Reflecting on a Big Year for Mental Health

As my year as APA president draws to a close, writing this final message to you gives me the opportunity to reflect on what we have accomplished together over the past year for psychiatry and the mental health of those we are entrusted to serve. This unprecedented year for psychiatry began last May, when we were finally able to gather at our Annual Meeting in New Orleans as the COVID-19 pandemic wound down. Now, with the end of the public health emergency (PHE), we are facing our future. We have witnessed a historic public recognition of the importance of mental health, yet this awareness has come as the result of an overwhelming need for services that this country is woefully underprepared to deliver.

Against this backdrop, we have shown how our ability to be nimble and innovate as well as to come together and collaborate has helped move the needle forward to ensure that our profession is strong and that every American has timely access to accessible and affordable high-quality, evidence-based mental health care.

As mental health captured center stage in the public consciousness, APA’s advocacy efforts made great strides in securing funding for critical treatment of mental and substance use disorders and delivery provisions: The final days of 2022 culminated in the passage of a federal omnibus bill that funded multiple APA legislative priorities. These measures, for example, secured funding for key advances in care delivery such as the implementation and expansion of the Collaborative Care Model and extensions to key telehealth flexibility provisions beyond the PHE. In addition, 100 new residency training slots were approved for psychiatry and psychiatric subspecialties—accounting for fully half of the 200 total slots allocated to all specialties and subspecialties. In addition, the bill reauthorized funding of the SAMHSA Minority Fellowship Program, providing five more years of funding to advance the diversity of the psychiatric workforce to meet the needs of our country’s population. Finally, we have come to a key societal recognition that there is no health without mental health with the appropriation of resources for parity enforcement to ensure that insurers follow the law in covering and reimbursing medically necessary mental health care on par with all other health care.

Within APA, we have continued to prepare for the future, and our Diversity, Equity, Inclusion, and Belonging journey and accountability continue. In the past year, the Board of Trustees expanded the Structural Racism Accountability Committee (SRAC) by approving broader membership and staff support from the Membership Department and the Division of Diversity and Health Equity, not only to advance its work at the leadership level of APA but also to promote extension to district branches, individual members, and staff. As APA continues to collect data from the implementation of the task force’s recommendations, the SRAC is evaluating progress and making recommendations to the Board of Trustees for continued work. For example, the SRAC recently met to review the results of the pilot procedures used for APA’s past two elections, which were aimed at promoting diversity and equity for all candidates. The Board also convened a work group on the definition of “minority/underrepresented (M/UR)” within APA, chaired by past President Maria A. Oquendo, M.D., Ph.D. The work group is tasked with looking at current nomenclature and recommending nomenclature that supports members of groups who have not achieved full voice and equity and/or face discrimination and inequity within the profession. Earlier this year, listening sessions were held with members of each of APA’s seven M/UR caucuses to learn about their experiences in APA, advance representation, and address unmet needs. APA will continue this work to dismantle structural racism at every level of the organization.

Finally, following adoption of the recommendations of my Work Group on a Roadmap for the Future of Psychiatry, chaired by Robert Trestman, Ph.D., M.D., APA is beginning to implement this broad vision for how psychiatry can move forward in the immediate, near, and long term as the thought, knowledge, practice, and policy leader for mental health and substance use (“Board Approves ‘A Roadmap for the Future of Psychiatry’”). I am grateful to Dr. Trestman and the members of the work group for their comprehensive and actionable plan to advance our profession. We are not alone in these efforts. As we re-established and strengthened our relationships with our psychiatric colleagues around the globe this year, our roadmap is an important tool for collaboration on a multinational agenda for advancing mental health. I hope you will take the opportunity to learn more about the accomplishments of the work group and APA’s plans for the future at APA’s Annual Meeting.

Now, it is with gratitude, admiration, and enthusiasm that I close my final column by introducing your next president—my colleague and friend, Petros Levounis, M.D., M.A. He has been an invaluable and trusted adviser this past year. As president, he will focus on addiction, drawing on his decades of experience in the field. In particular, Dr. Levounis will employ public education and strategic partnerships in his bold initiative to make meaningful progress in the fight to end the opioid epidemic and indelibly reframe substance use disorders as illnesses, rather than a moral failure. APA could not be in more capable hands, and we are here to support his success!

Finally, none of what we accomplished in the past year would have been possible without your support. The passion and dedication that each of you demonstrate day in and day out, in both routine and monumental words and deeds, is inspiring and humbling. Because of you, our future is bright. It has been an honor to serve as your president this past year. Together, our knowledge, compassion, and spirit will continue to advance mental health and human flourishing. ■