I knew for over a year that I was going to become the president of APA at 5
p.m. on a given Thursday in May 2008, but I was surprised by the impact of
that moment. Probably finishing my term at 5 p.m. on a Thursday in May this
year will be just as powerful. There are many things the APA president can't
do: make APA policy, ensure that media statements about psychiatry are
positive and accurate, please all the members of APA. The Board of Trustees
has the legal responsibility for APA. The medical director/chief executive
officer hires and administers the staff to carry out those
decisions.
But the president of APA sets the agenda for the Board. The president
should ensure that Board members have the information and discussion they need
to make good decisions. The APA president receives and responds to hundreds of
comments, requests, complaints, and suggestions from APA members and from
outside friends and enemies of APA. The president speaks for APA with other
organizations, with the media, and at hearings of Congress, the FDA, and other
arms of government. As an APA member, I had been candid about my opinions. As
the president of APA, I am not entitled to express personal opinions; I am
bound by APA policy, and my statements are APA statements. There are also
urgent situations that require carefully crafted strategy in the absence of
specific APA policy. The attitudes and statements of the APA president carry
weight with the APA staff, the membership, and the outside world. The
president needs to make the right decisions and the right statements,
promptly, for 365 days.
The APA president is received with great respect by colleagues all over the
world. I have enjoyed representing you at the meetings of the Royal College of
Psychiatrists in London; the Indian Psychiatric Association in Agra; and the
World Psychiatric Association in Paris, Shanghai, Prague, and Florence and
meeting you at local, state, and regional APA meetings from Seattle to New
York and Texas to Minnesota.
I came into my presidential year determined to address our relationships
with the pharmaceutical industry, reorganize our large and complex governance
structure, increase efforts to serve the underserved, carry on our tradition
of leadership on the social issues that impact mental health, highlight
preventive psychiatry, strengthen our relationships with mental health
advocacy groups and mental health and medical professionals, and not to be
intimidated by our enemies. I wanted to use every opportunity to impress upon
our government and the public the validity of our diagnoses and the
effectiveness of our treatments. I wanted to make our members from every
ethnic group, from every medical school, and from every subspecialty know how
much we respect their contributions. I wanted APA to participate in health
care reform and to prepare us for the psychiatry of five and 10 years from
now. With the support of the members and our excellent staff, I was able to
get many of these efforts in motion and complete some of them.
There were unexpected demands. Despite our leadership in addressing
conflicts of interest and our careful preparations for the development of
DSM-V, we suffered attacks on both in the past year. We responded
with facts. We sent a 50-page report to Sen. Charles Grassley (R-Iowa) and the
New York Times. I believe we are the first specialty society to put
up a Web site offering our members and the public detailed information about
the development of our diagnostic system and requesting feedback. Our decision
to discontinue industry-supported symposia and meals at our meetings was
reported in all the major media and was overwhelmingly well received by
members, as was our decision to right-size our governance. Public opinion
about psychiatry and psychiatrists is increasingly more informed and more
positive.
I have been on call 24/7 for 365 days. It will be a relief not to feel
responsible for APA, but it will also be a loss. I have loved traveling the
country and the world for APA, and I have felt proud to defend our field and
our Association. I have cherished the opportunity to listen and speak to you.
It has been an extraordinary privilege to represent the members of APA, who
have dedicated their knowledge, compassion, and wisdom to the relief of human
suffering. Thank you. ▪