Trustees Tackle Wide Range of Controversial Issues
At its meeting last month at APA headquarters in Arlington, Va., the Board of Trustees debated several topics that are much discussed in the media as well as in mental health circles.
The Board voted, for example, to address the high level of violence that has long plagued the United States and the piece of the puzzle to which psychiatrists may contribute some expertise. It agreed to appoint a new task force to address the complex issue of assessing violence risk and update a report APA issued on the subject in 1974. The task force will have three years to do its work and is to have members with expertise in child psychiatry and minority mental health issues. Among its charges is to summarize contexts in which psychiatrists may be called upon to assess violence risk, review literature on risk assessment, and explore related ethical dilemmas.
(From left) Keith Stowell, M.D., APA/GlaxoSmithKline Fellow; Patrick Runnels, M.D., APA/Bristol-Myers Squibb Fellow; and Molly McVoy, M.D., of the Committee of Residents and Fellows listen to a Board presentation on the 2008 APA budget.
Credit: David Hathcox
The use of electroconvulsive therapy (ECT) was also on the Board's agenda, with the Trustees voting to form an eight-member task force to revise the 2003 APA publication The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging in light of recently published National Institutes of Health studies on this treatment modality. The Trustees also approved a position statement on ECT.
The Trustees also voted to revise APA's position statement on the insanity defense, which will replace one issued in 1982 that was heavily influenced by the public debate over insanity acquittals after John Hinckley's 1981 attempted assassination of President Reagan. Many citations to court decisions in the earlier document are out of date as are empirical studies done prior to 1982, according to Paul Appelbaum, M.D., chair of the Council on Psychiatry and Law. The new statement says that while APA “strongly supports the insanity defense... [it] does not favor any particular legal standard for the insanity defense... so long as the standard is broad enough to allow meaningful consideration of the impact of serious mental disorders on individual culpability.”
Several membership items were also approved by the Board. The Trustees agreed, for example, to require that APA dues be paid by October 31 of each calendar year or the membership will be terminated. There will still be a three-month “administration reinstatement period” that will go through January 31 of the following year.
Also passed was a proposal to require that members pay their annual dues by the start of the annual meeting (usually in May) or be in the automatic monthly dues payment program if they want to qualify for the reduced member registration fee.
The Board also voted to reduce from three to two the number of recommendations a member needs as part of an application to become an APA fellow.
In other actions the Board voted to approve
a 2008 APA operating budget of $56.6 million, a reduction of about $423,000 from the original budget proposal to which the Board gave preliminary approval last October. | |||||
an APA Bylaws change to have separate positions for an APA secretary and treasurer. The functions of these two positions were combined in 2005 to reduce the size of the Board. Since then, however, the secretary-related duties have increased considerably, prompting the split. | |||||
publication of a manuscript developed jointly by APA and the American College of Obstetrics and Gynecology (ACOG) titled “The Management of Depression During Pregnancy.” The manuscript, which focuses on the use of antidepressant medications by pregnant women, will be published in the American Journal of Psychiatry and in an ACOG journal. It will also be available on APA's Web site once ACOG completes its final review. | |||||
the start of a process to develop an amicus curiae brief on same-sex marriage. In the past APA has signed on to an amicus brief on the issue developed by the American Psychological Association, but the Board preferred to have APA develop its own brief after a comprehensive literature review of mental health related aspects of the issue. The Board forwarded this charge to the Committee on Judicial Action to begin the development process. APA is on record as endorsing civil same-sex marriage, and an APA brief that describes the mental health consequences to individuals confronting laws that forbid such marriages could be submitted in state-level cases challenging those statutes. | |||||
a draft of a position statement on release of patients' records to state medical boards that stresses patients' privacy interests during medical board investigations while recognizing that these boards do perform an important function in protecting public safety and need access to certain types of information. It urges medical boards to notify patients whenever their medical records may be part of an investigation and to give the chance to object to their release. | |||||
appointment of the Corresponding Committee on Information Technology that is charged with assessing the information technology needs of APA members and recommending ways to meet those needs. | |||||
formation of a corresponding task force to examine APA's overall communication strategy and suggest ways to implement it. | |||||
that all new members of APA's Practice Guideline Steering Committee and work groups be held to the same disclosure and divestiture standards as participants in the DSM-V development process. ▪ | |||||
