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Summit Lays Groundwork for Patient-Centered Initiatives

Early last December, a historic event took place. On that day, the leadership of APA, in the form of the Board of Trustees Executive Committee, a few other Board members invited as consultants, and several senior APA staff members had a summit meeting with the leadership and senior staff of the National Alliance on Mental Illness (NAMI).

When I was running to become president-elect, I promised APA members that, if elected, I would give maximum priority to advocacy efforts, collaboration with patient-oriented organizations, and key patient-care issues such as quality of care, access, parity, and humane care.

Once elected, I began to focus on these commitments. For instance, I invited NAMI President Dr. Suzanne Vogel-Scibilia to give a presentation at my Board retreat in July 2006 on the topic of humane care; I also invited her to attend the July Board meeting to talk about NAMI's current goals and potential areas of collaboration between APA and NAMI.

Likewise, I accepted Dr. Vogel-Scibilia's invitation to participate in the NAMI convention last June. Later, I invited Dr. Vogel-Scibilia to make a presentation on current NAMI priorities and projects at the plenary session of the APA Fall Component Meetings last September and to speak at the Opening Session of APA's 58th Institute on Psychiatric Services in New York in October 2006. During the institute she suggested that we have a NAMI/APA summit, and I immediately accepted the invitation since it was very much in line with my goals and objectives for APA.

For years, APA has collaborated with NAMI on activities focusing on common goals such as advocacy on mental health care issues. I was, however, looking for the opportunity to build a real "partnership" between the organizations, which could evolve into a "consortium" of advocacy organizations. The current governmental and, to a certain extent, societal views of mental illness in the United States are abysmal. I believe that erasing the discrimination and stigma that surrounds people with mental illness in this country will require major coalition efforts. The mentally ill homeless population and the criminalization of the mentally ill are just a couple of examples of the results of such biased views of mental illness.

I see a window of opportunity opening for us to improve the situation. The changes in the composition of the U.S. Congress might offer a possibility for change regarding passage of parity legislation. In addition, state governments are beginning to act independently from the federal government on the issue of access to care and full (universal) health care coverage. Perhaps during the 2008 national elections, "universal coverage" might become the number-one priority issue.

Interest in attending this first APA/NAMI Summit proved greater than we had expected. About 20 APA representatives and a similar number of NAMI representatives met for about four hours. I proposed that we focus primarily on issues pertaining to patient care, and everyone present spoke at least once. Among the key topics brought to the table as potential areas of common interests and collaboration were insurance parity, access to care, criminalization of the mentally ill, the recovery model of mental health care, stigma and discrimination, work incentives for the mentally ill, ethnic minority and urban family initiatives, data-based needs, the role of poverty, housing problems for the mentally ill homeless population, state-level initiatives regarding the Medicaid program, and problems in the provision of psychiatric care in the Veterans Affairs hospital system.

It was obvious that we could not tackle all of these issues at once; thus the group selected the following three as its highest priority: (1) parity for mental health care, (2) state-level Medicaid reforms affecting mental health, and (3) veterans' care.

Both groups agreed that a partnership/coalition between APA and NAMI could accomplish major patient-care goals. A decision was made to appoint a steering committee to work on strategies and plans of actions. To ensure continuity for the coalition, I appointed APA President-Elect Dr. Carolyn Robinowitz as co-chair, and NAMI representatives chose Dr. Vogel-Scibilia. In total, six representatives from each organization were appointed by Dr. Vogel-Scibilia and me.

In my opinion, this summit was an outstanding success. It offered NAMI and APA wonderful opportunities to work together. The benefits to APA include a stronger advocacy effort, greater influence on governmental entities, a better image for the profession of psychiatry, and an enhanced sense of social responsibility. This summit was the most important meeting and accomplishment during my tenure as APA president.

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