Psychiatric News
Professional News

`We Are Winning' Fight for Equitable Care, Declares Eist

APA President Harold Eist's address at the Opening Session of APA's 1997 annual meeting last month in San Diego may be as memorable for his pauses as for his words: Eist was interrupted by applause and exhilarating shouts of approval more than 55 times.

Throughout his presidential year, Eist has clearly tapped into what is on the minds of many APA members concerning managed care organizations that deny or limit access to psychiatric care. He has used his presidency to publicize and help bring these practices to a halt while also working to obtain parity coverage of mental illness.

It was not surprising, then, that with pride Eist declared, "This year, with force, vigor, energy, and determination, the American Psychiatric Association has become the leading professional pro-patient advocacy organization in America."

At last year's annual meeting, Eist said, the core of his Opening Session speech was an outline of the areas in which APA must prevail. This year he emphasized the areas in which he said APA is winning. Here are some of the most important:

  • The APA membership has been reinvigorated as they fight together for quality patient care and support for psychiatric education and research.
  • In Jaffe v. Redmond, for which APA had submitted an amicus curiae brief, the Supreme Court backed therapist-patient confidentiality in federal courts.
  • HMO's are now being held liable for denying care to patients, and the first inroads to the Employee Retirement Income Security Act (ERISA) have been made. The courts are telling corporate America that it has a responsibility to employees, Eist said.
  • The first stage of parity has been signed into law on the federal level, and additional legislation expanding on this initial victory is now being worked on in Congress.
  • APA brought together a mental health coalition that now represents more than a million members. This group, called the Mental Health Professionals Coalition, released its Patient Bill of Rights at a press conference in February. The news made the front page of USA Today.
  • APA's Board of Trustees has approved participation in three major lawsuits challenging managed care's priorities and workplace discrimination against the disabled mentally ill.

    "Denying people access to care they require is worse than simply failing to honor a contract," said Eist. "It is a human rights violation. The APA Position Statement on Human Rights Violations, as does our ethics, requires psychiatrists to speak out whenever they become aware of any such violations and do what they can to prevent them."

  • Many states are passing a variety of laws curbing managed care practices that harm patients and undermine the patient-doctor relationship.
  • Parity legislation has been put forward in at least 32 states.
  • APA's "Managed Care and Your Mental Health" brochure has been mailed to every APA member for distribution to patients and other members of the public. The brochure provides information on health care systems and insurance plans that can influence care and limit treatment options.

    "I fought for fair play and a square deal for those suffering from mental illnesses, and I fought for our field, in all of its multiple dimensions," summarized Eist. "It is not true I eschewed negotiations [with managed care organizations]. It is true I adamantly oppose bullying and deceit, which are tactics of oppression, not negotiation."

    Parallel to Eist's unflagging work on addressing managed care wrongs was another important initiative to improve communications between APA and its members. He noted that he had talked to a majority of the more than 5,000 members who have called him on his toll-free 800 telephone line, visited more than two-thirds of APA's 76 district branches, and led town hall meetings in all of APA's seven Areas. He also responded to many of the thousands of faxes, e-mails, and letters he received.

    "You know, as well as any membership can know, that the APA presidency was and is a mission for me. We in APA understand that it was critical, in these difficult times, if we were to come together--and we have and we are--that leadership be available to membership."

    Eist's outreach to the public has been equally exhaustive. He noted that he had accepted all invitations to speak to patient advocacy groups this past year and was interviewed for some of the country's most popular news shows, newspapers, and magazines.

    In a touching gesture, Eist thanked his wife, Ann, not only for the emotional support she gave him during his terms as president-elect and president but also for the hours she labored each day on his behalf and that of APA.

    "I am enormously proud that I am a psychiatrist, that people entrust their children to my care, that I have a loving family and friends, that I belong to this great Association, and that I have earned enemies in a good cause," Eist concluded. "I am tremendously proud, too, that I was called forth by you to be your leader and hope you believe I have done the job you've demanded of me and our Association, for our patients and profession."

    Although Eist's term as president ended at the close of last month's annual meeting, the APA members who gave him a minutes-long standing ovation after his speech seemed to have little doubt that he will continue to pursue his mission until every mentally ill person receives the care he or she needs. --C.F.B.

    (Psychiatric News, June 20, 1997)