Machiavelli wrote in The Prince, "There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of things, because the innovator has for enemies all those who have done well under the old conditions and lukewarm defenders in those who may do well under the new."

I said something similar, although not so eloquently, at a recent Board of Trustees meeting in relation to election reform. We were debating what reforms were indicated. It was clear that many Trustees were reluctant to see any change in our policies or procedures. My position was that all of us sitting around the table had been successfully elected under the present system and could not be objective about the need for change. I encouraged that grass-roots members be asked how they feel about our elections and what changes, if any, they would like to see. I am pleased to report that the Committee to Review Election Policies and Procedures plans to do just that.

Making significant organizational changes is always difficult, and yet it is necessary. Some futuristic thinkers believe that in today’s rapidly changing world, anything that has been done in a particular way for 15 or 20 years is being done in the wrong way.

During the past year, the membership supported a change in corporate structure that will allow APA to provide more assistance to district branches and state organizations. The Assembly, Board of Trustees, councils, commissions, and committees made major changes that reallocate more of APA’s resources toward our strategic priorities. Many of these changes were long overdue, but could not be accomplished largely for the reasons noted above by Machiavelli. Had we not adopted a "base closing," all-or-nothing approach, it is unlikely that any significant change would have occurred.

Undoubtedly, additional changes are needed, and we must not wait another 15 years in adapting to today’s rapidly changing society. Our aim is to be ahead of the curve, not play catch up.

Other organizations have confronted needed changes in different ways. The National Alliance on Mental Illness recognized that its state organizations were not sufficiently integrated into a national network, and it wanted to increase its visibility. To accomplish this goal, the state organizations were asked to change their names to become branches of NAMI. For example, the California Alliance for the Mentally Ill (CAMI) became NAMI of California.

A number of suggested changes to streamline, strengthen, and improve APA outside of its Washington base have been proposed. States with multiple district branches have been encouraged to become one DB with chapters. Under this scenario, the number of Assembly representatives would be proportional to the number of members as it is in all other states. States with small numbers of members in their statewide DB have been encouraged to pool their resources, forming cooperative alliances with adjacent DBs to develop a robust infrastructure. I am hopeful that these and other ideas for potential changes will be considered and result in positive developments in the near future.

While discussing changes, some members dwell on which group is making the greater sacrifice. Instead of focusing on what some other part of our organization is contributing, members must spend their energies on constructive planning and actions to make APA, at the local and national levels, more efficient and more effective. We must come together as one organization, not separate entities in competition with each other.

APA is an extremely diverse organization. Some have suggested that getting our members to agree on anything is akin to herding cats. In our efforts to assist our patients and to advance our profession, all perspectives must be heard and considered. But we must be careful to avoid disintegrating into factions within our organization. Common purpose must be placed above personal or chauvinistic interests.

Coming together is a beginning. Keeping together is progress. Working together ensures success!