While the focus of the Assembly's meeting was on issues related to health
care economics and the Assembly's functioning and role in APA, the
representatives did take on a major clinical issue. They voted overwhelmingly
to urge APA to drop the multiaxial system in the next revision of
Introduced by Roger Peele, M.D., the Area 3 representative on the APA Board
of Trustees, the proposal notes, "Over the last two decades, the
multiaxial system has not caught on. Medicare, Medicaid, and most commercial
insurances, except under carveout circumstances, don't expect multiaxial
diagnosing." In addition, Peele emphasized, "There is no evidence
that most practitioners make use of it when they are free not to."
The Assembly voted to remove the multiaxial system from the diagnostic
manual unless "clear evidence" emerges that the system has
benefited patients with mental illness. The Assembly referred the issue to the
Committee on Psychiatric Diagnosis and Assessment, a component of the APA
Council on Research.
On the health care economics front, the Assembly voted to urge the APA
Board to adopt a position statement emphasizing that the federal government
should earmark the same percentage of the health care budget for mental
illness and substance abuse services as the percentage it annually devotes to
providing services to patients with other types of illnesses.
Introduced by Area 1 Deputy Representative Jeffrey Geller, M.D., the action
paper noted that the government's funding priorities have for years
shortchanged mental health services, and with states cutting their mental
health budgets in recent years, services are further threatened.
The Assembly also voted to ask the representative from each of APA's seven
Areas to identify a psychiatrist in each district branch within the Area who
would represent that state on an APA Medicaid Advisory Group.
On other proposals, the Assembly voted
Rep. Carolyn Maloney (D-N.Y.) is the recipient of a Speaker's Award from
Assembly Speaker Prakash Desai, M.D. Behind Maloney are (from left) Assembly
Speaker-elect James Nininger, M.D., New York County Representative Herbert
Peyser, M.D., and Desai. Nininger and Peyser are constituents of Maloney, who
was honored for her advocacy in Congress on mental health issues such as
parity, confidentiality, and patients' rights. Maloney said there "must
be full parity at the federal level," adding that the Bush
administration just provides "lip service" to the need for parity
legislation without following through with serious support.
The draft summary of the Assembly's actions is posted in the"
Members Corner" section of APA's Web site at<www.psych.org/members/index.cfm>
under "Assembly." ▪