November 20, 1998

Advances in research, psychiatric treatment, and family support are making schizophrenia a treatable medical illness and helping people with schizophrenia lead satisfying and productive lives.

That was APA's message, supported by its National Alliance on Mental Illness (NAMI) partners, delivered to an audience of legislators, their spouses, and representatives of more than 35 key Congressional offices at a symposium held each year during the APA-created Mental Illness Awareness Week. This year's Congressional symposium, titled "Treatment Works: Advances for Patients and Families Facing Schizophrenia," was viewed as a success.

APA created the symposia series to educate members of Congress and their staffs about the latest in psychiatric research, but this year's event quickly became a forum for members of Congress to praise the advocacy efforts of APA and the mental health community for keeping the issues surrounding mental illness and health care before Congress.

Despite the singular focus of Congress on impeachment hearings and the pressing budget crunch before the November 3 elections, eight representatives and one senator joined the symposium.

Six of the representatives and the senator took to the podium themselves to speak informatively about mental health issues. This unprecedented turn of events drove home the importance of APA's key issues to the congressional professional staff in the audience, many of whom represented the House and Senate leadership and health care policy and funding committees. The praise was in response to the grass-roots advocacy done year after year by the APA membership in bringing to the attention of their representatives and senators-when in Washington, D.C., but more importantly when they and their members are "back home"-the issues of interest to their patients.

"You [APA] never let us in Congress lose sight of what the leading research is and what issues Congress needs to address to improve mental health care," said Representative Richard Neal (D-Mass.), who serves on the powerful House Ways and Means Committee, which has jurisdiction over health care financing and policy.

Psychiatry has made significant advances in understanding the brain function of individuals with schizophrenia and how to treat them effectively, according to Herbert Pardes, M.D., vice president for health sciences and dean of the faculty at Columbia University's College of Physicians and Surgeons in New York. Pardes moderated a group of researchers, policymakers, and advocates, including Jack Gorman, M.D., chief of the department of clinical psychiatry at New York State Psychiatric Institute; Bernard S. Arons, M.D., director of the Center for Mental Health Services of the Department of Health and Human Services; Anthony Lehman, M.D., director of the University of Maryland's Center for Mental Health Services Research; and Laurie Flynn, NAMI's executive director.

"When President Bush declared the 1990s to be the Decade of the Brain, who knew how far we would come in understanding the brain, promoting effective treatment, and thereby reducing the stigma surrounding mental illness?," said Representative Constance Morella (R-Md.), whose district includes the National Institute of Mental Health. "I am proud to be part of your [APA] efforts and urge you to keep up the good work."

The symposium focused on research and treatment. Nevertheless, members of Congress rallied around APA's long-standing issue of insurance parity for mental health care. "With your [APA] help, we have seized every opportunity, even though they have been few, to push for full parity for mental health care," said Senator Paul Wellstone (D-Minn.), cochair of the Senate Working Group on Mental Health. "We, together, must keep fighting through this Congress and the next until it becomes a reality."

Representative Peter DeFazio (D-Ore.) related a story from his hometown of a woman who was forced to quit her job and go on welfare to get state-sponsored mental health treatment for her daughter. The insurance provided by the woman's employer rejected the daughter's need for medically necessary care.

"This story is one of many. For the sake of patients, families, and practitioners, this shortsighted health care must stop," said DeFazio, who cochairs the House Working Group on Mental Illness and Health Issues.

Other representatives who praised the advocacy efforts of APA and the mental health community included Representatives Marge Roukema (R-N.J.) and Bob Wise (D-W.V.), who cochair the House Working Group on Mental Illness and Health Issues with DeFazio, and Representative Lois Capps (D-Calif.), who related a family story of mental illness. "We must talk about the need for mental health care," she urged attendees.

Also at the symposium were Representative Ben Gilman (R-N.Y.), chair of the House International Relations Committee; Representative Steve Horn (R-Calif.); Nancy Domenici, longtime mental health advocate and wife of Senator Pete Domenici (R-N.M.); Amey Upton, wife of Representative Fred Upton (R-MI); and Sandie Knollen-berg, wife of Representative Joe Knollenberg (D-Mich).

The continual grass-roots advocacy of the APA membership, said APA Government Relations Director Jay Cutler, J.D., makes successful events like the symposium possible.

"It is clear that APA members have made a great deal of progress in shaping the public policy agenda, but we still have many goals to work for, including full insurance parity for mental illness, increased funding for psychiatric research, and elimination of the stigma surrounding mental illness."