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
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