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The initiatives, which he described at the Opening Session of APA's 1997 annual meeting last month in San Diego, are improving communication between APA leaders and members, improving the plight of children in America, meeting with members of the media, creating psychiatric health policy experts, and establishing a corporate advisory board.
In the area of intra-APA communication, Sacks noted that the APAfastFax service is now in operation. This service permits members to obtain via fax a variety of documents and information, including APA position statements and reports, district branch contacts, and meeting information and registration forms.
The fax service is the latest component of a longer-term electronic communications project in which members are now able to contact APA staff and receive information quickly through APA's Web site, e-mail, and Answer Center.
In addition, Sacks said, APA Trustees will be expected to visit district branches and hold town hall meetings, and district branch presidents-elect will be invited to Board meetings.
A child psychiatrist, Sacks aims to use his position as president to affect national policy toward this traditionally underserved population. First, in association with the American Academy of Child and Adolescent Psychiatry, he said, APA will explore aspects of the juvenile justice system in terms of services, as a place for training child and adolescent psychiatrists, as a source of non-managed care income, and "finally, as a heuristic opportunity," he said. "Major changes are required in this system to meet the dire needs of children and adolescents--many emotionally ill 'bad guys' whose errant behavior invites punishment by the state."
Next, Sacks said, APA will work with the American Academy of Pediatrics on passage of a federal insurance law, with parity, for children. He praised the work of Senators Orrin Hatch (R-Utah) and Ted Kennedy (D-Mass.) in this area.
In addition, he continued, APA must take the lead with the Coalition of Child Advocate Organizations to promote the development of legislation aimed at ameliorating "the plight of the one million children who will be on the streets as a consequence of last year's welfare statute."
He noted that 25 percent of the children in the United States already live below the poverty line and suffer from such problems as abuse, neglect, and poor education, which can lead to developmental disorders and serious psychiatric illness.
"We demand health insurance for the 10 million uninsured children of working families who are not eligible for Medicaid," said Sacks. "Will our nation continue to invest in pork-barrel defense projects that we don't need and reduce capital gains taxes while 5 million children go uncovered? We demand nondiscriminatory coverage for the treatment of children and adolescents with mental disorders. Why now? President Kennedy said it best when calling for new civil rights legislation in 1961: 'We have to do it, because it is right.' A nation is measured by how it treats its children, and we have failed the test."
Sacks's fourth initiative concerns the development of psychiatric health policy experts. Funded by outside sources, two to four early career psychiatrists will spend one year in a health policy program at a major university. Sacks hopes that such training will help APA anticipate and respond in a more effective and informed manner to governmental health policy changes.
Sacks's last initiative is to establish a corporate advisory board for APA made up of senior corporate officers to advocate for psychiatry in such matters as health care financing and access and employee health insurance. Sacks announced that this effort will be led by Robert Millman, M.D., the Saul Steinberg Professor of Psychiatry at Cornell Medical College.
Sacks observed that psychiatry is at a paradoxical crossroads in its history. At the same time that the field is in its strongest position ever to help patients, patient care is under assault by profit-driven managed care systems aided by minimal government regulation.
Still, he said, "there is a bright future ahead. In the past two years a sea change of public opinion has compelled legislative action." Leading the counterattack has been APA, he noted. He invited APA members who work in managed care to join in APA's effort to achieve greater accountability of managed care and better outcome studies and prevention strategies.
Sacks expressed concern over the impact that managed care has had on recruitment of medical students into psychiatry residency training.
"In the present climate, in the extreme we run the risk of training production-line workers, not physicians with a special vocation. The defining question is: To whom will you send a member of your family?"
In the end, Sacks said, "We will triumph because of who we are." APA's membership, he noted, is a diverse group of professional men and women with many different backgrounds and political beliefs.
"Diversity, with its inherent creative tensions, is the measure of our APA's strength, and how we handle adversity is the measure of our organization's character. We will grow our professional organization together and help our pluralistic company of dedicated men and women to flourish. We look to the future with optimism, encouraging fresh ideas and faces." --C.F.B.
(Psychiatric News, June 20, 1997)