With last month's Board of Trustees meeting being held in New Orleans
following the close of the Institute on Psychiatric Services, it was fitting
that Board members received a report from the presidents of two local district
branches (DBs)—those representing Louisiana and Mississippi—on
issues they and their colleagues face in the post-Katrina environment.
Daphne Glindmeyer, M.D, president of the Louisiana district branch, and
Philip Scurria, M.D., president of the Mississippi district branch, gave vivid
and often disturbing accounts of post-Katrina mental health care in their
states and answered questions from APA Board members.
Daphne Glindmeyer, M.D., of the Louisiana DB, said her organization is
dealing with a greatly reduced membership roster and an attendant loss of
income that has added to their struggles. Many members resigned after the
state granted psychologists prescribing privileges, with some blaming the
local DB and national APA for not doing enough to head it off, she noted. In
2003, the year before the prescribing bill passed, the DB had 464 members; by
2005, there were only 392. And then Katrina hit, further devastating the
membership as psychiatrists moved to other states where they didn't have to
cope "with a broken system" and a lack of health-system"
infrastructure." Membership has recently edged up to 403.
Now the remaining psychiatrists face far more patients who are very sick,
and waits for care are growing rapidly.
Further complicating the lives of Louisiana psychiatrists, she said, is the
imminent application of a term-limits law in the legislature, which means
there will be a major turnover, "and we don't know who our friends and
foes are" and thus who to target in lobbying efforts.
Philip Scurria, M.D., president of the Mississippi DB, also described how
Katrina devastated an already seriously underfunded and understaffed mental
health system in his state. He noted that he is the only full-time
psychiatrist in the Mississippi Delta region between Baton Rouge and Memphis.
In many parts of the state waits of two to three months to see a psychiatrist
are the norm, putting "a tremendous load on emergency rooms." In
the storm-ravaged Gulf Coast area, the suffering is particularly dramatic, and
while he expressed gratitude for the volunteers who provided mental health
crisis intervention after the storm, he said there are far too few clinicians
left there to treat people who will be "suffering with lifelong
Incarcertaing mentally ill individuals is common in the state, he added,
with the state hospital routinely having a three-week wait for beds to become
available. "Some are just sent home to wait for a bed, even though they
may have been declared dangerous to themselves or others," Scurria
Mississippi's clinician shortage is most severe for children needing
psychiatric care. There are fewer than 20 child psychiatrists in the state, he
pointed out, with 90 percent of them located in Jackson, the state's largest
city and site of its only medical school.
NAMI President Anand Pandya, M.D., describes major initiatives the
organization is undertaking, including programs focusing on gay, lesbian,
bisexual, and transgender people with mental illness.
The Trustees also heard from psychiatrist Anand Pandya, M.D., president of
the National Alliance on Mental Illness (NAMI), who discussed the
organization's new initiatives. One effort, NAMI Connections, is to have a
three-year roll-out of a peer-support-group model to be available in every
state and major metropolitan area. As is the case with Alcoholics Anonymous,
people who participate in one of these support groups could find one in any
state to which they traveled and understand the concept and terminology being
used. He said that these programs were already operational in 12 states
through funding from AstraZeneca.
NAMI is also focusing on lesbian, gay, bisexual, and transgender people
with major mental illness, Pandya explained, including the difficulty some of
these individuals have in getting a psychiatrist or mental health professional
to treat them unless they agree to discuss their sexual orientation as a major
part of therapy.
He also urged APA to add "consumer members" to its Academic
Consortium, which lobbies Congress on research funding for mental illness
The Board took action on several issues at last month's meeting. Among
them, the Trustees voted to