During the Opening Session of the 53rd Institute on Psychiatric Services (IPS) in Orlando last month, APA President Richard Harding, M.D., challenged all members to "take a leadership role" in helping the country recover from the events of September 11 and their aftermath (see page 6). The IPS Scientific Program Committee, headed by Harvey Bluestone, M.D., immediately focused its attention on adapting the meeting agenda to help those attending respond to Harding’s challenge.

The committee responded by taking a few moments at the end of the opening ceremony to get input from attendees on how the program could be altered to help them deal with the aftermath of what many seemed to prefer to call the "atrocity" rather than the "disaster."

The result of that input was the addition of nine special sessions based on the attendees’ recommendations.

"The flexibility of the institute program allowed us to rapidly address the impact of the tragedy on our practice, our patients, and our profession," Bluestone later told the Daily Bulletin, the meeting newsletter.

The special sessions ranged from an interactive session on disaster response and an informal session featuring a New York City residency training director who shared the experiences of the psychiatric residents she oversees, to sessions on handling acute stress, dealing with cultural stigma in times of crisis, helping different populations such as the chronically mentally ill cope with disaster, and managing anxiety in children and adolescents.

Additional sessions focused on mental health community outreach leadership and the lessons learned from the Oklahoma City bombing. Interventions for people with acute stress disorders became part of the program, and health care system and policy issues related to disasters were discussed during other sessions.

The institute’s theme, "Multidisciplinary Roles in the 21st Century," was not only timely because of the surgeon general’s focus on mental illness as an unrecognized and undertreated public health crisis, but was also prophetic, Bluestone told attendees at the institute’s Opening Session.

The tragic events of September 11, he said, are placing unprecedented stress on the nation’s mental health care system, and that stress has exposed flaws that must be corrected in order to address the needs of those affected by the atrocity.

"Each and every one of us," Bluestone said, "must confront the inefficiencies caused by duplication of services, turf wars, and competition among professions and institutions, bureaucratic infighting, conflicting rules and regulations, and discriminatory insurance that bars millions of people from obtaining mental health care."

All psychiatrists and mental health professionals, Bluestone said, play a critical role in meeting these needs and in addressing the problems inherent in the current system. "But we cannot succeed by going our separate ways. Events now demand that we find coordinated, multidisciplinary approaches to mental health care."

Though the institute program was planned months in advance, it was obvious to members of the Scientific Program Committee that the overwhelming events of September 11 would have an impact.

"We knew we could not ignore the issue," Paula Panzer, M.D., told Psychiatric News. Panzer, vice chair of the committee for this year’s institute, will head the committee for next year’s institute in Chicago. "We knew there would be huge need, but when we really looked, of course, we hadn’t addressed the issue in the program."

Panzer said the committee knew that trying to put together formal sessions dealing with disaster psychiatry issues would be difficult, simply because there are not a great many experts available on the subject. Instead, the committee chose to arrange more informal presentations on the topics suggested by the attendees.

"We did not want to take over the whole program, but it was evident that people had issues that needed to be addressed, and we chose to do so in facilitated discussions rather than more formal sessions," Panzer said.

No doubt, Panzer predicted, next year’s institute will feature sessions dealing with various aspects of the aftermath of September 11 and bioterrorism. The theme for the Chicago meeting, she said, will be "Community Counts: Creating and Supporting Systems of Care," a concept more vital now than ever before. ▪