The resources of APA’s district branches are stretched far too thin to meet the challenges that bedevil them on multiple fronts, according to the presidents-elect of several district branches.

During presentations at last month’s meeting of the APA Board of Trustees in Washington, D.C., the presidents-elect of the Georgia, Colorado, and Indiana psychiatric societies described internal and external pressures that are consuming a substantial portion of their time and financial resources.

In Georgia, psychiatrists are enjoying a state legislative victory—short-lived though it may be—over psychologists who mounted an all-out push for prescribing privileges, said Elizabeth Howell, M.D., of the Georgia Psychiatric Physicians Association (GPPA). She attributed this success to an extensive and very expensive public education and lobbying effort in which they had considerable help from the state medical association and a financial grant from APA, for which she thanked the Trustees.

She lamented the imminent return of the prescribing bill in the next legislative session and the difficulty GPPA leaders are having in motivating psychiatrists to become involved in advocacy and public education efforts. Howell also noted that to many district branches, "APA is a mystery." She said the Association needs to do a much better job of communicating with its district branches and answering members’ questions.

Members of the Colorado Psychiatric Society (CPS) have for the last year been dealing with the repercussions from the killings at Columbine High School, explained President-elect Doris Gundersen, M.D. That tragedy unfortunately "uncovered major fragmentation" among mental health professionals, who spent much time "jockeying for position rather than collaborating" on helping those touched by the disaster. She pointed out that her district branch had a disaster-response plan ready to go, but to make resource deployment more effective, the CPS is developing a partnership with the Red Cross and several state agencies.

Gundersen emphasized as well the toll that managed care is exacting from psychiatry services in terms of steadily shrinking availability of hospital beds and "collapsing services." Particularly troubling, she said, is that "residents are questioning their careers in psychiatry," and "private practitioners are fleeing to salaried positions" or refusing to take on new patients insured through managed care companies.

Jeffrey Kellams, M.D., of the Indiana Psychiatric Society described good and bad news on the parity front in his state. On the positive side, the governor signed parity legislation into law, but signs point to insurers and managed care firms "finding ways to evade it," he said. It will probably fall to the courts to make mental health parity "really effective for citizens," Kellams stressed.

He also cited a problem his district branch is having in convincing residents of the value of joining APA. The Association needs to find a more effective way of demonstrating to them that the "organization works hard in patients’ and members’ best interests," Kellams told the Board.