APA president gives her inaugural speech
Rebecca Weintraub Brendel, MD, JD, FACLP, gave her inaugural speech as president to the American Psychiatric Association ahead of APA’s annual conference this month on Social Determinants of Mental Health.
Reviewing the impact of COVID-19, Dr. Brendel (ACLP president 2018-19) said: “We are just beginning to fully appreciate that it is not limited to physical illness.”
Some psychiatric consequences were to be anticipated based on neuropsychiatric sequelae following previous widespread viral outbreaks.
Others—such as racial disparities in society laid bare by the pandemic—”are but one stark example of health inequity in the US and the necessary and painful journey ahead of us to achieve health equity and racial justice.”
Moreover, emerging mental health data “close the door on any doubt that we are indeed in the midst of a mental health pandemic: the challenges before us—as citizens and as psychiatrists—are daunting,” said Dr. Brendel.
As 2022 began, Americans expressed concern about their mental health: 25% made resolutions to improve it. Suicide deaths increased in 2021; 100,000 Americans were lost to opiate overdose; “and our youth, in particular, are reporting unprecedented levels of anxiety, depression, and psychological distress.”
Yet, she added, “when Americans seek mental health care, it often cannot be found, much less in a timely fashion.”
Meanwhile, psychiatrists are struggling to practice within a health care system characterized by a shortage of psychiatrists, low reimbursement compared to other physicians for the same care and services rendered, and administrative practice burden.
“Our workforce lacks the diversity required to reach its potential and to provide high-quality, evidence-based care to the increasingly diverse population we serve. In addition, while practice demands and costs increase, physicians are reporting high rates of burnout, and our next generation of psychiatrists is entering practice with unprecedented education debt.” [Nearly three-quarters of medical school graduates in 2021 had education debt, averaging more than $200,000.]
“While we have made great strides in advocacy for mental health, parity remains elusive. We know there is no health without mental health, yet insurers continue efforts to effectively limit access to mental health care on par with all other health care through opaque internal procedures, loopholes, and exclusions. We cannot and must not just stand by or, worse, retreat in the face of these substantial challenges to our profession and those we serve.
“Instead, faced with these current challenges before us—and those of which we are not yet aware—we must seize existing and create new opportunities to advance Psychiatry and mental health care. There is no doubt that this path ahead will be hard work requiring bold ideas and interventions.”
Detailing her roadmap of public-facing activities, profession- and psychiatrist-supporting activities, and policy initiatives, Dr. Brendel said it was “a once-in-a-lifetime opportunity for Psychiatry to ensure that mental health, once and for all, permanently establishes its place as an integral part of overall health on par with all other medical care.”
In particular, she said, to meet the mental health needs of every American, “we must lead in providing evidence-based information to reduce stigma and use an equity lens to promote access to high-quality care to the underserved, hard to reach, and historically excluded…Psychiatry must continue to change the conversation around mental health to reduce stigma, encourage treatment, and save lives.”
“Insurers continue efforts to limit access to mental health care on par with all other health care through opaque internal procedures, loopholes, and exclusions.”