“HALF A LEAGUE, HALF A LEAGUE, HALF A LEAGUE ONWARD”
The Department of Veterans Affairs (VA) recently highlighted September as Suicide Prevention Month. VA Secretary David Shulkin: “We know that in 2014, an average of 20 Veterans a day died in this country from suicide, which is 20 too many. This is a national public health crisis requiring a national public health approach. When it comes to preventing Veteran suicide, VA can’t – and should not – do this alone.” This pronouncement, which Ken Pope thoughtfully shared with us, stressed the VA’s commitment to increasing the number of Veterans and providers connecting through its Telemental Health services, as well as the number of its partnerships, including a national network of volunteer professionals at Give an Hour, in order to expand the availability of community-based mental health services for Veteran and military communities. The VA further noted that it will continue working with the Department of Defense (DoD) to identify at-risk service members and enroll them for VA care and engage them through community programs before they transition out of the military. Barbara Van Dahlen, President of Give an Hour, will be hosting a special interview with Secretary Shulkin on Sirius XM radio, honoring the VA’s role in changing the culture of mental health during September.
During the period leading up to our inspirational 125th APA annual convention, I had the opportunity to attend a meeting of the Association of VA Psychology Leaders (AVAPL), conducted under the stewardship of Russell Lemle, where those present actively addressed these issues and psychology’s potential contributions. I would have hoped that Division 19’s leadership would have been present as a number of your members will someday be providing or receiving care through the VA. There is a unique military culture which should definitely be represented throughout VA’s psychology and nursing corps, which employs (and is a major trainer of) more members of these professions than any other organization in the nation.
We have been particularly pleased with the flexibility Give an Hour has demonstrated in adjusting to “changing times.” Their successful model is now being expanded to address the mental health concerns of other populations who also clearly are in need -- including at risk teens, at risk seniors, survivors of gun violence, and victims of human trafficking. Give an Hour offers psychologists, psychiatric nurse practitioners, and other mental health professionals the opportunity to join their network in order to respond to natural and man-made disasters. Give an Hour has opened its network in response to the trauma in Charlottesville and most recently is now partnering with the Red Cross to respond to the unprecedented devastation on the Gulf Coast as a result of Hurricane Harvey.
From a broader policy perspective, health care in the United States is dramatically changing, as is the federal government’s approach to its historical clinical delivery and training responsibilities. Health care providers serving in the military should appreciate the significance of the fact that, along with VA Secretary David Shulkin, U.S. Army Surgeon General Nadja West, the highest ranking woman to graduate from the U.S. Military Academy, is also actively attempting to reshape military (i.e., federal) health care delivery by creating a culture of innovation and shifting the historical mindset that treatment can only be provided in a clinic. Two of her expressed priorities are: * Better access to behavioral health -- embedded behavioral health specialists and more virtual appointments to make it easier for soldiers and their families to get needed care more quickly and discreetly. And, * Telehealth – making virtual medical appointments become more commonplace as the Army ramps up its ability to deliver care at home with new equipment and training for care givers. Her underlying expressed goal is to build a “premier, expeditionary, globally integrated medical force.”
As Interim CEO, Cynthia Belar established the APA Office of Director of Military and Veterans Health Policy and appointed Heather O’Beirne Kelly, who has worked for APA for 19 years, as its first director. The administrative and legislative agendas of colleagues serving within these two federal agencies have considerable overlap; for example, providing visionary leadership in the training of the next generation of psychology’s clinicians to provide quality psychopharmacological (RxP) integrated care. Both Departments have long possessed the clinical expertise and clinical placements necessary to develop cutting-edge, quality training initiatives. From my discussions with students at the Uniformed Services University (USU) and during our annual conventions, many of our next generation desire to obtain this clinical skill – which former APA President Ron Fox and current President Tony Puente have always appreciated. Why is it, regardless of professional discipline, that those who have obtained positions of leadership (and perhaps authority) often seem to be the most difficult to convince that change is inevitable?
On August 15, 2017 for the second time a Governor of the State of Oregon vetoed the OPA RxP legislation. Several decades ago, U.S. Navy pioneers Morgan Sammons and John Sexton demonstrated that psychology could provide quality clinical psychopharmological care, notwithstanding the “public health hazard” arguments of organized medicine. Her expressed concern “related to patient safety and ensuring appropriate prescribing” has been addressed for over two decades. Our sincerest appreciation to Robin Henderson and her colleagues for continuing their quest on behalf of the citizens of Oregon. The “Nobel six hundred!” Aloha,
Pat DeLeon, former APA President – Division 19 – September, 2017
