Assembly Seeks APA Sign-On To Climate Statement, Takes Other Actions
Abstract
Assembly members approved more than a dozen action papers and position statements.
At an agenda-packed meeting last month in Washington, D.C., the APA Assembly approved an action paper asking APA to sign the “U.S. Call to Action on Climate, Health, and Equity,” a document endorsed by more than 100 organizations including the AMA and other medical groups.
APA’s Assembly took up issues related to provision of psychiatric and general medical services for immigrants detained at the border, climate change, and reaching out to other physicians about the value of hiring psychiatrists to work within general medical practices. At the podium is APA President Bruce Schwartz, M.D.
The document calls on government, business, civil society leaders, elected officials, and candidates for office to recognize climate change as a health emergency. The action paper states the issue is of “sufficient urgency” that it be referred directly to the Board of Trustees for approval and enactment. All action papers, resolutions, and position statements approved by the Assembly do not become policy unless approved by the Board of Trustees.
The “U.S. Call to Action on Climate, Health, and Equity” states, “Without transformational action, climate change will be increasingly severe, leading to more illness, injury, and death; mass migration and violent conflict; and worsening health inequities. By mobilizing climate action for health and health action for climate, the U.S. can reduce climate pollution and build healthy communities that are resilient in the face of climate risks.”
James Fleming, M.D., one of the sponsors of the Assembly action paper, noted that three member organizations of the “Group of Six”—a coalition of primary care and specialty groups with which APA partners on advocacy initiatives—have signed the “Call to Action on Climate, Health and Equity.”
The three groups that have signed the document are the Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Physicians. (The other Group of Six members are APA, the American College of Obstetricians and Gynecologists, and the American Osteopathic Association.)
Fleming added that the American College of Emergency Physicians has also signed the document. “I think it’s safe to say the emergency physicians wouldn’t sign onto something like this if they didn’t think it was a true emergency,” he told Psychiatric News. Fleming is an Assembly representative from the Missouri Psychiatric Physicians Association, chair of the APA Caucus on Climate Change and Mental Health, and a member of the steering committee of the Climate Psychiatry Alliance (CPA). The CPA is a group of psychiatrists who focus on climate change and mental health.
The document lists 10 recommendations (see end of article for website address). “It’s a broad-ranging document that addresses a number of intersecting components of the climate crisis, each of which in and of itself is problematic,” Fleming said. Among those components are health, transportation, employment, and food distribution.
“They can exacerbate each other, and not dealing with the worst aspects of climate disruption will worsen every other component, including the structures of society we need to practice medicine and psychiatry. This can also be an opportunity to solve several problems at once,” he said.
Other Actions
In other business, the Assembly voted to approve an action paper asking APA to issue a position statement regarding age-appropriate services for U.S. border detainees, to include the following:
A screen for mental and other medical conditions, especially those that may be acute in nature and include factors related to potential psychological trauma.
A timely medical examination of each detainee.
A timely mental health examination by a licensed medical professional.
Conditions of detention consistent with the Flores settlement for children with families and unaccompanied minors and with the ICE Performance-Based National Detention Standards for adults.
Immigration legal services per due process standards.
Staffing with language literacy consistent with that of detainees.
Legal representation for detainees with mental disabilities.
Competency to stand trial evaluations.
Confidential translators.
Additionally, the Assembly approved an action paper asking that the APA Council on Healthcare Systems and Financing create a toolkit for psychiatrists to educate nonphysician administrators on the benefits of hiring psychiatrists. The toolkit should seek to address issues related to finance, rigor and duration of training, credentialing and certification, disparity in access, quality of care, and outcomes. It should be prominently advertised to the membership on the APA homepage and social media and by email to APA members (and nonmembers as able).
The Assembly also approved the following action papers:
Public Education to Increase Responsible Disposal of Prescription Medication. The action paper asks that APA lobby the National Alliance of State Pharmacy Associations and the National Association of Boards of Pharmacy to encourage all pharmacies to provide specific information for local medication collection sites and drug disposal options when a controlled prescription medication is dispensed for outpatient administration.
Variability in State Law Concerning Emergency Holds for Psychiatric Evaluation. The action paper asks that APA form a work group to examine state, territorial, and provincial laws concerning emergency holds and create a resource document outlining these findings.
Action Paper Against Affiliate Membership. The action paper asks that APA refrain from making available any category of voting or nonvoting membership that would be open to nonphysicians. ■
