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 125^th 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

 

Sent from my iPhone

ALOHA - D19 column

“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 125^th 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

 

SOME MEN SEE THINGS AS THEY ARE, AND ASK WHY

   The Windy City:  After our inspirational 125^th APA annual convention, I was invited by Beth Rom-Rymer to participate in her third, extraordinarily exciting prescriptive authority (RxP) Illinois "social gathering."  "Illinois is continuing to move quickly with the implementation of our Prescriptive Authority Law.  It is expected that our Rules will be approved on or about September 15, 2017.  We have at least 150 psychologists who are currently training to become prescribing psychologists and 20 psychologists who have completed their Masters Degrees in Clinical Psychopharmacology and their seven required basic science undergraduate courses and are poised to enter their medical rotations.  These medical rotations include: psychiatry, family medicine, internal medicine, emergency medicine, pediatrics, geriatrics, ob/gynecology, surgery, and an elective.  We have at least eight hospitals and medical centers, throughout the state, whose CEOs and Medical Directors are working with us to provide the rotation opportunities for our prescribing psychology trainees.

"It has been a great gift of our law that we have been mandated to create training programs in hospitals, clinics, and medical centers.  Creating the medical rotations has, indeed, generated much good will and lots of interdisciplinary work among the medical, the psychiatric, and the psychological communities.  Undergraduate and graduate students are also taking advantage of training opportunities in our state to become prescribing psychologists.  There are currently as many as 15 graduate students who are ready to embark on earning their joint degrees in Clinical Psychopharmacology at New Mexico State University while pursuing their doctorates in clinical psychology at schools in Illinois.  At the University of Illinois, Champaign-Urbana, there are 75 undergraduates who have chosen to 'concentrate' in a 'pre-prescribing psychologist' curriculum and I have been asked to formally mentor them.  The Chicago School of Professional Psychology will be opening its doors to training students in Clinical Psychopharmacology on September 1^st.

"On August 18^th I hosted a networking dinner for our prescribing psychology trainees, ranging in age from 19 to 85 years old; our hospital and medical center CEOs and medical directors; the assistant director and the chief psychologist of the Illinois Department of Corrections; the Executive Director of NAMI; the Vice President of our largest social service organization, Thresholds; and the President, administrative staff, and faculty of The Chicago School of Professional Psychology.  Governor Pat Quinn, our former Illinois governor who signed our legislation into law on June 25, 2014, was there to give a rousing speech on the importance of prescribing psychologists and the revolution in healthcare around the nation.  More than 105 individuals were present and we are looking forward to our next event in January, 2018 with some additional special guests [Beth Rom-Rymer]."  Beth recently sponsored up to nine $5,000 scholarships – following up on her earlier commitment at Alliant International University -- to support graduate students and practicing licensed psychologists to complete their training in psychopharmacology.  Her expectation is that half of the scholarships, which give a preference to those committed to working with the underserved, will be awarded to pre-doctoral graduate students.

Give an Hour:  For the past 12 years, Give an Hour has provided free mental health care to those who serve, our Veterans and their families.  Give an Hour's generous volunteer mental health professionals have collectively donated over 124,000 hours of free care and support valued at nearly $23 million.  Psychologist Barbara Van Dahlen founded the organization and has become a noted expert on harnessing skill based volunteers as well as the mental health consequences of military service.  She has received numerous honors for this innovative work – most notably, she was named to Time Magazine's list of the 100 Most Influential People in the World for her creation of Give an Hour in 2012.  In 2013 she received an APA Presidential Citation from President Don Bersoff and in 2014 Barbara received the Outstanding Civilian Service Award from the U.S. Army.

Give an Hour also leads the Campaign to Change Direction [www.changedirection.org], a collective impact effort that includes the APA as a founding member.  This public health approach is focused on changing the culture of mental health by encouraging everyone to Know the Five Signs of Emotional Suffering.  It also encourages everyone to Learn the Healthy Habits of Emotional Well-Being.  President Barack Obama has personally heralded their importance.

Barbara's work has been so successful in identifying and engaging champions for this work including First Lady Michelle Obama, Dr. Jill Biden, Richard Gere, Brian Wilson, and Chris Stapleton.  Through her relationship with the Royal Foundation, Barbara secured participation in the Campaign by Prince Harry.  She recently wrote a poignant piece about the anniversary of Princess Diana's death – and how Price Harry and Prince William are carrying on their mother's legacy of caring for those who are suffering emotionally [http://bit.ly/2vART1E].

Give an Hour's model has been proven and is now being expanded to address the mental health concerns of other populations 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 the network in order to respond to natural and man-made disasters.  Most recently, Give an Hour opened its network in response to the trauma in Charlottesville and is opening its network to respond to the devastation in Houston.  If you aren't currently giving your hour, please consider giving your gift of time and expertise and join today at [www.giveanhour.org].

We are especially pleased with the extent to which Barbara has been supportive of our efforts at the Uniformed Services University (USU) to train the next generation of military clinical psychologists and psychiatric nurse practitioners.  Faculty member Teresa Combs of the Daniel K. Inouye Graduate School of Nursing: "For approximately the past two years, I've volunteered for Give an Hour.  I've treated several members and volunteered at several of their local events.  The Service Members I've seen are genuinely appreciative to have this service available.  I'm convinced there is the need for more mental health providers to offer services.  It is not uncommon for the Members to report the length of time they have waited for services.  Furthermore, there is a sign of relief when they are convinced the sessions are absolutely confidential."  Will you make that all important individual commitment?

Especially in the Face of Adversity:  In April, 2010 the Governor of Oregon vetoed the OPA psychology RxP legislation.  This August, another Governor vetoed HB 3355, expressing concern "particularly related to patient safety and ensuring appropriate prescribing."  OPA's legislation had overwhelming passed both houses of the Oregon legislature, which clearly has a different perspective.  Our sincerest appreciation to Robin Henderson and her colleagues for continuing to work tirelessly on behalf of the citizens of their state.  The Governor's expressed concerns can be satisfactorily addressed.  Her comment "There is insufficient evidence that the bill will improve access or quality of care" ignores the federal experience, especially that of Oregonian Morgan Sammons.  "I dream of things that never were, and ask why not."  Aloha.

Pat DeLeon, former APA President – HPA -- September, 2017

 

Sent from my iPhone

HPA - September column

“SOME MEN SEE THINGS AS THEY ARE, AND ASK WHY”

            The Windy City:  After our inspirational 125^th APA annual convention, I was invited by Beth Rom-Rymer to participate in her third, extraordinarily exciting prescriptive authority (RxP) Illinois “social gathering.”  “Illinois is continuing to move quickly with the implementation of our Prescriptive Authority Law.  It is expected that our Rules will be approved on or about September 15, 2017.  We have at least 150 psychologists who are currently training to become prescribing psychologists and 20 psychologists who have completed their Masters Degrees in Clinical Psychopharmacology and their seven required basic science undergraduate courses and are poised to enter their medical rotations.  These medical rotations include: psychiatry, family medicine, internal medicine, emergency medicine, pediatrics, geriatrics, ob/gynecology, surgery, and an elective.  We have at least eight hospitals and medical centers, throughout the state, whose CEOs and Medical Directors are working with us to provide the rotation opportunities for our prescribing psychology trainees.

“It has been a great gift of our law that we have been mandated to create training programs in hospitals, clinics, and medical centers.  Creating the medical rotations has, indeed, generated much good will and lots of interdisciplinary work among the medical, the psychiatric, and the psychological communities.  Undergraduate and graduate students are also taking advantage of training opportunities in our state to become prescribing psychologists.  There are currently as many as 15 graduate students who are ready to embark on earning their joint degrees in Clinical Psychopharmacology at New Mexico State University while pursuing their doctorates in clinical psychology at schools in Illinois.  At the University of Illinois, Champaign-Urbana, there are 75 undergraduates who have chosen to ‘concentrate’ in a ‘pre-prescribing psychologist’ curriculum and I have been asked to formally mentor them.  The Chicago School of Professional Psychology will be opening its doors to training students in Clinical Psychopharmacology on September 1^st.

“On August 18^th I hosted a networking dinner for our prescribing psychology trainees, ranging in age from 19 to 85 years old; our hospital and medical center CEOs and medical directors; the assistant director and the chief psychologist of the Illinois Department of Corrections; the Executive Director of NAMI; the Vice President of our largest social service organization, Thresholds; and the President, administrative staff, and faculty of The Chicago School of Professional Psychology.  Governor Pat Quinn, our former Illinois governor who signed our legislation into law on June 25, 2014, was there to give a rousing speech on the importance of prescribing psychologists and the revolution in healthcare around the nation.  More than 105 individuals were present and we are looking forward to our next event in January, 2018 with some additional special guests [Beth Rom-Rymer].”  Beth recently sponsored up to nine $5,000 scholarships – following up on her earlier commitment at Alliant International University -- to support graduate students and practicing licensed psychologists to complete their training in psychopharmacology.  Her expectation is that half of the scholarships, which give a preference to those committed to working with the underserved, will be awarded to pre-doctoral graduate students.

Give an Hour:  For the past 12 years, Give an Hour has provided free mental health care to those who serve, our Veterans and their families.  Give an Hour’s generous volunteer mental health professionals have collectively donated over 124,000 hours of free care and support valued at nearly $23 million.  Psychologist Barbara Van Dahlen founded the organization and has become a noted expert on harnessing skill based volunteers as well as the mental health consequences of military service.  She has received numerous honors for this innovative work – most notably, she was named to Time Magazine’s list of the 100 Most Influential People in the World for her creation of Give an Hour in 2012.  In 2013 she received an APA Presidential Citation from President Don Bersoff and in 2014 Barbara received the Outstanding Civilian Service Award from the U.S. Army.

Give an Hour also leads the Campaign to Change Direction [www.changedirection.org], a collective impact effort that includes the APA as a founding member.  This public health approach is focused on changing the culture of mental health by encouraging everyone to Know the Five Signs of Emotional Suffering.  It also encourages everyone to Learn the Healthy Habits of Emotional Well-Being.  President Barack Obama has personally heralded their importance.

Barbara’s work has been so successful in identifying and engaging champions for this work including First Lady Michelle Obama, Dr. Jill Biden, Richard Gere, Brian Wilson, and Chris Stapleton.  Through her relationship with the Royal Foundation, Barbara secured participation in the Campaign by Prince Harry.  She recently wrote a poignant piece about the anniversary of Princess Diana’s death – and how Price Harry and Prince William are carrying on their mother’s legacy of caring for those who are suffering emotionally [http://bit.ly/2vART1E].

Give an Hour’s model has been proven and is now being expanded to address the mental health concerns of other populations 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 the network in order to respond to natural and man-made disasters.  Most recently, Give an Hour opened its network in response to the trauma in Charlottesville and is opening its network to respond to the devastation in Houston.  If you aren’t currently giving your hour, please consider giving your gift of time and expertise and join today at [www.giveanhour.org].

We are especially pleased with the extent to which Barbara has been supportive of our efforts at the Uniformed Services University (USU) to train the next generation of military clinical psychologists and psychiatric nurse practitioners.  Faculty member Teresa Combs of the Daniel K. Inouye Graduate School of Nursing: “For approximately the past two years, I’ve volunteered for Give an Hour.  I’ve treated several members and volunteered at several of their local events.  The Service Members I’ve seen are genuinely appreciative to have this service available.  I’m convinced there is the need for more mental health providers to offer services.  It is not uncommon for the Members to report the length of time they have waited for services.  Furthermore, there is a sign of relief when they are convinced the sessions are absolutely confidential.”  Will you make that all important individual commitment?

Especially in the Face of Adversity:  In April, 2010 the Governor of Oregon vetoed the OPA psychology RxP legislation.  This August, another Governor vetoed HB 3355, expressing concern “particularly related to patient safety and ensuring appropriate prescribing.”  OPA’s legislation had overwhelming passed both houses of the Oregon legislature, which clearly has a different perspective.  Our sincerest appreciation to Robin Henderson and her colleagues for continuing to work tirelessly on behalf of the citizens of their state.  The Governor’s expressed concerns can be satisfactorily addressed.  Her comment “There is insufficient evidence that the bill will improve access or quality of care” ignores the federal experience, especially that of Oregonian Morgan Sammons.  “I dream of things that never were, and ask why not.”  Aloha.

Pat DeLeon, former APA President – HPA -- September, 2017

 

HPA - September column

“SOME MEN SEE THINGS AS THEY ARE, AND ASK WHY”

            The Windy City:  After our inspirational 125^th APA annual convention, I was invited by Beth Rom-Rymer to participate in her third, extraordinarily exciting prescriptive authority (RxP) Illinois “social gathering.”  “Illinois is continuing to move quickly with the implementation of our Prescriptive Authority Law.  It is expected that our Rules will be approved on or about September 15, 2017.  We have at least 150 psychologists who are currently training to become prescribing psychologists and 20 psychologists who have completed their Masters Degrees in Clinical Psychopharmacology and their seven required basic science undergraduate courses and are poised to enter their medical rotations.  These medical rotations include: psychiatry, family medicine, internal medicine, emergency medicine, pediatrics, geriatrics, ob/gynecology, surgery, and an elective.  We have at least eight hospitals and medical centers, throughout the state, whose CEOs and Medical Directors are working with us to provide the rotation opportunities for our prescribing psychology trainees.

“It has been a great gift of our law that we have been mandated to create training programs in hospitals, clinics, and medical centers.  Creating the medical rotations has, indeed, generated much good will and lots of interdisciplinary work among the medical, the psychiatric, and the psychological communities.  Undergraduate and graduate students are also taking advantage of training opportunities in our state to become prescribing psychologists.  There are currently as many as 15 graduate students who are ready to embark on earning their joint degrees in Clinical Psychopharmacology at New Mexico State University while pursuing their doctorates in clinical psychology at schools in Illinois.  At the University of Illinois, Champaign-Urbana, there are 75 undergraduates who have chosen to ‘concentrate’ in a ‘pre-prescribing psychologist’ curriculum and I have been asked to formally mentor them.  The Chicago School of Professional Psychology will be opening its doors to training students in Clinical Psychopharmacology on September 1^st.

“On August 18^th I hosted a networking dinner for our prescribing psychology trainees, ranging in age from 19 to 85 years old; our hospital and medical center CEOs and medical directors; the assistant director and the chief psychologist of the Illinois Department of Corrections; the Executive Director of NAMI; the Vice President of our largest social service organization, Thresholds; and the President, administrative staff, and faculty of The Chicago School of Professional Psychology.  Governor Pat Quinn, our former Illinois governor who signed our legislation into law on June 25, 2014, was there to give a rousing speech on the importance of prescribing psychologists and the revolution in healthcare around the nation.  More than 105 individuals were present and we are looking forward to our next event in January, 2018 with some additional special guests [Beth Rom-Rymer].”  Beth recently sponsored up to nine $5,000 scholarships – following up on her earlier commitment at Alliant International University -- to support graduate students and practicing licensed psychologists to complete their training in psychopharmacology.  Her expectation is that half of the scholarships, which give a preference to those committed to working with the underserved, will be awarded to pre-doctoral graduate students.

Give an Hour:  For the past 12 years, Give an Hour has provided free mental health care to those who serve, our Veterans and their families.  Give an Hour’s generous volunteer mental health professionals have collectively donated over 124,000 hours of free care and support valued at nearly $23 million.  Psychologist Barbara Van Dahlen founded the organization and has become a noted expert on harnessing skill based volunteers as well as the mental health consequences of military service.  She has received numerous honors for this innovative work – most notably, she was named to Time Magazine’s list of the 100 Most Influential People in the World for her creation of Give an Hour in 2012.  In 2013 she received an APA Presidential Citation from President Don Bersoff and in 2014 Barbara received the Outstanding Civilian Service Award from the U.S. Army.

Give an Hour also leads the Campaign to Change Direction [www.changedirection.org], a collective impact effort that includes the APA as a founding member.  This public health approach is focused on changing the culture of mental health by encouraging everyone to Know the Five Signs of Emotional Suffering.  It also encourages everyone to Learn the Healthy Habits of Emotional Well-Being.  President Barack Obama has personally heralded their importance.

Barbara’s work has been so successful in identifying and engaging champions for this work including First Lady Michelle Obama, Dr. Jill Biden, Richard Gere, Brian Wilson, and Chris Stapleton.  Through her relationship with the Royal Foundation, Barbara secured participation in the Campaign by Prince Harry.  She recently wrote a poignant piece about the anniversary of Princess Diana’s death – and how Price Harry and Prince William are carrying on their mother’s legacy of caring for those who are suffering emotionally [http://bit.ly/2vART1E].

Give an Hour’s model has been proven and is now being expanded to address the mental health concerns of other populations 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 the network in order to respond to natural and man-made disasters.  Most recently, Give an Hour opened its network in response to the trauma in Charlottesville and is opening its network to respond to the devastation in Houston.  If you aren’t currently giving your hour, please consider giving your gift of time and expertise and join today at [www.giveanhour.org].

We are especially pleased with the extent to which Barbara has been supportive of our efforts at the Uniformed Services University (USU) to train the next generation of military clinical psychologists and psychiatric nurse practitioners.  Faculty member Teresa Combs of the Daniel K. Inouye Graduate School of Nursing: “For approximately the past two years, I’ve volunteered for Give an Hour.  I’ve treated several members and volunteered at several of their local events.  The Service Members I’ve seen are genuinely appreciative to have this service available.  I’m convinced there is the need for more mental health providers to offer services.  It is not uncommon for the Members to report the length of time they have waited for services.  Furthermore, there is a sign of relief when they are convinced the sessions are absolutely confidential.”  Will you make that all important individual commitment?

Especially in the Face of Adversity:  In April, 2010 the Governor of Oregon vetoed the OPA psychology RxP legislation.  This August, another Governor vetoed HB 3355, expressing concern “particularly related to patient safety and ensuring appropriate prescribing.”  OPA’s legislation had overwhelming passed both houses of the Oregon legislature, which clearly has a different perspective.  Our sincerest appreciation to Robin Henderson and her colleagues for continuing to work tirelessly on behalf of the citizens of their state.  The Governor’s expressed concerns can be satisfactorily addressed.  Her comment “There is insufficient evidence that the bill will improve access or quality of care” ignores the federal experience, especially that of Oregonian Morgan Sammons.  “I dream of things that never were, and ask why not.”  Aloha.

Pat DeLeon, former APA President – HPA -- September, 2017

 

THE 125th APA ANNUAL CONVENTION

Exciting Times:  Ever since graduate school, I have always felt that attending the annual APA convention was "my gift to me."  It represents a time to reunite with colleagues that I have not seen in a while and at the same time, actually learn quite a bit about the advances occurring within psychology.  At its conclusion, I always feel exhausted and yet emotionally recharged.  These interpersonal interactions reaffirm why I chose psychology decades ago.  We can make a significant difference in the lives of our nation's citizens.  This year was no exception with 12,000 in attendance, including the Presidents of 26 national psychological associations.  I was especially impressed with the enthusiasm and dedication expressed by psychology's next generation of graduate students and early career psychologists.

President Tony Puente's programmatic initiative "Past Presidents Unscripted" provided an opportunity to reflect; it was very enjoyable and well received by the membership.  Tony's open invitation to the membership to visit the Smithsonian National Museum of American History was fascinating – especially seeing the Star-Spangled Banner flag which flew over Fort McHenry and inspired Francis Scott Key to write what would become our national anthem.  Not surprisingly, those programs addressing telehealth and the increasingly sophisticated clinical utilization of apps were standing room only.

Several panels on which Linda Campbell, Fred Millan, Jana Martin, and Deborah Baker participated took the unique approach of having all of their speakers address a common vignette, with active audience participation.  The application of the Telepsychology Guidelines through vignettes brought home the complexities and yet the basic ethical standards that apply to telepsychology just as they do to in-person services.  The fact that there was standing room only supports the notion that telepsychology is a cutting edge aspect of psychological practice.

On a personal level, I was particularly pleased to learn of APA's renewed interest in addressing the master's issue – an admittedly highly complex and controversial topic which several colleagues, members of the Board of Directors and I, during my APA Presidency in 2000, attempted to resolve – without any meaningful success.  Members of the Education and Practice Directorate and the current Board of Directors coordinated a recent Masters Summit which was sponsored by the APA Minority Fellowship Program and its director Andrew Austin-Dailey, during which 32 members of the APA governance actively participated.  Those in attendance represented practice, education and training, public and private sector psychology, the VA and other hospital settings, as well as additional identifiable stakeholders.  There was representation from several other disciplines, as well as a master's accreditation organization.  The APA Council of Representatives, Council Leadership Team, Board of Directors, and other governance groups will consider and deliberate in due course on further potential action.  The report on the summit can be found on the APA Website.  Tony's summary: "The Council addressed a complicated issue that has eluded successful resolution by the discipline of psychology over more than 70 years, agreeing by acclamation that 'current issues and developments have risen to the level that APA should take a position on master's level training and/or practice….  Council directs staff and governance to identify and explore options for APA to pursue.'  Further action is expected on this issue in February."

In my judgment, this particular development is extraordinarily important, especially with the nation's steady evolution towards interdisciplinary, team-based health care, in which psychological and behavioral health services will be increasingly integrated into primary care.  Psychology is one of the bona fide health care professions.  We must provide visionary leadership to effectively address the access and quality health care needs of our nation.

            The Nation's Evolving Health Care Environment:  It is critically important for psychology to appreciate that no profession lives or practices in an isolated environment.  A recently published nursing journal noted: "It appears that the tipping point for barriers to nurse practitioner (NP) practice is either here or imminent, given that 22 states and the District of Columbia now have full practice authority."  The author further urged her profession to understand that in drafting legislation, NPs need to include the authority to do things other than prescribe.  They need authorization to make medical diagnoses, order tests and therapies, perform procedures needed in primary care or acute care, as well as prescribe.

The Department of Veterans Affairs (VA) is the largest employer of nurses and it is also the largest employer and trainer of psychologists.  Under the leadership of Secretary David Shulkin, the VA has now adopted a national scope of practice for its nurses providing full practice authority for advanced practice registered nurses (APRNs) (with the exception of nurse anesthetists), as long as they are working within the scope of their VA employment.  APRNs can provide care, regardless of historical state or local legal restrictions, without the clinical oversight of a physician.  This includes taking comprehensive histories, providing physical examinations; and diagnosing, treating, and managing patients with acute and chronic illnesses and diseases.  It allows VA APRNs to prescribe medications and make appropriate referrals.

Under the Secretary's leadership, the VA announced five top priorities which included Suicide Prevention – Getting to Zero (sadly, from 20 daily).  The number two priority was Improving Timeliness, highlighting the potential for telehealth.  The Department reported having established 10 Tele-Mental health hubs and eight Tele-Primary Care hubs.  During the APA pre-convention period, the Association of VA Psychology Leaders (AVAPL), under the stewardship of Russell Lemle, actively addressed these issues and psychology's contributions.

            Similarly, U.S. Army Surgeon General Nadja West, the highest ranking woman to graduate from the U.S. Military Academy, is actively attempting to reshape military 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 top 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 -- virtual medical appointments becoming more commonplace as the Army ramps up its ability to deliver care at home with new equipment and training for care givers.  Her underlying goal is building a "premier, expeditionary, globally integrated medical force."

            With the ever-changing federal health delivery environment as background, one of the most exciting convention events was the informal gathering of those passionately interested in the prescriptive authority (RxP) agenda.  Beth Rom-Rymer: "On Saturday of the convention, Bob Ax and I chaired a meeting of like-minded psychologists in the Division 18 (Public Service) suite to discuss the rationale for graduate students to take a joint degree in Clinical Psychopharmacology, in conjunction with their doctoral degree in psychology, as they prepare for becoming licensed prescribing psychologists as well as licensed clinical psychologists.  The key components of the rationale are that, by studying Clinical Psychopharmacology in graduate school: * Students will be better able to integrate all components of their training – the basic sciences; the traditional psychology course curriculum; and the biological, chemical, and neurological processes by which psychotropic medications can support the cognitive and emotional learning that takes place during psychotherapy.  * A greater number of trainees can enroll in the Clinical Psychopharmacology training as graduate students, at the point that they begin to shape their careers, rather than as licensed, practicing, clinical psychologists who face the steep challenge of 'returning to school' after having already received the doctorate degree.  And, * Access to care will become significantly improved, thus better serving the public, as the numbers of prescribing psychologists will multiplicatively increase with graduate students taking the opportunity to earn the joint degrees.

            "Lenore Walker offered positive data from the training program at NOVA Southeastern University.  For five years, NOVA trained graduate students as well as licensed, practicing psychologists and found few differences in achievement between the two groups.  The largest difference, perhaps, was that the graduate students often scored more highly on the class exams.  Moreover, NOVA has learned the graduate students who are now licensed clinical psychologists are effectively using their training in Clinical Psychopharmacology, whether they work in prescribing states or not.  Dean Karen Grosby, of the College of Psychology at NOVA, is looking forward to the day when they will again begin to train graduate students in Clinical Psychopharmacology.

            "Other psychologists discussed the parameters under which graduate students would take the additional training.  It was pointed out that the strongest students would probably be the ones who would be able to manage the joint degree.  In a similar way, we noted that a certain percentage of psychology graduate students already take joint degrees in other fields (nursing, business administration, biology, law, journalism) and, typically, these students carve out interesting and highly successful career paths.

            "APA has just appointed a curriculum committee that will be reviewing the criteria for APA 'designation' for training programs in Clinical Psychopharmacology.  Some of our meeting discussants have been appointed to that committee.  In the future, APA may decide to approve training in Clinical Psychopharmacology at the graduate, predoctoral level.  Right now, graduate students in Illinois are preparing to be the first cohort of graduate students, nationally, who will be, indeed, doing the joint degree in Clinical Psychopharmacology at New Mexico State University, in conjunction with their doctoral degrees in universities in Illinois.  I have started a dialogue with out new APA CEO, Arthur Evans, about training at the graduate level.  He hopes to learn more about our Illinois law when he comes to Chicago early in the new year.  Change does not come easily.  Stitch by stitch, we are piecing together an innovative design.  With time and patience, all will come together."

            Psychology is Critical for Effective Change:  Former APA President Frank Farley (extremely active throughout the convention) has been stressing this message since his involvement in the association's governance.  Under the leadership of former APA Congressional Science Fellow Natacha Blain, the National Academy of Medicine will be exploring what role technology can play in improving educational outcomes.  In 1984, there was 1 computer per 125 students in the U.S.; in 1998 there was 1 per 7 students; and in 2008 it was 1 per 3.  This does not include home computer use or smart phones.  The potential of information technology as a learning aid is significant.  Computer literacy and fluency are essential life skills in today's highly technology-reliant society.  However, U.S. high school students consistently rank below average in math and close to average for science and reading in international comparisons.  How can we collectively contribute to this important agenda?  Aloha,

Pat DeLeon, former APA President – Division 29 – August, 2017

 

Sent from my iPhone

ALOHA - D29 August column

THE 125^th APA ANNUAL CONVENTION

            Exciting Times:  Ever since graduate school, I have always felt that attending the annual APA convention was “my gift to me.”  It represents a time to reunite with colleagues that I have not seen in a while and at the same time, actually learn quite a bit about the advances occurring within psychology.  At its conclusion, I always feel exhausted and yet emotionally recharged.  These interpersonal interactions reaffirm why I chose psychology decades ago.  We can make a significant difference in the lives of our nation’s citizens.  This year was no exception with 12,000 in attendance, including the Presidents of 26 national psychological associations.  I was especially impressed with the enthusiasm and dedication expressed by psychology’s next generation of graduate students and early career psychologists.

President Tony Puente’s programmatic initiative “Past Presidents Unscripted” provided an opportunity to reflect; it was very enjoyable and well received by the membership.  Tony’s open invitation to the membership to visit the Smithsonian National Museum of American History was fascinating – especially seeing the Star-Spangled Banner flag which flew over Fort McHenry and inspired Francis Scott Key to write what would become our national anthem.  Not surprisingly, those programs addressing telehealth and the increasingly sophisticated clinical utilization of apps were standing room only.

Several panels on which Linda Campbell, Fred Millan, Jana Martin, and Deborah Baker participated took the unique approach of having all of their speakers address a common vignette, with active audience participation.  The application of the Telepsychology Guidelines through vignettes brought home the complexities and yet the basic ethical standards that apply to telepsychology just as they do to in-person services.  The fact that there was standing room only supports the notion that telepsychology is a cutting edge aspect of psychological practice.

On a personal level, I was particularly pleased to learn of APA’s renewed interest in addressing the master’s issue – an admittedly highly complex and controversial topic which several colleagues, members of the Board of Directors and I, during my APA Presidency in 2000, attempted to resolve – without any meaningful success.  Members of the Education and Practice Directorate and the current Board of Directors coordinated a recent Masters Summit which was sponsored by the APA Minority Fellowship Program and its director Andrew Austin-Dailey, during which 32 members of the APA governance actively participated.  Those in attendance represented practice, education and training, public and private sector psychology, the VA and other hospital settings, as well as additional identifiable stakeholders.  There was representation from several other disciplines, as well as a master’s accreditation organization.  The APA Council of Representatives, Council Leadership Team, Board of Directors, and other governance groups will consider and deliberate in due course on further potential action.  The report on the summit can be found on the APA Website.  Tony’s summary: “The Council addressed a complicated issue that has eluded successful resolution by the discipline of psychology over more than 70 years, agreeing by acclamation that ‘current issues and developments have risen to the level that APA should take a position on master’s level training and/or practice….  Council directs staff and governance to identify and explore options for APA to pursue.’  Further action is expected on this issue in February.”

In my judgment, this particular development is extraordinarily important, especially with the nation’s steady evolution towards interdisciplinary, team-based health care, in which psychological and behavioral health services will be increasingly integrated into primary care.  Psychology is one of the bona fide health care professions.  We must provide visionary leadership to effectively address the access and quality health care needs of our nation.

            The Nation’s Evolving Health Care Environment:  It is critically important for psychology to appreciate that no profession lives or practices in an isolated environment.  A recently published nursing journal noted: “It appears that the tipping point for barriers to nurse practitioner (NP) practice is either here or imminent, given that 22 states and the District of Columbia now have full practice authority.”  The author further urged her profession to understand that in drafting legislation, NPs need to include the authority to do things other than prescribe.  They need authorization to make medical diagnoses, order tests and therapies, perform procedures needed in primary care or acute care, as well as prescribe.

The Department of Veterans Affairs (VA) is the largest employer of nurses and it is also the largest employer and trainer of psychologists.  Under the leadership of Secretary David Shulkin, the VA has now adopted a national scope of practice for its nurses providing full practice authority for advanced practice registered nurses (APRNs) (with the exception of nurse anesthetists), as long as they are working within the scope of their VA employment.  APRNs can provide care, regardless of historical state or local legal restrictions, without the clinical oversight of a physician.  This includes taking comprehensive histories, providing physical examinations; and diagnosing, treating, and managing patients with acute and chronic illnesses and diseases.  It allows VA APRNs to prescribe medications and make appropriate referrals.

Under the Secretary’s leadership, the VA announced five top priorities which included Suicide Prevention – Getting to Zero (sadly, from 20 daily).  The number two priority was Improving Timeliness, highlighting the potential for telehealth.  The Department reported having established 10 Tele-Mental health hubs and eight Tele-Primary Care hubs.  During the APA pre-convention period, the Association of VA Psychology Leaders (AVAPL), under the stewardship of Russell Lemle, actively addressed these issues and psychology’s contributions.

            Similarly, U.S. Army Surgeon General Nadja West, the highest ranking woman to graduate from the U.S. Military Academy, is actively attempting to reshape military 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 top 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 -- virtual medical appointments becoming more commonplace as the Army ramps up its ability to deliver care at home with new equipment and training for care givers.  Her underlying goal is building a “premier, expeditionary, globally integrated medical force.”

            With the ever-changing federal health delivery environment as background, one of the most exciting convention events was the informal gathering of those passionately interested in the prescriptive authority (RxP) agenda.  Beth Rom-Rymer: “On Saturday of the convention, Bob Ax and I chaired a meeting of like-minded psychologists in the Division 18 (Public Service) suite to discuss the rationale for graduate students to take a joint degree in Clinical Psychopharmacology, in conjunction with their doctoral degree in psychology, as they prepare for becoming licensed prescribing psychologists as well as licensed clinical psychologists.  The key components of the rationale are that, by studying Clinical Psychopharmacology in graduate school: * Students will be better able to integrate all components of their training – the basic sciences; the traditional psychology course curriculum; and the biological, chemical, and neurological processes by which psychotropic medications can support the cognitive and emotional learning that takes place during psychotherapy.  * A greater number of trainees can enroll in the Clinical Psychopharmacology training as graduate students, at the point that they begin to shape their careers, rather than as licensed, practicing, clinical psychologists who face the steep challenge of ‘returning to school’ after having already received the doctorate degree.  And, * Access to care will become significantly improved, thus better serving the public, as the numbers of prescribing psychologists will multiplicatively increase with graduate students taking the opportunity to earn the joint degrees.

            “Lenore Walker offered positive data from the training program at NOVA Southeastern University.  For five years, NOVA trained graduate students as well as licensed, practicing psychologists and found few differences in achievement between the two groups.  The largest difference, perhaps, was that the graduate students often scored more highly on the class exams.  Moreover, NOVA has learned the graduate students who are now licensed clinical psychologists are effectively using their training in Clinical Psychopharmacology, whether they work in prescribing states or not.  Dean Karen Grosby, of the College of Psychology at NOVA, is looking forward to the day when they will again begin to train graduate students in Clinical Psychopharmacology.

            “Other psychologists discussed the parameters under which graduate students would take the additional training.  It was pointed out that the strongest students would probably be the ones who would be able to manage the joint degree.  In a similar way, we noted that a certain percentage of psychology graduate students already take joint degrees in other fields (nursing, business administration, biology, law, journalism) and, typically, these students carve out interesting and highly successful career paths.

            “APA has just appointed a curriculum committee that will be reviewing the criteria for APA ‘designation’ for training programs in Clinical Psychopharmacology.  Some of our meeting discussants have been appointed to that committee.  In the future, APA may decide to approve training in Clinical Psychopharmacology at the graduate, predoctoral level.  Right now, graduate students in Illinois are preparing to be the first cohort of graduate students, nationally, who will be, indeed, doing the joint degree in Clinical Psychopharmacology at New Mexico State University, in conjunction with their doctoral degrees in universities in Illinois.  I have started a dialogue with out new APA CEO, Arthur Evans, about training at the graduate level.  He hopes to learn more about our Illinois law when he comes to Chicago early in the new year.  Change does not come easily.  Stitch by stitch, we are piecing together an innovative design.  With time and patience, all will come together.”

            Psychology is Critical for Effective Change:  Former APA President Frank Farley (extremely active throughout the convention) has been stressing this message since his involvement in the association’s governance.  Under the leadership of former APA Congressional Science Fellow Natacha Blain, the National Academy of Medicine will be exploring what role technology can play in improving educational outcomes.  In 1984, there was 1 computer per 125 students in the U.S.; in 1998 there was 1 per 7 students; and in 2008 it was 1 per 3.  This does not include home computer use or smart phones.  The potential of information technology as a learning aid is significant.  Computer literacy and fluency are essential life skills in today’s highly technology-reliant society.  However, U.S. high school students consistently rank below average in math and close to average for science and reading in international comparisons.  How can we collectively contribute to this important agenda?  Aloha,

Pat DeLeon, former APA President – Division 29 – August, 2017