Saturday, December 8, 2018

ONE MAN WITH CONVICTION WILL OVERWHELM A HUNDRED WHO HAVE ONLY OPINIONS

The 2018 elections will definitely bring a new face and new voice to the U.S. Congress. More than 100 women are projected to win seats in the House of Representatives; an all-time record with women never having held more than 84 seats in the past. Many of these victorious candidates campaigned on the need for better health care for all Americans. They came from a wide variety of backgrounds, from military Veterans to teachers, and many had never run for office before. On Election Day Veterans won at least 77 House seats, joining 15 others already in the U.S. Senate. Together, they represent the largest cohort of Veterans in Congress in almost a decade. For much of the later part of the 20th century Veterans accounted for more than half of the Members of Congress; their percentage shrinking to less than 20% in recent years. As The Washington Post noted: "Veterans – trained in teamwork, and perhaps less invested in proving their toughness with public put-downs and posturing – are more inclined to work across the aisle…. (They) sign on to bipartisan legislation more often than Members who have not served in the military."

Long time VA visionary and public servant Russell Lemle, along with colleagues Joan Zweben and Joe Ruzek, have been working with the non-profit Veterans Healthcare Policy Institute (VHPI) to ensure that the Veterans Health Administration (VHA) will be strengthened and reformed, and not dismantled and privatized, as some leading political commentators have suggested. They have produced detailed analyses about the impact of various proposed policies on Veterans, written investigative pieces on mental health Choice options, and placed interdisciplinary-oriented briefs into the official record of Congressional hearings. They have especially worked to elevate the positive stories of Veterans' healthcare experiences, with the active support of former heads of various governmental healthcare agencies and a dedicated group of Veterans, healthcare providers, journalists, and activists. Suzanne Gordon, another VHPI analyst, just published an incisive book, Wounds of War, that illuminates the innovate care throughout the VHA system, devoting eight chapters to mental health. These efforts are more important than ever as the Administration continues to contemplate outsourcing much of traditional VA healthcare to the private sector, while downsizing VHA facilities. Russell is increasingly optimistic that their collective voices will be heard by the new Congress.

Another visionary colleague, Femina Varghese, serves as Associate Editor for the Division 18 journal Psychological Services, where she strives to expose our nation's public service colleagues to the evolving trends of the future; for example, interprofessional, team-based integrated care and how the unprecedented developments within the technology field will continue to have a major impact upon healthcare. She was recently awarded $350,000 from the Robert Wood Johnson Foundation (RWJF) for her project "Regional Expansion of Treatment for Addiction in Corrections via Tele-Health: Project REACH." Femina, who is at the University of Central Arkansas, and her colleagues, Nickolas Zaller (University of Arkansas for Medical Sciences) and Ben Udochi (Arkansas Department of Community Corrections), are the principal investigators. Their project will provide counseling services through video conferencing to parolees in rural Arkansas to target risk factors to recidivism. It was selected as part of the competitive RWJF Interdisciplinary Research Leaders program, which engages both researchers and community partners to strengthen communities towards positive health outcomes. Counseling psychology doctoral students from the University of Central Arkansas's APA accredited PhD program will be delivering supervised services through telehealth. The students are excited to have the experience of providing services to such a marginalized population using up-to-date technology. Their aspiration is to develop a model for a rural telehealth program to provide treatment for behavioral health disorders in a community corrections office. They hope that their findings will increase the use of telehealth services to reach correctional populations and thereby provide needed services.

Nick Cummings served as APA President in 1979 and is well known for his highly accurate, although often quite unpopular, predictions, over the years, regarding the nation's ever-evolving healthcare environment. "The terrible massacre in Pittsburg has caused us to focus on anti-Semitism; but this is only the latest in a series of extensive murders by mentally ill persons with so-called 'honorable' miss-beliefs. Having lived to age 94, I remember well the era when mentally ill persons were by law forcibly hospitalized. There were no such murders then, but the system was much abused. For example, gay men were regarded as 'mentally ill' and were subjected to hospitalization until they ostensibly demonstrated they had become heterosexual. As a result, the mental hospital system was over-flowing with patients who did not belong there. Even worse was the subsequent era of Dr. Freeman who purported to 'cure' the mentally ill by giving them all a lobotomy. Mental hospitals lined up mentally ill patients while Freeman performed one prefrontal lobotomy after another using a box of ordinary non-sterilized ice picks, throwing each away after use. I recall when Freeman bragged he had performed his number 5,000 lobotomy. Mental hospitals would line up their hapless patients upon his arrival. Because hospitalized patients did not (could not) commit crimes, the absurd conclusion was reached that mentally ill patients were not dangerous and should be given their civil rights. This has resulted in allowing dangerously mentally ill persons, who openly threaten, to maintain their freedom until they commit a punishable crime. Unfortunately this is not only late; it very often results in a mass murder. The health system, along with psychology, needs to strike a balance between free speech and public safety."

This fall I had the pleasure of attending the celebration of the 25th Anniversary of The Board of Children, Youth, and Families of the National Academies of Sciences, Engineering, and Medicine. Former APA Congressional Fellow Natacha Blain is the current staff Director, following upon the impressive successes of fellow psychologist Kimber Bogard. Over the years, the Board has developed a number of insightful, interdisciplinary-oriented, cutting-edge reports bringing the best of science to focus upon the needs of our nation's future generations. Equally impressive, has been their visionary conviction regarding the importance of effectively bringing their recommendations to the attention of our nation's policy-makers at the local, regional, and national level. For example, "Young adulthood (spanning the ages of approximately 18-26) is a significant and pivotal time of life…. Any conversation with today's young adults is likely to evoke observations about the stresses and uncertainties they confront. (Their) needs, and the challenges they face, do not receive a great deal of systematic attention in policy and research…." That, "Increasing numbers of evidence-based interventions have proven effective in preventing and treating behavioral disorders in children. However, the adoption of these interventions in the health care system and other systems that affect the lives of children has been slow…." And, "Parents are among the most important people in the lives of young children." Over the years, their insightful strategies have, and are continuing to, make a real difference in the lives of our nation's children. As one keynote speaker envisions, Evidence-base practice is not the destination, it is the start of an important process. [Winston Churchill]. Aloha,

Pat DeLeon, former APA President – Hawaii Psychological Association – December, 2018


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