Personal contact with elected representatives is the best way to increase
the odds that your message will impact future legislation.
Various speakers at APA's fall component meetings last month in Washington,
D.C., encouraged psychiatrists to become politically active for their
profession and patients. Attempts to influence state and federal legislators
are the only way to mitigate the impact of the ever-increasing influence that
government officials exert over medicine, they
Suzanne Vogel-Scibilia, M.D., president of the National Alliance on
Mental Illness (NAMI), tells APA members last month in Washington, D.C., that
APA and NAMI should collaborate more closely on such efforts as seeking
funding to implement recommendations of the New Freedom Commission on Mental
Health. At right is APA President Pedro Ruiz, M.D. (see pages 2 and
At a luncheon during the fall meetings, Rep. Charles Norwood (R-Ga.) told
attendees that physicians need to be involved “to protect the patients
in this country from an increasing third-party presence.” The dentist
and cosponsor of federal mental health parity legislation told attendees that
many members of Congress are either uninterested in health care or concerned
only with its financial impact on the federal budget.
He urged psychiatrists to develop personal relationships with their
representatives through contributions and offers to work on their campaigns
and be a resource they can consult on health care issues.
“Members of Congress actually listen to their constituents if they
see them eyeball to eyeball,” Norwood said. “It's important to get
people on your side who [have the power to] ruin your profession with the
stroke of a pen.”
Norwood called on physicians to help elect or reelect state and federal
legislators who support physicians' positions on health care issues by
contributing annually to their campaign funds.
Norwood said his “number-one priority” for the remainder of the
current congressional session is to get other members to join him in
overriding the planned 5.1 percent cut in Medicare physician reimbursement
scheduled to take effect in January 2007 (see
The plea to psychiatrists to get involved in the political process was
repeated during the plenary session of the fall meetings. APA President-elect
Carolyn Robinowitz, M.D., told attendees that APA attempts to develop
relationships with members of Congress from across the political spectrum to
ensure continuous influence. The lobbying effort is a years' long“
complex process,” similar in length and complexity to the care
that psychiatric patients require, she said.
Critical to the success of APA's lobbying efforts is the participation of
its members in APA's political action committee, APAPAC. Its
membership has increased from 1,472 in 2001-2002 to 2,579 in 2005-2006.
ApaPAC supported about 135 members of Congress in the current cycle,
with the support almost evenly split between the two major political parties
(see page 3).
“We have to counter the Scientologists and their well-funded message
to Congress,” Robinowitz said. “We've got to educate; we've got to
APA also can increase its political profile and advocacy impact by
partnering with organizations that have many of the same views, said Suzanne
Vogel-Scibilia, M.D., president of the National Alliance on Mental Illness
(NAMI). She proposed a collaborative relationship to spur action on the state
and federal level. Such a “partnership” could push for federal
funding for the recommendations of the President's New Freedom Commission on
Mental Health, among other initiatives.
APA President Pedro Ruiz, M.D., said the collaboration would help cement
relationships between APA and patient advocacy groups. He highlighted various
areas in which APA might benefit from such collaboration and urged component
members to consider issues on which they could collaborate with patient
Vogel-Scibilia discounted the notion that implementation of the New Freedom
Commission's recommendations was held up by erroneous claims that the
commission was mandating child mental health screenings. The problems
affecting the delivery of high-quality mental health care are so complex, and
each state uses such different systems, that no one has been able to push
through the changes needed.
“If we have a strong partnership, then we can push people in
government to make decisions that are politically unpopular,” she
The proposed alliance would be a change from the current mental health
alliance in Washington, D.C., of 16 advocacy groups that Vogel-Scibilia
described as somewhat like “herding cats.” Better results would be
possible, she said, if two or three of the most powerful mental health groups
provided a more unified push on issues.
In response to a question from a member of the audience, Vogel-Scibilia
said the dysfunction of the current mental health system led to the chain of
circumstances that allowed a patient of Wayne Fenton, M.D., to allegedly
bludgeon him to death in his office (see
“When the system is broken, it is we as providers who are trying to
help who are in danger,” Vogel-Scibilia said.
She said the tragic event should spur psychiatrists to push for
improvements in the system.
The need for government action in a health care crisis also was highlighted
by a presentation at the plenary session on the 25 years since the first U.S.
Cases of AIDS appeared. Marshall Forstein, M.D., who chaired the APA
commission on AIDS for 12 years, traced the AIDS epidemic from its earliest
days in this country and highlighted the points when the public and the
federal government finally confronted the disease and took steps to control
Although the government's early approach to largely ignore the disease
showed how destructive an unchecked health care crisis can be, Forstein said,
government research funding was eventually critical to understanding and
treating the disease.
Forstein told psychiatrists that the mental health consequences of the AIDS
epidemic among those with the disease and their families and friends will be
felt for many years, and they should be ready for these patients.
“if there was ever a disease that truly needs a combined
biopsychosocial approach, this is it,” he said. ▪