APA will lead the psychiatric profession in restoring patients’ access to high-quality care in both the public and private sectors, incoming APA President Daniel B. Borenstein, M.D., declared in his presidential response speech last month at the Opening Session of APA’s 2000 annual meeting in Chicago.

How APA will accomplish this goal, he said, is through a number of initiatives that are already under way or will be during his presidency, which began at the conclusion of the annual meeting.

Chief among these initiatives is APA’s new business and industry initiative, in which APA will be working with leaders in business and industry to help them evaluate the real costs of restricting access to mental health care and educate them about the cost-effectiveness of providing psychiatric treatment to their employees.

"A recent study of major corporations revealed that three years of aggressive managed care led to a 44 percent decrease in total mental health costs," said Borenstein. "During the same period, there was a 37 percent increase in general health care costs, a 22 percent increase in absenteeism, and a decrease in work performance—resulting in no net cost savings. Moreover, this study did not include the well-documented, significant increase in employee disabilities and disability payments that has occurred under managed care."

He also noted that the percentage of health care dollars devoted to mental illness and substance abuse treatments dropped from about 6 percent in 1988 to 3 percent in 1998. This represented a 50 percent reduction at a time when overall health benefits dropped 7.4 percent.

APA is also enhancing its advocacy activities on behalf of psychiatry patients and the profession, Borenstein continued. He announced that he has appointed the members of APA’s new Commission on Public Policy, Litigation, and Advocacy, which is charged with formulating "action plans" that incorporate a combination of approaches appropriate for the task, including advocacy of legislation, public education campaigns, and litigation. Three priorities around which action plans will be developed are psychologist prescribing, parity for mental health benefits, and confidentiality and privacy issues, he said. The plans will be implemented at both the state and federal levels, and at the state level, APA will work "shoulder to shoulder" with its district branches.

Also making APA’s increased advocacy possible, said Borenstein, is its corporate reorganization recently approved by members in the 2000 election. As APA moves from a 501(c)3 charitable organization to a 501(c)6 business organization, it will be able to conduct more lobbying and public education activities and expand its political action committee.

Borenstein said that he also plans on continuing APA’s initiative on improving communication between APA and its members. "Members must know what APA is doing, and APA must learn what members are concerned about," he said. He is working toward expanding APA’s Web site and making it interactive, as well as sending members e-mail or fax updates detailing APA’s recent activities. He also plans on continuing the involvement of district branch leaders at Board of Trustees meetings, in the Assembly, and on APA components. In turn, he hopes that district branch leaders will develop methods to communicate with their members at the grass-roots level.

The final topic that Borenstein addressed was his "desire to integrate our organization, our members, and our science." APA needs to develop closer working relationships with psychiatric specialty societies to make their voices more effective and limit redundancies, he said. Toward this end, he has planned an allied society leadership summit to be held this month as a step toward further integration. He also anticipates forming closer alliances with international colleagues, including collaborating with the World Psychiatric Association on such projects as eliminating the differences between DSM-V and psychiatric aspects of the International Classification of Diseases.

To accomplish these and other goals, Borenstein observed that all segments of the APA membership have a place in the organization and warned against the membership’s disintegrating into factions. "We must place our common purposes above personal or chauvinistic interests," he said to applause. "Working together ensures success."

Referring enthusiastically to the numerous scientific developments that psychiatry has seen in the past decade, Borenstein announced that the theme he has selected for next year’s annual meeting is "Mind Meets Brain: Integrating Psychiatry, Psychoanalysis, and Neuroscience."

"Our future is bright," Borenstein concluded. "Your American Psychiatric Association is here to represent your interests, safeguarding our work with patients in need. I look forward to working with you in the coming year, and with your help we can meet any challenge."—C.F.B.