Psychiatr News June 15, 2007
Volume 42, Number 12, page 1
© 2007 American Psychiatric Association
Ruiz Urges Colleagues to Keep Up Demands
Catherine F. Brown
Advocating for humane care is not an option; it's a professional and
moral imperative for all psychiatrists, says APA's outgoing president.
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APA President Pedro Ruiz, M.D., challenges his fellow psychiatrists to
keep up the battle with him for mental health parity and access to
high-quality, humane care.
Credit: David Hathcox
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In a voice filled with passion and urgency, APA President Pedro Ruiz, M.D.,
instructed colleagues at APA's 2007 annual meeting last month in San Diego
that they—along with him—must continue to work toward achieving
the "promised land" for people with mental illness through
eradicating barriers to mental health care and establishing a system in which
high-quality, humane care is available to all.
"My fellow psychiatrists," said Ruiz at the meeting's Opening
Session, "we must have the courage to do it. We must provide humane
care. The future and image of APA and our profession depend on it. We must do
it, and we will do it together with the National Alliance on Mental Illness
[NAMI], Mental Health America, and any other advocacy group that has the
courage to do it with us."
He spoke with particular intensity about mentally ill people who exist on
the fringes of society and evoke little empathy from Americans living
comfortable lives. Among them: people who have no health or mental health
insurance, members of minority groups who cannot get culturally competent
mental health care, homeless mentally ill individuals, mentally ill people who
are warehoused in jails and prisons because of inadequate community mental
health services and resources.
Ruiz continued, "It is our social responsibility, as psychiatrists
and citizens, to ensure that humane care will not just be a privilege for
some, but a right for all human beings who live in the United States, as well
as in every country in the world.... What are we going to do? How much
inhumane care do we have to observe in our daily practices and society at
large before we say enough is enough?"
Ruiz himself reached that point many years ago, and his term as APA
president gave him another national platform to continue his efforts to right
these wrongs.
To an audience of about 1,000 psychiatrists and guests, he spoke of the
many initiatives and actions he had undertaken during this past year to follow
through on the theme he had selected for his presidency: "Addressing
Patient Needs: Access, Parity, and Humane Care."
Ruiz reminded his audience that at last year's annual meeting he had said
that addressing the three prongs of his presidential theme required APA to
build "strong, genuine" partnerships with patient-oriented
advocacy groups. He got to work on that task immediately by inviting Suzanne
Vogel-Scibilia, M.D., the president of NAMI, to address the Board of Trustees
at its July 2006 retreat and meeting. He and Vogel-Scibilia went on to plan a
formal APA/NAMI leadership meeting that took place last December in which
common issues and goals were identified (Psychiatric News, January
19). Both organizations appointed individuals to a work group to turn plans
into action.
That professional ethics and values were central to Ruiz's presidency was
evidenced in numerous ways throughout this past year. One was the selection
process of DSM-V's leadership. At a time when medical researchers
were being criticized for using funding by sources that had a vested interest
in the studies' outcomes, Ruiz wanted "the most transparent and
ethically driven policy that one could humanly design" for selecting
leadership of DSM-V. The results were a rigorous screening process
that all nominees of the DSM-V Task Force and working groups had to
undergo and the creation of a conflict-of-interest disclosure form "that
is second to none in the medical field."
Another example was Ruiz's visit to Guantanamo Bay Naval Station last
November. One reason that he accepted the invitation from the Department of
Defense to visit the camp—marking his first return to Cuba since leaving
there at the age of 21—was "to pay respect" to the
psychiatrists and other health care personnel who were working there under
"the most difficult and challenging circumstances. As your APA
president, the well-being of even one APA member is as relevant, or even more
important, to me than any political ideology, including my own."
He was among the APA leaders who opposed the participation of psychiatrists
in the interrogation of prisoners and detainees, which led to the approval of
an official position statement to that effect last year (Psychiatric
News, June 16, 2006).
Paralleling Ruiz's initiatives to strengthen APA's relationship with
advocacy groups were initiatives to do likewise with the National Institute of
Mental Health, National Institute on Drug Abuse, and National Institute on
Alcohol Abuse and Alcoholism.
Ruiz noted that the two psychiatrists in line to succeed him as APA
president—Carolyn Robinowitz, M.D., and Nada Stotland, M.D., share his
commitment to achieving humane care and have the personal and professional
qualities needed to do so. "Thus, let's continue to use our principles,
let's continue to use our values, and let's continue to operate our APA within
a framework of social responsibility."
Nonetheless, the end of Ruiz's term as president does not mean it's time
for him to step aside and let them and others carry on the battle.
"I am not planning to fade away," he declared to a standing
ovation. "As long as there is a mental patient without access to health
and mental health care, without full and comprehensive parity of psychiatric
care and without receiving proper humane care, and who is still living in the
shadows, whether in this country or in any other part of the world, I will
return and join you in the trenches again, again, and again." 
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