in psychiatric medicine at medical facilities of the Department of Defense.  If the Secretary decides to conduct this pilot program, a report is to be submitted to the Congressional Committees on Armed Services of the Senate and House of Representatives within 90 days of completion of the program.

This January, several faculty and students from our health policy class at USUHS had the opportunity to tour the aircraft carrier USS George H.W. Bush (CVN 77) on which psychologist Navy Lieutenant Amanda Berg, along with 5,500 Navy colleagues (approximately 80% of whom are less than 25 years old), serves.  “Mental health on an aircraft carrier takes psychologists out of the office and onto the deckplates to the heart of human experience.  Mental health professionals in these settings are on the front line of preventive medicine and in vivo training to enact change and reinforce healthy behaviors.  The embedded psychologist becomes an accessible resource for Sailors dealing with stressors as well as leaders seeking ways to enhance the performance of their ‘organization.’  By living and working together around the clock, this nontraditional approach to mental health care breaks down the barriers of seeking help from experts in human behavior, emotions, cognitions, and motivation to promote individual and group development.  These nontraditional practices parallel movements across the field of psychology which is becoming to note the ‘value added’ by mental health through integration in primary care settings and multidisciplinary teams.”  Gary VandenBos and I co-edit the Division 18 journal Psychological Services and we would love to receive submissions describing similar unique training and service opportunities from our public service colleagues.

National Guard:  During our nation’s longest armed conflict, the role and expectations for the National Guard have been dramatically transformed.  This was evident in the briefing our class received from U.S. Army Major Jamie Cook, chief of Behavioral Health for the Army National Guard and at the Sirius XM radio broadcast “Changing the Culture of Mental Health: It’s Time,” hosted by Barbara Van Dahlen of Give an Hour (who recently received the Secretary of the Army’s Public Service Award) featuring Dr. Jill Biden.  “The Biden family is a National Guard family.  Eight years ago, our son Beau proudly deployed for a year to Iraq with the Delaware Army National Guard 261^st Signal Brigade….  When Beau returned home – knowing that Mrs. Obama and I had begun to plan the work eventually known as Joining Forces – he asked that we especially focus on de-stigmatizing and addressing the wounds that could not be seen: such as PTSD and TBI.  The length of those wars and multiple deployments had naturally taken its toll.  And we needed to address the mental wellbeing of our military upfront with dignity and respect.”  “Any road can take you there.”   Aloha,

Pat DeLeon, former APA President – Division 19 – February, 2017

 

IF YOU DON’T KNOW WHERE YOU ARE GOING

   These are "interesting" times.  On January 27, 2017, President Trump issued a National Security Presidential Memorandum: "Policy: To pursue peace through strength, it shall be the policy of the United States to rebuild the U.S. Armed Forces."   He has continued to reaffirm his commitment to repealing the Affordable Care Act.  Undoubtedly, victory will eventually be proclaimed.  The details, however, will be critical.  Does the Administration appreciate the strategic importance of a robust international humanitarian presence to national security, the long-term benefits of preventive health care, or the effectiveness of integrated behavioral health care?  APA is very fortunate that President Susan McDaniel possessed the vision during her tenure to make a special effort to actively encourage interactions with our international colleagues, as well as to invite Jeff Goodie of the Uniformed Services University of the Health Sciences (USUHS) to co-chair her efforts to establish a curriculum for an Interprofessional Seminar on Integrated Primary Care.  Colleagues within the VA had the opportunity to engage with her during their 2016 VA Psychology Leadership (AVAPL) conference in San Antonio.  Yet, APA still does not have an office of Veterans or Military Affairs.

            The Fiscal Year 2017 National Defense Authorization Act (P.L. 114-328) foreshadows significant change within the military health care system.  The conferees: "After careful study and deliberation, the conferees conclude that a single agency [Defense Health Agency] responsible for the administration of all MTFs [military treatment facilities] would best improve and sustain operational medical force readiness and the medical readiness of the Armed Forces, improve beneficiaries' access to care and the experience of care, improve health outcomes, and lower the total management cost of the military health system.  The conferees believe that the current organizational structure of the military health system – essentially three separate health systems each managed by one of the three Services – paralyzes rapid decision-making and stifles innovation in producing a modern health care delivery system that would better serve all beneficiaries.  A streamlined military health system management structure would eliminate redundancy and generate greater efficiency, yielding monetary savings to the Department while leading to true reform of the military health system and improving the experience of care for beneficiaries."

            The law further repealed the statutory specification of general flag officers for various corps specific leadership positions (i.e., two-star rank for the dental and nursing corps and one-star rank for the veterinary corps).  The conferees also removed the statutory general officer grade requirement associated with the military Surgeon Generals.  Of particular interest to mental health, the final agreement included a provision which authorized the Secretary to conduct a pilot program to assess the feasibility and advisability of expanding the use of physician assistants (PAs) specializing in psychiatric medicine at medical facilities of the Department of Defense.  If the Secretary decides to conduct this pilot program, a report is to be submitted to the Congressional Committees on Armed Services of the Senate and House of Representatives within 90 days of completion of the program.

This January, several faculty and students from our health policy class at USUHS had the opportunity to tour the aircraft carrier USS George H.W. Bush (CVN 77) on which psychologist Navy Lieutenant Amanda Berg, along with 5,500 Navy colleagues (approximately 80% of whom are less than 25 years old), serves.  "Mental health on an aircraft carrier takes psychologists out of the office and onto the deckplates to the heart of human experience.  Mental health professionals in these settings are on the front line of preventive medicine and in vivo training to enact change and reinforce healthy behaviors.  The embedded psychologist becomes an accessible resource for Sailors dealing with stressors as well as leaders seeking ways to enhance the performance of their 'organization.'  By living and working together around the clock, this nontraditional approach to mental health care breaks down the barriers of seeking help from experts in human behavior, emotions, cognitions, and motivation to promote individual and group development.  These nontraditional practices parallel movements across the field of psychology which is becoming to note the 'value added' by mental health through integration in primary care settings and multidisciplinary teams."  Gary VandenBos and I co-edit the Division 18 journal Psychological Servicesand we would love to receive submissions describing similar unique training and service opportunities from our public service colleagues.

National Guard:  During our nation's longest armed conflict, the role and expectations for the National Guard have been dramatically transformed.  This was evident in the briefing our class received from U.S. Army Major Jamie Cook, chief of Behavioral Health for the Army National Guard and at the Sirius XM radio broadcast "Changing the Culture of Mental Health: It's Time," hosted by Barbara Van Dahlen of Give an Hour (who recently received the Secretary of the Army's Public Service Award) featuring Dr. Jill Biden.  "The Biden family is a National Guard family.  Eight years ago, our son Beau proudly deployed for a year to Iraq with the Delaware Army National Guard 261^stSignal Brigade….  When Beau returned home – knowing that Mrs. Obama and I had begun to plan the work eventually known as Joining Forces – he asked that we especially focus on de-stigmatizing and addressing the wounds that could not be seen: such as PTSD and TBI.  The length of those wars and multiple deployments had naturally taken its toll.  And we needed to address the mental wellbeing of our military upfront with dignity and respect."  "Any road can take you there."   Aloha,

Pat DeLeon, former APA President – Division 19 – February, 2017

 

Sent from my iPhone