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From the PresidentFull Access

Collaboration With NAMI Adds Impact to Advocacy

Published Online:https://doi.org/10.1176/pn.38.19.0003

A few weeks ago while in the Washington, D.C., area for a meeting of APA’s Scientific Program Committee, I scheduled a visit with the director of the National Alliance for the Mentally Ill (NAMI), Rick Birkel. We had a valuable talk in which we shared information about our organizations’ current work, projects, and future plans. Although our two associations historically have not always seen eye to eye on every issue, we have the same basic mission—advocating for the mentally ill.

NAMI has formalized a process for reviewing issues with the NAMI Policy Research Institute (NPRI). The institute brings together policymakers, advocates, and scientists to develop recommendations on various matters of importance for the care and treatment of mentally ill people.

Policy Reports

This year NAMI has published three task force reports as products of this NPRI:

Recommendations on prescribing privileges: This report states, “Based on the testimony and evidence, the task force concluded that there is nothing to lead NAMI to support legislation at this time to allow prescribing privileges for psychologists.”

The text goes on to recommend several measures to address the general mental health workforce shortage, which includes encouraging the Substance Abuse and Mental Health Services Administration to conduct a study that would characterize the nature and magnitude of the workforce problem. Needless to say, this proposal, coming from a patient advocacy group, is very persuasive!

Access to medication: This document recommends numerous strategies to safeguard open access to medications in the current budget-deficit environment. They include state, federal, and community legislative and regulatory efforts. NAMI is also advocating strongly for increased research on evidence-based practices.

Seclusion and restraint: The paper on this topic states that the long-term goal of all mental health treatment facilities and systems is the elimination of seclusion and restraint.

These reports are worth reading and can be accessed on the Web at <www.nami.org>. They contain some very well-conceived arguments and strategies for change.

The recommendations on prescribing privileges and access to medication provide powerful support for our advocacy in these areas. Both our organizations would agree in principle on the goal of eliminating seclusion and restraint. As clinicians, we are faced with the practical reality of dealing with violent crises and the urgent need, at times, to manage patients by using seclusion and restraint.

Collaboration at Work

An additional area where APA and NAMI are in agreement is the criminalization of mentally ill people. When APA asked NAMI to appoint Tom Hamilton liaison to the Corresponding Committee on Jails and Prisons, the president of NAMI readily agreed. Several years ago, Mr. Hamilton, a former president of NAMI Texas, was successful in convincing the Texas legislature to divert funds destined for the criminal justice system into the mental health system (see Original article: page 35). An astute businessman, he demonstrated to the Texas legislature that money destined for a new jail complex would be better spent providing mental health care for inmates as they exited the prison system. Texas has now spent $35 million doing just that over the past two years. In spite of the current huge budget deficit and massive cuts to the criminal justice system budget, it appears that Texas is going to retain this program—so, as some say, “they must feel that they are getting their money’s worth.” Data on programs like this will be in the Corresponding Committee on Jails and Prisons advocacy report, which will be readied for distribution early next year. NAMI will be an active collaborator in the distribution of this APA work product.

NAMI’s Growth and Our Partnership

Since its inception in 1979, NAMI has grown from 284 members to more than 200,000 in 2002. The organization has fought for parity and increased government funding for research in mental illness. The organization’s ongoing antistigma campaign has been effective.

Our advocacy partnership is vital for the advancement of the mission for both of our organizations. We are fortunate to have such a vital ally as we continue in our determination to make a difference. ▪