It can be difficult to involve residents in state psychiatric societies. Massachusetts had this problem once, but no longer does, because last year, due to considerable interest by residents, the Massachusetts Psychiatric Society (MPS) approved the establishment of a Residents’ Council. That council became active early this year.

Now we have a core group of residents committed to the the new Residents’ Council, and with each meeting more new residents come seeking information about it.

I would like to explain how and why I founded the MPS’s Residents’ Council and what, I believe, accounts for its success.

I first contacted the MPS two years ago, after an unpleasant exchange with a utilization reviewer. I had called the MPS office to find out whether they had a managed care committee. Executive Director Dorothy Moonie went out of her way to give me all the information I needed. She also put me in touch with the members of that committee.

I was invited to join the managed care committee almost immediately. The committee’s co-chairs, Drs. Michael Bennett and Eugene Fiermann, were clearly delighted to have a resident involved. Soon MPS President Dr. Jerry Rogoff invited me to attend the MPS council meetings.

All the council members welcomed me wholeheartedly. Many of them even approached me after that first meeting, asking whether I knew of other residents who wanted to be on their various committees.

I began to wonder, in the face of all that friendly support and genuine interest, why were so few residents involved? The history of resident involvement in the MPS conforms to a general pattern that has been repeated elsewhere in the country. That is, every few years some enthusiastic resident would establish a connection with the district branch and, for a time, residents would become involved in MPS functions and activities. Things would go well until that resident graduated, and then there would be a hiatus until another enthusiastic resident came along.

I wanted to establish something more permanent; something that would continue to function even after I was gone.

With the help of Dr. Justine Lalonde, at that time the Area 1 Member-in-Training Representative to the APA Assembly, I invited a number of residents over to my apartment to discuss ways in which we could make the MPS attractive to residents and increase their involvement in the district branch. We began by explaining the structure of APA and the MPS, outlining the fellowships and appointments available to residents.

But the more we described the detailed structure of APA, the more their eyes glazed over. In fact, residents wanted immediate involvement with issues that could help them improve their own situation or that of their patients. After all, most residents feel overburdened with social and organizational demands already.

So instead of dwelling on organizational structures, we dedicated council meetings to the identification and pursuit of specific goals. We invited the MPS lobbyist to an early meeting, and she briefed us on many of the most important issues affecting psychiatry today.

We soon decided that an insurance parity bill before the Massachusetts legislature constituted a good target for action. Working quickly, we collected signatures and sent letters to legislators. Not only were we working to effect legislative change, but we were also educating other residents. This helped build interest in the Residents’ Council by demonstrating its commitment to action. The next meeting, at which we could announce that the parity bill had passed, also saw an increase in the number of participants.

The Residents’ Council remains committed to action. Recently, for example, we asked APA Vice President Dr. Paul Appelbaum, who is a member of our district branch, and MPS President Dr. Frederick Stoddard to address the Residents’ Council about ways in which residents could become involved in developing policy and effecting change.

Of course, none of this would be possible without the support of the MPS Council, whose members voted unanimously to support a Residents’ Council, and even to include it in the organization’s charter. They also invite one resident each year to serve as a voting member on the MPS Council.

Naturally we have had to pay some attention to organizational matters. The important point, however, is that the goals and interests of the residents should always dictate the everyday form and function of the organization. In this way, the Residents’ Council hopes to avoid meeting for meeting’s sake.

I envision a Residents’ Council that provides its members with a sense of optimism and purpose, with a sense that they can actually get things done in the larger community. Of most interest at the present time is ensuring broad access to child mental health services. This reflects the large number of Residents’ Council members who plan to enter the field of child psychiatry.

Not everyone will be interested in this kind of organization. There are many residents, for example, who do not consider this brand of political activism to be part of their professional role. But if the Residents’ Council continues to be effective, if it continues to draw residents, if it offers a forum for the discussion of important issues, and if it succeeds in promoting and championing important changes, then even some of the pessimists will take note. And if the Residents’ Council succeeds in banishing some of the fatalism and pessimism so typical of overworked residents, then it will have served an important function. 

________________________________________________________________________________

Dr. Kornbluh is a resident in psychiatry at the Massachusetts General Hospital and McLean Hospital in Boston. She is also founder of the Residents' Council of the Massachusetts Psychiatric Society.