Speaking at the Opening Session of the 53rd Institute on Psychiatric Services in Orlando, Fla., APA President Richard Harding, M.D., declared that although many things had fundamentally changed since September 11, APA’s goals and objectives had not.
Harding noted that now, "with the fallout from the September 11 tragedy, millions of Americans will no longer look at those with symptoms of anxiety and depression as ‘weak of character.’ " APA members must use this opportunity to advance the cause of mental health, he emphasized.
"You are being summoned by history to take a leadership role in helping this country recover from and deal with traumas that have occurred, and symptoms yet to occur."
In the four weeks between the attacks and the opening of the institute on October 10, Harding said, APA renewed its commitment to advocacy for its members and the patients they treat, its dedication to delivering the best science and education anywhere, and to upholding its high principles of professionalism.
In the month since the atrocity, Harding told attendees, "each of you has seen the members of our Association from the New York County District Branch, the Washington Psychiatric Society, and the Society of Uniformed Services Psychiatrists, along with those from surrounding DBs, respond to the challenges in their communities and beyond."
The national APA has responded, he said, through supplying educational materials, policy statements, and pamphlets to thousands of citizens, the press and other media, teachers, and government officials to help them understand the impossible and try to devise road maps for their immediate future.
"Each of us has struggled," Harding said. "We have seen ourselves grapple with our own feelings while helping our individual patients and staffs deal with loss, anger, and gut-level hatred."
Yet APA and its members have, during one of the most difficult times in most people’s memories, remained focused on the challenges and opportunities of which Harding believes the Association must take advantage to advance the issues critical to those with mental illness.
"There are few if any silver linings to such a savage criminal act, yet there are lessons to be learned," Harding declared.
APA has been fighting for nondiscrimination in mental health insurance benefits at all levels of government. As a profession, Harding said, psychiatry can neither ask for more nor accept less. In times of challenge and change, he cautioned, "ends-based ethics," in which the rights of the community often win out over the rights of the individual, APA must remain committed to the rights of every individual to have medical privacy and control of his or her identifiable medical information. This continued struggle, Harding declared, "will not be popular, but it is right."
In the aftermath of September 11, Harding speculated, there will be a new expectation and demand among middle and higher socioeconomic groups for mental health services for themselves and their families. "They will also begin to see that diagnostic labels will lead to stigma and ultimately discrimination. They will demand change in the system," he said.
He also predicted increased use of the Internet for information about psychiatric issues. "Our patients," Harding pointed out, "will be more informed, leading to better treatment compliance, leading to better therapeutic outcomes."
It is important, Harding noted, not to forget the hard work by various components of APA leading to many recent scientific, political, and pragmatic successes. He cited the following achievements as examples:
• The Bush administration’s implementation of the medical privacy regulations proposed by the Clinton administration was an "incredible victory," attained with the help of members and the staff of the Division of Government Relations.
• The APA-sponsored National Conference on Mental Health in the Workplace held at the Carter Center.
• The continued push for an end to discrimination in Medicare’s mental health outpatient payment policies through the demise of the 50 percent discriminatory copayment.
• Continued progress in the DSM-V development process, with expert planning groups now being formed.
• A conference earlier this year, cosponsored by APA and CMHS, on issues of psychiatric training and cultural competence.
• The award of the first Jeanne Spurlock Congressional fellowship to a psychiatrist interested in advocating for minority and child mental health issues.
• Continued progress on the Patients’ Bill of Rights, which is before a congressional conference committee to iron out differences between the Senate and House versions.
Harding noted as well that the timing of the institute, only four weeks after the attacks, served to amplify the appropriateness of the theme for the meeting, "Multidisciplinary Roles in the 21st Century."
"We are all aware that psychiatrists and mental health professionals are not an homogenous group," Harding observed. Each group, he said, is proud of its collaboration with the others for the greater good of the patients that the groups collectively serve. "This has been especially apparent during the last four weeks, as we all have been overwhelmed by recent events."
"The cowardly terrorists who thought their fanatic actions would divide us, cower us, and bring us to our knees were mistaken. They do not know this generation of Americans," Harding declared. "Now we will show them what and who we truly are." ▪