Over the past year, an APA Work Group on the Future of Psychiatry and the APA Board of Trustees have been laying out a roadmap for the future of mental health and substance use disorder care in the US. They say in a statement:
“As we look to the future, innovation and collaboration will be a necessary component of every step we take to support, preserve, and grow the influence of Psychiatry and the continued influence of our important work products such as the DSM [Diagnostic and Statistical Manual of Mental Disorders].
“C-L psychiatrists are already integral to this effort and will continue to be indispensable as we work to realize our goals in the near- and long-term. C-L psychiatrists have been innovating for more than a decade in bringing embedded mental health care into many different systems. C-L Psychiatry, once a specialty of the general hospital, has now moved into varied practice settings from primary care integration and collaboration to outpatient specialty practices, and to disease-focused practice such as in cancer centers.
“C-L psychiatrists have been early leaders in collaborative/integrated care models and have done a huge credit to Psychiatry at large in helping to proliferate the truth that we simply cannot apply treatment principles that worked decades ago to today’s health care landscape. There simply aren’t enough psychiatrists to continue on with ‘business as usual.’
“As it stands, psychiatrists make up only six percent of the workforce, and we are going to need to adopt a team-based model of care delivery to meet the demand for mental health and SUD treatment. C-L psychiatrists are uniquely positioned to be leaders in helping our profession to adapt to this necessary change and facilitating its wide adoption among the broader medical community. After all, from the early days of hospital-based practice, C-L psychiatrists have always worked with and consulted to teams.
“To continue to develop innovative practice models that expand the individual reach of a single psychiatrist to more than a single patient— for example, collaborative care can add a multiplier of up to 20 when a psychiatrist works with a care manager in a primary care or pediatrics practice—we will need measurement-based outcomes metrics to inform the effectiveness and possibility of new models of care.
“Expanding the PsychPro registry to become a national standard is essential as we work to improve our research efforts and ease the administrative burden on psychiatrists. The PsychPro registry is how APA can lead and innovate in research and clinical development through data infrastructure including nationwide practices across levels of training.
“As a profession, patient safety is paramount, and psychiatrists simply cannot meet the mental needs of the public alone. PsychPro can also help us develop and test the efficacy of new quality measures and standards of care across disciplines to be sure that, as we collaborate with other mental health professionals with varied levels of training, skill, and experience, patient care and safety remain central.
“APA needs to be a leader in the development and testing of quality metrics and data-driven system development. Here, C-L psychiatrists are at the helm again. Carol Alter, MD, FACLP, is the current chair of the Council on Quality of the APA and also a member of the Work Group on the Future of Psychiatry and has helped shape the recommendations that APA will take in the near-, short-, and long-term regarding development and evaluation of quality metrics.
“As integral as C-L Psychiatry is to the future of our profession, it is also woven into the fabric of APA. The profile of C-L Psychiatry within APA will continue to grow as we continue to promote team-based care and produce resources and educational materials to prepare psychiatrists and our partners in the House of Medicine for the transition. Our incoming president-elect, Ramaswamy Viswanathan, MD, DrMedSc, DLFAPA, FACLP, is a C-L psychiatrist and training director who understands the challenges we face regarding our workforce, and the urgency of growing and diversifying our profession.
“We are on the right track, with ACLP applying for full membership in the AMA House of Delegates over the next year, and the APA and the APA Foundation ramping up their non-psychiatrist physician education and public information efforts. We must keep this momentum going, form new partnerships, continue to engage the public, and drive home the message that our mental and physical health are inextricably linked.
“The road ahead of us is long and there are numerous challenges we must face, but I know that psychiatrists have the passion and dedication necessary to put ideas into action. C-L psychiatrists will be the leaders of this effort, helping all psychiatrists leverage their expertise and affect lasting positive change for our patients and profession.”