In this article, Drs. Wilfrid Raby and Molly Finnerty, fourth-year psychiatry residents at Columbia University, describe the remarkable success of the Picnic for Parity, an annual event in New York City that brings together people with mental illness, their families and friends, psychiatrists and other mental health care providers, and mental health advocates. This coalition gathers together to take a public stand against the stigma of mental illness and for the right of parity coverage.

Drs. Raby and Finnerty and the resident section of the New York County APA district branch were responsible for conceiving and implementing the Picnic for Parity. They will hold a workshop at APA's 1997 annual meeting next month in San Diego on how to organize a similar event for parity in your community.

Please call me with your questions, ideas, columns, or concerns. My e-mail address is hegger@psych.mc.duke.edu, and my phone number is (919) 416-7223. I welcome your input.

Helen Egger, M.D.
APA Member-in-Training Trustee

By Wilfrid Noel Raby, M.D.

Molly Finnerty, M.D.

The two issues of greatest importance to our patients and the future of psychiatry are parity and stigma. The disparity in coverage of medical benefits conveys a message that mental illnesses are unreal, untrue, and fake. It nourishes a stigma that causes people suffering from a mental disorder to hide their illness and perhaps not seek treatment. These issues also influence us as psychiatrists. They trivialize our work and undermine our efforts to advocate for our patients. We may even come to believe that our work as doctors is somehow of lesser importance than the work of other doctors. In short, stigmatization isolates patients from society, families from their community, and psychiatrists from their colleagues.

This was how members of the resident committee of the New York County district branch viewed these issues and their effects in 1994. We concluded that stigmatization was a social phenomenon that could be challenged only in a public forum. We wished to help break the isolation in which many sufferers of mental illness live and take a stand against the New York state budget cuts that threatened the existence of many programs for the chronically mentally ill. We also wanted to address the emergence of managed care in New York and the fear that it could perpetuate the inequality to access to psychiatric care. With these objectives in mind, the committee chose the Picnic for Parity as the event they would try to foster.

We envisioned an annual picnic in New York's Central Park where patients and their families, psychiatrists, advocates, and the public would be invited to participate and begin to build a coalition to challenge the political, social, and economic obstacles to obtaining care. We hoped to show that mental illness affects people from all walks of life and to add our voices to those demanding that parity for mental health care be enacted in insurance policies and state laws.

The first picnic was held in Central Park on May 7, 1995. Five hundred patients, family members, psychiatrists, and advocates gathered in Central Park amid balloon arches and banners. The food was provided by The Bridge, a patient-run catering company. Booths offered information on voter registration, clubhouses, APA district branches, and local advocacy groups such as AMI/FAMI and the New York chapter of the Mental Health Association. Notable speakers included Harold Eist, M.D., then APA president-elect; Herbert Pardes, M.D., former APA president and dean of Columbia's College of Physicians and Surgeons; and Luis Marcos, commissioner of the New York City Department of Mental health. The event was covered by local and national media, including the New York Times.

This first Picnic for Parity was such a success that when the second picnic took place in May 1996, 2,500 people attended and heard letters sent by Tipper Gore and Senator Pete Domenici. By then, the organizing committee had expanded to involve a broad coalition of organizations, including the National Alliance on Mental Illness, the National Stigma Clearinghouse, and many New York-based consumer organizations.

Both years the Picnic for Parity received generous financial support from the New York State APA district branches, New York State Psychiatric Association, New York City Department of Mental Health, and New York Mental Health Association. All recognized the timeliness of such an event, and all continue to be committed to building this event into an annual tradition in New York City, calling attention to the plight of people with mental illness and the issues of equity and fairness in access to health care.

Psychiatry residents across the country can help make the Picnic for Parity an important annual event for mental health coalitions in their communities, too. To learn more about the picnic and how to organize one in your area, come to Workshop 44, "Picnic for Parity: Creation of a National Event," on Monday, May 20, at 9 a.m. at APA's 1997 annual meeting in San Diego. The speakers include members of the organizing committee, which represents consumer, family, and professional groups. Together, we can help make the Picnic for Parity a nationwide tool to advocate for our patients and their right to fair treatment. We look forward to seeing you there.

(Psychiatric News, April 4, 1997)