Council Of Representatives: February 20-22, 2004

Approved Minutes

I. MINUTES OF MEETING

A.(1) Council voted to approve the minutes of the August 6 & 10, 2003, Council of Representatives meeting.

II. ELECTIONS, AWARDS, MEMBERSHIP AND HUMAN RESOURCES

A.(2) Council voted to approve the withdrawal of Council New Business Item 26A: New Criteria for Dues Exempt Status.

B.(3) Council voted to approve the withdrawal of Council New Business Item 29: Information for Potential APA Presidential Candidates.

C.(4) Council voted to approve the withdrawal of Council New Business Item 30: Orientation for

APA Presidents.

D.(20) Council voted to approve the inclusion of $83,800 in the 2004 Final Budget, with a portion of the funding devoted to the recruitment of ethnic minority students to psychology.

E.(39) Council received information regarding the establishment of two Raymond D. Fowler awards (a Member award and a staff award) in recognition of his longstanding contributions to the association.

ETHICS

No items.

BOARD OF DIRECTORS

A.(5) Council voted to approve the following motion:

That the Council of Representatives establishes a three-year trial of Representation and Information Exchange Sessions.

At the discretion of the President, Council will break out into one or two ninety-minute to two hour Representation and Information Exchange Sessions at each February meeting.

There will be topical groups reflecting the structure of the organization, meeting simultaneously, such as:

Education: COR members in dialogue with the chairperson of the Board of Educational Affairs (BEA) and the Executive Director for Education.

Practice: COR members in dialogue with the chairpersons of Board of Professional Affairs (BPA), Committee for the Advancement of Professional Practice (CAPP) and the Executive Director for Practice.

Public Interest: COR members in dialogue with the chairperson of the Board for the Advancement of Psychology in the Public Interest (BAPPI) and the Executive Director for Public Interest.

Science: COR members in dialogue with the chairperson of the Board of Scientific Affairs (BSA) and the Executive Director for Science.

Finance: COR members in dialogue with the chairperson of the Finance Committee and the Chief Financial Officer (CFO).

Priorities: COR members in dialogue with the chairperson of the Policy and Planning Board (P&P), the President, the Chief Executive Officer (CEO) and/or Chief Operating Officer (COO).

Association : COR members in dialogue with the chairpersons of the relevant committees (CSFC, BOD, Board of Convention Affairs), Communications, and others as appropriate, as well as relevant APA staff.

Council members will be assigned one group per session and circulate through the groups at subsequent sessions, not repeating any group in a single three-year term.

The President will appoint one Facilitator, responsible for devising an agenda and moderating the session, and one Recorder, responsible for taking and distributing minutes, for each group at each meeting of Council.

Council notes that if a meeting has a full agenda or urgent business arises, it will be left to the discretion of the President to determine if there is sufficient time to hold a breakout session.

At the end of three years (2007), Council will evaluate the effectiveness of the Representation and Information Exchange Sessions and determine whether they should be continued, modified, or suspended.

B.(6) Council voted to refer the recommendations of the Task Force on Governance that deal directly with the functioning and effectiveness of Council (Section VI.c of the Final Report) to the Committee on the Structure and Function of Council (CSFC) for review, revision, and implementation as appropriate.

C.(7) Council voted to approve the following substitute motion, as originated by Council, in response to Council new business item 27S: Accountability to Vision and Goals:

Council shall review and update its list of priorities at least every 3 years; 2) the Committee on Structure and Function of Council will recommend to Council a process for developing, reviewing and updating these priorities; 4) the latest list of the top priorities shall be included in each year’s Council agenda book; 5) new business item forms will include the list of these priorities so that the maker of a motion may identify the applicable priority/priorities to which the item is addressed or specify other issues to which it is speaking

D.(8) Council voted to approve the withdrawal of Council New Business Item 27Q: Enhancing Future of APA.

E.(9) Council voted to approve the withdrawal of Council New Business Item 27T: More Proactive Involvement with Other Disciplines, Organizations, Media and Political Bodies.

F.(10) Council voted to approve the withdrawal of Council New Business Item 27W: Institutionalizing Change.

G. (21) Council voted to refer the item “Task Force on External Funding: Request for Discretionary Funds” to the Board for its consideration, upon receipt of the interim report of the task force.

H.(22) Council voted to extend the charge of the Ad Hoc Committee on Early Career Psychologists for two years and allocated $12,000 from its 2004 discretionary fund to support two meetings of the Ad Hoc Committee on Early Career Psychologists in 2004, recognizing that the Ad Hoc Committee will need to seek additional funding in 2005.

I.(28D) A new business item “Council/Directorate Communication Regarding COR Priorities for APA” was referred to the CEO.

J. (29) Council received an update on the business pending item “Eligibility for Service on the Board of Directors.”

V. DIVISIONS AND STATE AND PROVINCIAL ASSOCIATIONS

A.(28B) A new business item “Travel Support for Council Representatives” was referred to CSFC, CAPP, CODAPAR and P&P.

VI. ORGANIZATION OF THE APA

A.(23) Council voted to postpone the item “Better Articulation Between Council and Its Board and Committee Structure” to its August 2005 meeting.

B.(40) Council was provided as information the policies to be added to the APA Policy Manual, as approved by Council at its February and August 2003 meetings.

VII. PUBLICATIONS AND COMMUNICATIONS

A.(28C) A new business item “Support for the Archives of the History of American Psychology” was referred to the History Oversight Committee, BEA and P&P.

B.(40A) Council received as information a publications update. Total revenue for APA's core scholarly and professional publishing program (APA Journals, APA Books, PsycINFO abstracts, PsycARTICLES full-text, Publication Manual) exceeded $50 million in 2003. This is the 18th straight year of stable and continuing growth in overall revenue. Fifty-five percent (55%) of the APA publishing revenue in 2003 was from revenue streams that did not exist in 1984.

The Publications and Communications (P&C) Board met twice in 2003: April 5-6 and November 1-2. Susan McDaniel served as the 2003 Chair and Mark Appelbaum served as the 2003 Chair-Elect. The P&C Board made six editorial appointments in 2003, naming the following to six-year terms to begin in 2005 (with 2004 as the incoming editor): Journal of Experimental Psychology: Animal (Nicholas Mackintosh); Journal of Family Psychology (Anne E. Kazak); Journal of Personality and Social Psychology: PPID (Charles S. Carver); Psychological Review (Keith Rayner); Psychological Assessment (Milton E. Strauss); Psychology and Aging (Rose T. Zacks). Searches were opened on eight journals.

APA Journals published over 35,000 pages in 2003 in 46 journals and four Abstract/Scan publications. In addition, 2,000 full-text articles were added to the PsycARTICLES database during 2003. PsycINFO added 77,617 new records to the PsycINFO abstract database during 2003, and expanded coverage by adding 80 journals to the coverage list. In addition, 51,598 abstracts were added to the historical file (1840-1974) during 2003. APA Books released 57 new titles in 2003, and Magination Press released eight new titles in 2003. The APA Psychotherapy Video program released 12 titles is Series IV on relationships. Sales of the Publication Manual again exceeded $7 million. The all-electronic journal, Prevention and Treatment, was terminated at the end of 2003, while the APA publishing program added three new journals during 2003: Psychological Services (Division 18), International Journal of Stress Management, and Dreaming.

Approved making the Journal Back Office (JBO) manuscript tracking system mandatory for new editors and encouraging current editors to utilize the system. At the end of 2003, twenty-five (25) APA journals were operating in the JBO. Developmental work on a new electronic product, PsycEXTRA, which will offer users access to a variety of "grey literature" publications in psychology not traditionally covered in scholarly indexes was started in the fall of 2003. Documents will include newspapers, magazines, web sites, government documents, consumer brochures and fact sheets, videos, technical reports, and newsletters. Much of the content provided in PsycEXTRA will be full-text.

VIII. CONVENTION AFFAIRS

A.(41) Council was provided as information the 2002-2003 Convention Restructuring Survey Results.

IX. EDUCATIONAL AFFAIRS

A.(11) Council voted to adopt as APA policy the document Developing and Evaluating Standards and Guidelines Related to Education and Training in Psychology: Context, Procedures and Criteria.

B.(11A) Council voted to approve the withdrawal of Council New Business Item 27G: Statement on Specialization in Professional Psychology.

C.(24) Council voted to allocate $9,300 from its 2004 discretionary fund to support the Task Force on the Assessment of Clinical Competencies in Professional Education and Training.

D.(25) Council voted to allocate $12,500 from its 2004 discretionary fund to support the activities of the Coalition for Psychology in the Schools.

E.(30) Council received an update on the business pending item “Greater Autonomy for Committee on Accreditation.”

F.(31) Council received an update on the business pending item “ Future Composition of the Committee on Accreditation.”

G.(32) Council received an update on the business pending item “ Guidelines for Education and Training at the Doctoral and Post-Doctoral Level in Consulting Psychology-Organizational Psychology.”

H.(33) Council received an update on the business pending item “ Statement on Specialization in Professional Psychology.”

I.(42) Council received as information the revisions to the Procedures for the Recognition of Specialties and Proficiencies in Professional Psychology.

J.(48) Council received an update on the new-business-in-progress item Rescinding Certain Actions Taken by Council in August 1999 .”

PROFESSIONAL AFFAIRS

A.(28A) A new business item “Listing of ABAP (American Board of Assessment P sychology) Diplomates in APA Directory” wasreferred to BPA, COLI, the Membership Committee and P&P.

B.(28F) A new business item “APA Resolution on Health Care Priority” was referred to BPA, BAPPI, CAPP and P&P.

C.(43) Council received information regarding revisions made to the Practice Organization’s Special

Assessment -- the Practice Assessment -- beginning with the 2005 dues cycle.

D.(49) Council received an update on the new-business-in-progress item “Guidelines for Psychological Practice with Girls and Women.”

E.(50) Council received an update on the new-business-in-progress item “ Public’s Need to Recognize and Identify Specialty Practitioners who are Board Certified by a Certifying Board which Meets the Guidelines Promulgated by the Profession/APA.”

F.(51) Council received an update on the new-business-in-progress item “ Public Education Campaign -- Psychology is an Empirically-Based Profession.”

G.(52) Council received an update on the new-business-in-progress item “Public Education Campaign Assessment.”

XI. SCIENTIFIC AFFAIRS

A.(12) Council voted to endorse the revised Code of Fair Testing Practices in Education.

B.(26) Council voted to allocate $15,000 from its 2004 discretionary fund to support one meeting of the BSA Task Force on Research Regulation and the production and dissemination of resources developed by the task force.

C.( 34) Council received an update on the business pending item “ Scientific Expertise Categories in the APA Database.”

D.(35) Council received an update on the business pending item “ Increase Media Staff in Science Writing.”

E.(36) Council received an update on the business pending item “ Increase Science Directorate Public Policy Staff.”

F.(37) Council received an update on the business pending item “ Develop Mechanisms to Identify Critical Issues that Need to Be Informed by Research.”

XII. PUBLIC INTEREST

A.(13) Council voted to adopt the following Resolution on HIV Prevention Strategies Involving Legal Access to Sterile Injection Equipment:

WHEREAS the primary route of HIV transmission among injection drug users (IDUs) is the sharing of contaminated injection equipment; and WHEREAS injection drug use and the HIV and hepatitis C epidemics are inextricably linked in American society; and

WHEREAS injection drug use is associated with one-half of hepatitis C cases and almost one-third of all AIDS cases both through direct transmission through shared needles and indirect transmission through sex with HIV-infected injecting drug users (CDC, 2002 and 2002a); and

WHEREAS one million active users of injection drugs are estimated to live in the United States (CDC, 2002b); and

WHEREAS only a fraction of people who need substance abuse treatment are able to obtain it through public agencies (CDC, 2002b); and

WHEREAS infected injection drug users (IDUs) transmit HIV through the sharing of contaminated syringes and other drug injection equipment (CDC, 2002a); and

WHEREAS injection drug users inject approximately 1000 times per year (Lurie, Jones, and Foley, 1998); and

WHEREAS ongoing injection-related risk behaviors are associated with restricted syringe access (Gostin, Lazzarini, Jones, & Flaherty, 1997; Rich, Dickinson, Liu, et al., 1998; Broadhead, van Hulst, & Heckathorn, 1999);

WHEREAS use of needle exchange programs is associated with reductions in reusing syringes, lending used syringes to others, and other indirect sharing activities (Blumenthal et al., 2000; Hagan & Thiede, 2000; Robles et al., 1998; Vlahov, Junge, Brookmeyer, et al., 1997); and

WHEREAS regular use of needle exchange programs by IDUs is associated with less drug-related HIV risk behavior and lower rates of seroconversion (Des Jarlais, Marmor, Paone, et al., 1996); and

WHEREAS IDUs who use needle exchange programs have reduced incident hepatitis C virus (Taylor et al., 2000); and

WHEREAS the incidence of HIV among IDUs who use needle exchange programs is less than one third of the incidence of HIV among IDUs who do not use NEPs (Des Jarlais, 2000); and

WHEREAS IDUs who use needle exchange programs exhibit reductions in the mean number of injections per syringe as well as reductions in the mean number of injections per day (Vlahov, Junge, Brookmeyer, et al., 1997); and

WHEREAS most needle exchange programs provide a range of adjunctive services including primary medical services, HIV/AIDS education, condom distribution, referrals to drug abuse treatment, on-site HIV testing and counseling, and screening for tuberculosis (TB) as well as hepatitis B and C; and

WHEREAS participation in needle exchange programs is associated with improved access to health care and drug treatment (Strathdee, Celentano, Shah et al., 1999); and

WHEREAS needle exchange programs have been shown to be cost-effective (Gold et al., 1997; Holtgrave and Pinkerton, 1997, Jacobs et al., 1999); and

WHEREAS needle exchange programs do not result in increased use of illicit drugs or encourage first time drug use (Robles et al., 1998; Vlahov and Junge, 1998); and

WHEREAS only about half of the approximately 100 needle exchange programs currently operational in North America are legal (CDC, 2000; Vahlov and Junge, 1998); and

WHEREAS injection drug users will use sterile syringes if they can obtain them (Junge et al., 1999; Heimer, Khoshnood, Bigg et al., 1998); and

WHEREAS guaranteed access to sterile injection equipment acquired through pharmacies has been associated with reduced rates of both needle sharing and HIV transmission (Cotten-Oldenburg, Carr, DeBoer, et al., 2001; Weinstein, 1999); and

WHEREAS a comprehensive policy providing public funding of needle exchange programs, pharmacy sales of syringes, and syringe disposal programs would be cost-effective based on lower costs of caring for newly infected persons with HIV (Holtgrave et al., 1998); and

WHEREAS access to syringe disposal programs reduces circulation of needles in the community and reduced HIV prevalence in syringes (Kaplan et al., 1994; Riley et al, 1998) and would reduce needle stick injuries to children, sanitation workers, and other community group members (Philipp, 1992); and

WHEREAS strategies such as needle exchange programs, legal access to sterile syringes at pharmacies, syringe prescription, and safer syringe disposal strategies all reduce the prevalence of unsafe injection drug use practices that lead to the transmission of HIV (Centers for Disease Control and Prevention, 2002a; National Institute on Drug Abuse, 2002; Macalino, Springer, Rahman, et al., 1998; Riley, Beilenson, Vlahov, et al., 1998; Springer, Sterk, Jones, & Friedman, 1999; Kaplan, Khoshnook, & Heimer, 1994; Sulkowski, Ray, & Thomas, 2002; Philipp, 1993); and

WHEREAS the US Department of Health and Human Services recommends that all IDUs who continue to inject drugs use a new, sterile syringe for each injection (CDC, 2002c); and

WHEREAS Congressional bans on the use of federal funds to support needle exchange programs and state laws restricting the sale and distribution of syringes (i.e., through “paraphernalia” statutes, syringe prescription statutes, and pharmacy regulations/guidelines) have the effect of limiting access to sterile syringes and thus constitute substantial obstacles to HIV prevention and public health (Gostin, 1998); and

WHEREAS the ban on federal funding of needle exchange programs is perhaps the most significant barrier to realizing their potential to prevent disease (NIH Consensus Development Conference, 2000); and

WHEREAS the availability of drug maintenance treatments for injection drug users is inadequate; and

WHEREAS many prominent national professional associations have issued public statements that call for action to reduce legal and regulatory barriers that restrict access to sterile syringes in order to help prevent the transmission of contagious diseases ( e.g., American Association of Public Health; American Medical Association, American Pharmaceutical Association, Association of State and Territorial Health Officials, Infectious Diseases Society of America, National Alliance of State and Territorial AIDS Directors, and the National Association of Boards of Pharmacy; American Medical Association, 2002; American Public Health Association, 2002; Infectious Diseases Society of America, 2002);

Therefore be it resolved that the American Psychological Association (APA) actively support and promote HIV prevention strategies such as needle exchange programs, legal access to sterile syringes at pharmacies, syringe prescription, and syringe disposal programs to stop the spread of HIV, hepatitis C, and other contagious diseases.

Moreover,

Given that psychologists have many areas of relevant practice competence, including assessment, intervention, and prevention skills, that could and should inform the discourse about HIV prevention and substance abuse treatment for IDUs and their significant others; and

Given that psychologists’ training in research makes them especially well-qualified to assist policy-makers in making informed judgements based on the best available science;

Let it be further resolved that the APA:

Encourage state governments, Congress, and the executive branch to promote public policies that support harm reduction strategies such as needle exchange programs, legal access to sterile syringes at pharmacies, syringe prescription, and syringe disposal programs, and

Promote increased funding for HIV prevention research that includes a wide range of harm reduction strategies for decreasing transmission of HIV; and

Support training in HIV prevention interventions, including harm reduction interventions for injection drug users, within psychology training programs at all levels; and

Promote and facilitate psychologists’ acquisition of competencies in harm reduction strategies that decrease transmission of HIV infection among injection drug users, including mastery of the literature on treatment of injection drug users and familiarity with effective interventions that are employed to address this problem; and

Encourage psychologists to develop cultural sensitivity to the sub-group of individuals who use and inject drugs; and

Advocate for reimbursement of psychologists for provision of drug treatment, including provision of harm reduction interventions that decrease drug-related HIV risk behavior among IDUs; and

Support psychologists as they engage in interdisciplinary efforts involving other health, mental health, and substance abuse professionals who seek to enhance understanding and treatment of drug dependence.

REFERENCES

American Medical Association (1999) HIV Prevention & Access to Sterile Syringes. Retrieved October 1, 2002, from http://www.ama-assn.org/ama/pub/category/1808.html

American Public Health Association (1994) Syringe and Needle Exchange and HIV Disease. Retrieved October 1, 2002, from http://www.apha.org/legislative/policy/policysearch/ Blumenthal, R,N., Kral, A.H., Gee, L., Erringer, E.A., and Edlin, B.R. (2000). The effect of syringe exchange use on high risk injection drug users: A cohort study. AIDS, 14(5), 605-611.

Broadhead RS, van Hulst Y, Heckathorn DD. (1999). The impact of a needle exchange's closure. Public Health Reports,114, 439-447.

Bruneau, J., Lamothe, F., Franco, E., Lachance, N., Desy, M., Soto, J., and Vincelette, J. (1997). High rates of HIV infection among injection drug users participating in needle exchange programs in Montreal: Results of a cohort study. American Journal of Epidemiology, 146(12), 994-1002.

Bruneau, J., and Schecter, M.T. (1998). The politics of needles and AIDS. New York Times, April 9, 1998.

Centers for Disease Control and Prevention. (2002;). HIV/AIDS Surveillance Report.13, 1-41.

Centers for Disease Control and Prevention (2002a). Fact Sheet Series: Access to Syringes. Retrieved February 25, 2002, from http://www.cdc.gov/idu/facts.htm

Centers for Disease Control and Prevention (2002b). Fact Sheet Series: Substance Abuse Treatment. Retrieved February 25, 2002, from http://www.cdc.gov/idu/substance.htm.

Centers for Disease Control and Prevention (2002c). IDU/HIV Prevention. HIV Prevention Bulletin: Medical advice for persons who inject illicit drugs. May 9, 1997. Retrieved October 13, 2002 from http://www.cdc.gov/idu/ pubs/hiv_prev.htm.

Coffin, P.O., Linas, B.P., Factor, S.H., and Vlahov, D. (2000). New York City pharmacists’ attitudes toward sale of needles/syringes to injection drug users before implementation of law expanding syringe access. Journal of Urban Health, 77(4), 781-93.

Cotton-Oldenburg, N.U., Carr, P., DeBoer, J.M., Collison, E.K., and Novotny, G. (2001). Impact of pharmacy-based syringe access on injection practices among injecting drug users in Minnesota, 1998 to 1999, Journal of Acquired Immune Deficiency Syndrome, 27(2), 183-192.

Des Jarlais, D.C. (2000). Research, politics, and needle exchange. American Journal of Public Health, 90(9), 1392-1394.

Des Jarlais, D.C., Marmor, M., Paone, D., Titus, S., Qiuhu, S., Perlis, T., Jose, B., and Friedman, S. (1996). HIV incidence among injecting drug users in New York City syringe-exchange programs. Lancet, 348, 987-991.

Gossop, M., Marsden, J., Stewart, D. & Treacy, S. (2002). Reduced injection risk and sexual risk behaviors after drug misuse treatment: results from the National Treatment Outcome Research Study. AIDS Care, 14, 77-93.

Gold, M., Gafni, A., Nelligan, P., & Millson, P. (1997). Needle exchange programs: an economic evaluation of a local experience. CMAJ, 157, 255-262.

Gostin, L.O. (1998). The legal environment impeding access to sterile syringes and needles: The conflict between law enforcement and public health. Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, 18 (suppl 1),S60-70.

Gostin LO, Lazzarini Z, Jones TS, Flaherty K. (1997). Prevention of HIV/AIDS and other blood-borne diseases among injection drug users: a national survey on the regulation of syringes and needles. JAMA.277, 53-62.

Hagan, H. & Thiede, H. (2000). Changes in injection risk behavior associated with participation in the Seattle needle-exchange program. J. Urban Health, 77, 369-382.

Hartel, D. M., & Schoenbaum, E. E. (1998). Methadone treatment protects against HIV infection: two decades of experience in the Bronx, New York City. Public Health Reports, 113, 107-115.

Heimer, R., Khoshnood, K., Biggs, D., Guydish, J., and Junge, B. (1998). Syringe use and re-use: Effects of needle exchange programs in three cities. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 18 (suppl 1), S37-S44.

Holtgrave, D., and Pinkerton, S.D. (1997). Updates of cost of illness and quality of life estimates for use in economic evaluations of HIV prevention programs. Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, 16, 54-62.

Holtgrave, D., Pinkerton, S. D., Jones, T. S., Lurie, P., & Vlahov, D. (1998). Cost and cost-effectiveness of increasing access to sterile syringes and needles as an HIV prevention intervention in the United States. J. of Acquired Immune Deficiency Syndrome and Human Retrovirology, 18 suppl, S133-138.

Infectious Diseases Society of American (2001). Infectious Diseases Society of America Policy Statement on Syringe Exchange, Prescribing and Paraphernalia Laws. Retrieved October 1, 2002, from http://www.idsociety.org/PA/PS&P/Syringe_11-17-00.htm Jacobs, P., Calder, P., Taylor, M., Houston, S., Saunders, L. D., & Albert, T. (1999). Cost effectiveness of Streetworks’ needle exchange program of Edmonton. Can. J. Public Health, 90, 168-171.

Junge, B., Vlahov, D., Riley, E., Huettner, S., Brown, M., & Beilenson, P. (1999). Pharmacy access to sterile syringes for injecting drug users: attitudes of participants in a syringe exchange program. J. Am. Pharm. Assoc., 39, 17-22.

Kaplan EH, Khoshnood K, Heimer R. (1994). A decline in HIV-infected needles returned to New Haven's needle exchange program: client shift or needle exchange? American J Public Health, 84, 1991-1994.

Koester, S., White, B.A., Bush, T.W., and Christiansen, C.E. (1999). Role of pharmacists in increasing sterile syringe accessibility: A formative study. 1999 National HIV Prevention Conference (abstract 225).

Kwiatkowski, C.F., and Booth, R.E. (2001). Methadone maintenance as HIV risk reduction with street-recruited injecting drug users. Journal of Acquired Immune Deficiency Syndrome, 26(5), 483-489.

Lurie, P., Jones, T.S., and Foley, J. (1998). A sterile syringe for every drug user injection: How many injections take place annually, and how might pharmacists contribute to syringe distribution? Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, 18 (suppl 1), S45-S51.

Macalino GE, Springer KW, Rahman ZS, et al. (1998) Community-based programs for safe disposal of used needles and syringes. J Acquir Immune Defic Syndr Hum Retrovirol. , 18(suppl 1), S111-S119.

Magura, S., Rosenblum, A., and Rodriguez, E.M., (1998). Changes in HIV risk behaviors among cocaine using methadone patients. Journal of Addictive Diseases, (17(4), 71-90.

Marsch, L.A. (1998). The efficacy of methadone maintenance interventions in reducing illicit opiate use, HIV risk behavior and criminality: A meta-analysis. Addiction, 93(4), 515-532.

Moss, A.R. (2000). Epidemiology and the politics of needle exchange. American Journal of Public Health, 90, 1385-1387.

National Institute on Drug Abuse (2002). Principles of HIV Prevention in Drug-using Populations. NIH publication no. 02-4733.

National Institutes of Health (1997). Consensus Development Statement. Interventions to prevent HIV risk behaviors. February 11-13, 7-8. www.nih.gov/news/pr/feb97/nihod13b.htm

National Institutes of Health (2000). Consensus Development Statement. Interventions to prevent HIV risk behaviors. AIDS, 14 (suppl 2), S85-S96.

Novotny, G., DeBoer, J., Collison, E., Nelson, R., and Moore, S. (1999). Minnesota Pharmacy Syringe/Needle Access Initiative (SAI). 1999 National HIV Prevention Conference (Abstract 148).

Philipp R. (1993). Community needlestick accident data and trends in environmental quality. Public Health, 107, 363-369.

Prendergast, M. L., Grella, C., Perry, S. M., Anglin, M. D. (1995). Levo-alpha acetylmethadol (LAAM): clinical, research, and policy issue of a new pharmacotherapy for opioid addiction. J. of Psychoactive Drugs, 27, 239-247.

Rich JD, Dickinson B, Liu K, et al. (!998). Strict syringe laws in Rhode Island are associated with high rates of reusing syringes and HIV risks among injection drug users. J Acquired Immune Deficiency Syndrome and Human Retrovirology, 18(suppl 1), S140.

Riley E, Beilenson P, Vlahov D, et al. (1998). Operation Red Box: a pilot project of needle and syringe drop boxes for injection drug users in East Baltimore. J Acquir Immune Defic Syndr Hum Retrovirology , 18(suppl 1), S120-S125.

Schecter, M.T., Strathdee, S.A., Cornelisse, P.G., Currie, S., Pastrick, D.M., Rekart, M.L., and O’Shaughnessy, M.V. (1999). Do needle exchange programs increase the spread of HIV among injection drug users?: An investigation of the Vancouver outbreak. AIDS, 13(6), 45-51).

Singer, M., Baer, H.A., Scott, G., Horowitz, S., and Weinstein, B. (1998). Pharmacy access to syringes among injecting drug users: Follow-up findings from Hartford, Connecticut. Public Health Report, 113 (suppl. 1 ), 81-89.

Springer KW, Sterk CE, Jones TS, Friedman L. (1999). Syringe disposal options for injection drug users: a community-based perspective. Substance Use & Misuse. 34, 1917-1934.

Strathdee, S.A., Celentano, D.D., Shah, N., Lyles, C., Stambolis, V.A., Macalino, G., Nelson, K., and Vlahov, D. (1999). Needle-exchange attendance and health care utilization promote entry into detoxification. Journal of Urban Health, 76(4), 448-460.

Sulkowski MS, Ray SC, Thomas DL. (2002). Needlestick transmission of hepatitis C. JAMA.287, 2406-2413.

Taylor, A., Goldberg, D., Hutchinson, S., Cameron, S., Gore, S. M., McMenamin, J., Green, S., Pithie, A. & Fox, R. (2000). Prevalence of hepatitis C virus infection among injecting drug users in Glasgow 1990-1996: are current harm reduction strategies working? J. Infect, 40, 176-183.

Vlahov, D., and Junge, B. (1998). The role of needle exchange programs in HIV prevention. Public Health Report, 113 (suppl 1), 75-80.

Vlahov, D., Junge, B., Brookmeyer, R., Cohn, S., Riley, E., Armenian, H., and Beilenson, P. (1997). Reductions in high-risk drug use behaviors among participants in the Baltimore needle exchange program. Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, 16(5), 400-406.

Weinstein, B. (1999). Clean needles from pharmacies: How to make it happen. 1999 National HIV Prevention Conference (Abstract#320).

B.(14) Council voted to 1) receive Psychological Issues in the Increasing Commercialization of Childhood: Psychological Implications of Commercialism in Schools; and Summary of Findings and Conclusions: The Report of the APA Task Force on Advertising and Children and 2) adopt as APA policy the Recommendations of the APA Task Force on Advertising and Children.

C.(15) Council voted to adopt the following APA Resolution on Children's 1 Mental Health:

October 2003

The Report of the Surgeon General’s Conference on Children’s Mental Health: A National Action Agenda states that the “nation is facing a public crisis in mental healthcare for infants, children and adolescents. Many children have mental health problems that interfere with normal development and functioning” (U.S. Public Health Service, 2000). Currently, the best epidemiological evidence indicates that between 10 and 15% of children and adolescents in the United States suffer from a mental disorder severe enough to cause some level of functional impairment (Burns et al., 1995; Shaffer et al., 1996; Roberts, Attkisson, & Rosenblatt, 1998) however, only about 1 in 5 of these children receive specialty mental health services (Burns et al.). The World Health Organization indicates that by the year 2020, childhood psychiatric disorders will rise proportionately by over 50% internationally, and will become one of the 5 most common causes of morbidity, mortality, and disability among children. The Surgeon General’s report highlights the lack of a unified infrastructure nationwide to provide mental health services to children, leading to fragmented treatment services, limited prevention and early identification, and low priorities for resources.

Given the vicissitudes of healthy child development, the complexities of child mental disorders, and the multiple settings in which children live, grow, and function, there is need for a comprehensive policy to promote child mental health. According to the Surgeon General’s report “Mental health in childhood and adolescence is defined by the achievement of expected developmental cognitive, social, and emotional milestones and by secure attachments, satisfying social relationships, and effective coping skills. Mentally healthy children and adolescents enjoy a positive quality of life; function well at home, in school, and in their communities; and are free of disabling symptoms of psychopathology” (Hoagwood et al., 1996).

The report further suggests the need for a community health system for children’s mental health that balances mental health promotion, disease prevention, early detection, and universal access to care. This system must include a balanced research agenda, including basic biomedical, clinical, behavioral, health services, and community-based prevention research, address the issue of stigma, and eliminate racial/ethnic and socioeconomic disparities in access to quality mental health care services (U.S. Public Health Service, 2000).

Whereas psychology has been in the lead in demonstrating the importance of mental health in child development (Burns, Hoagwood, & Mrazek, 1999; Coie et al., 1993; Mrazek, & Haggerty, 1990; Marsh & Fristad, 2002; Wolchik & Sandler, 1997).

Whereas psychology is committed to providing the highest quality mental health care to children based on the best available evidence derived from ecologically valid research and evaluation of promotion, prevention, and treatment interventions ( Biglan, A., Mrazek, P. J., Carnine, D., & Flay, B. R. 2003; Nation, M., Crusto, C., Wandersman, A., Kumpfer, K. L., Seybolt, D., Morrissey-Kane, E., & Davino, K. 2003; Weisz, J.R., Jensen, A.L., & McLeod, B.D. in press).

Whereas there are various types of useful evidence of the effectiveness of interventions, including clinical consensus, program evaluations, research using randomized experimental and quasi-experimental designs, single-subject designs, and successful replicated demonstrations of effectiveness in real world settings ( Chamberlain, P., & Smith D.K. in press; Durlak, J. A. & Wells, A. M.1997; Durlak, J.A., Wells, A.M., Cotton, J.K., & Johnson, S. 1995). For the purposes of this document, “evidence-based practice” involves the integration of best research evidence with clinical expertise and patient values (Institute of Medicine, 2001).

Whereas psychology has taken a leadership role in developing mental health promotion, prevention, and treatment interventions that meet high standards of effectiveness ( Christopherson, E. R. & Mortweet, S. L. 2001; A. E. Kazdin & J. R. Weisz, Eds., 2003).

Whereas there is inadequate access to appropriate evidence-based promotion, prevention, and treatment services for children with, or at risk for, mental disorders (Paavola, 1994; Weisz, Donenberg, Han, & Weiss, 1995).

Whereas stigma regarding mental health imposes risk for children, and impedes understanding of mental health issues and access to needed mental health services (Corrigan & Lundin, 2002).

Whereas there is a disparity of access to appropriate evidence based promotion, prevention, and treatment services based on poverty, ethnicity, race, and special needs of children (Leong, 2001; Rollock & Gordon, 2000; U.S. Department of Health and Human Services, 2001).

Whereas there is inadequate financing for culturally competent, appropriate, evidence-based promotion, prevention, and treatment services (Bazelon Center for Mental Health Law, 1999; Sturm et al., 2000).

Whereas there is a need for increased research on the translation of evidence-based practices into promotion, prevention, or treatment services that are appropriate for children, families, schools, and communities in real world settings (Burns, 1999; Burns & Friedman, 1990; Burns & Hoagwood, 2002; Clarke, 1995; Kazdin & Weisz, 1998; Schoenwald & Hoagwood, 2001).

Whereas there is a need for increased research on the effectiveness of promotion, prevention, and treatment services for children, families, schools, and communities that are developed by practitioners dealing with problems and varied contexts in the community (Weisz, Donenberg, Hans, & Weiss, 1995).

Whereas there is an increased need for research on assessment and diagnosis of children’s mental health problems and strengths in the context of their culture, family, school and community ( Wandersman, A., & Florin, P., 2003; Kumpfer, K. L. & Alvarado, R., 2003; Wilson, D. B., Gottfredson, D. C., & Najaka, S. S., 2001; Wolchik, S. A., Sandler, I. N., Millsap, R. E., Plummer, B. A., Greene, S. M., Anderson, E. R., Dawson-McClure, S. R., Hipke, K., & Haine, R. A., 2002).

Whereas there is a shortage of trained providers to deliver culturally competent evidence-based promotion, prevention, and treatment services for children (U.S. Department of Health and Human Services, 1999; U.S. Public Health Service, 2000).

Therefore be it resolved that:

The American Psychological Association (APA) take a significant leadership role to support and advocate that it is every child’s right to have access to culturally competent, developmentally appropriate, family oriented, evidence-based, high-quality mental health services that are in accessible settings.

APA take a leadership role in ensuring that the utilization of promotion, prevention, and treatment interventions for child mental health meet the highest standards of available evidence.

APA collaborate with other organizations, consumers, and policy makers to develop and implement a primary mental health care system for children that integrates culturally competent, evidence-based, high quality, promotion, prevention, and treatment services for children, families, schools and communities.

APA provide leadership, support, and advocacy for basic and applied research to develop culturally appropriate knowledge on the promotion of mental health and the prevention and treatment of mental health problems, to translate findings from research into effective services and to evaluate services that are developed at the community level.

APA support and advocate for developing adequate funding sources that are coordinated and efficient for supporting a primary mental health care system.

APA support, advocate, and provide leadership for education and training that builds upon culturally competent, evidence–based promotion of mental health and prevention and treatment of mental health problems for all children, and reduces economic, racial, ethnic and gender disparities.

1 For ease of presentation the term child is used to refer to infants, children and adolescents.

References

Bazelon Center for Mental Health Law. (1999). Making sense of Medicaid for children with serious emotional disturbance. Washington, D.C.: Author.

Biglan, A., Mrazek, P. J., Carnine, D., & Flay, B. R. (2003). The integration of research and practice in the prevention of youth problem behaviors. American Psychologist, 58, No. 6/7, 433-440.

Burns, B. J., Costello, E. J., Angold, A., Tweed, D., Stangl, D., Farmer, E. M., & Erkanli, A. (1995). Children’s mental health service use across service sectors. Health Affairs, 14, 147-159.

Burns, B., & Friedman, R. (1990). Examining the research base for child mental health services and policy. Journal of Mental Health Administration, 17, 87-98.

Burns, B & Hoagwood, K. (Eds.). (2002). Community treatment for youth: Evidence-based interventions for severe emotional and behavioral disorders. New York: Oxford University Press.

Burns, B., Hoagwood, K., & Mrazek, P. (1999). Effective treatment for mental disorders in children and adolescents. Clinical Child and Family Psychology Review, 2(4), 199-254.

Chamberlain, P., & Smith D.K. (in press). Antisocial behavior in children and adolescents: The Oregon multidimensional treatment foster care model. In A. E. Kazdin & J. R. Weisz (Eds), Evidence-based psychotherapies for children and Adolescents. New York: Guilford Press.

Christopherson, E. R. & Mortweet, S. L. (2001). Childhood therapies that help: A much needed resource. Washington, D.C: American Psychological Association.

Clarke, G. N. (1995). Improving the transition from basic efficacy research to effectiveness studies: Methodological issues and procedures. Journal of Consulting and Clinical Psychology, 63, 718-725.

Coie, J., Watt, N., West, S., Hawkins, J., Asarnow, J., Markman, J., Ramey, S., Shire, M., & Long, B. (1993). The science of prevention: A conceptual framework and some directions for a national research program. American Psychologist, 4(8), 1013-22.

Corrigan, P., & Lundin, R. (2002). Don’t call me nuts: Coping with the stigma of mental illness. Chicago: University of Chicago Recovery Press.

Durlak, J. A. & Wells, A. M. (1997). Primary prevention mental health programs for children and adolescents: A meta-analytic review. American Journal of Community Psychology, 25, 115-152.

Durlak, J.A., Wells, A.M., Cotton, J.K., & Johnson, S. (1995). Analysis of selected methodological issues in child psychotherapy research. Journal of Clinical Child Psychology, 24, 141-148

Hoagwood, K. (2001). Evidence-based practice in children’s mental health services: What do we know? Why aren’t we putting it to use? Report on Emotional & Behavioral Disorders in Youth, 1(4), 84-88.

Institute of Medicine (U.S.) Committee on Quality of Health Care in America (2001). Crossing the Quality Chasm: A New Health System for the 21 st Century. Washington, DC: National Academy Press.

Kazdin, A. E. & Weisz, J. R. (Eds), (2003). Evidence-based psychotherapies for children and adolescents. New York Guilford Press.

Kazdin, A. E., & Weisz, J. R. (1998). Identifying and developing empirically supported child and adolescent treatments. Journal of Consulting and Clinical Psychology, 66, 19-36.

Kumpfer, K. L. & Alvarado, R. (2003). Family-strengthening approaches for the prevention of youth problem behaviors. American Psychologist, 58, No. 6/7, 457-465.

Leong, F. (Ed.). (2001). Barriers to providing effective mental health services to racial and ethnic minorities in the United States. Mental Health Services Research, 3(4).

Marsh, D., & Fristad, M. (Eds.). (2002). Handbook of serious emotional disturbance in children and adolescents. New York: John Wiley and Sons.

Mrazek, P., & Haggerty, R. (Eds.). (1990). Handbook of early childhood intervention: Frontiers in preventive intervention research. Washington, D.C.: National Academy of Sciences.

Nation, M., Crusto, C., Wandersman, A., Kumpfer, K. L., Seybolt, D., Morrissey-Kane, E., & Davino, K. (2003). What works in prevention. American Psychologist, 58, No. 6/7, 449-456.

Paavola, J. et al. (1994). Comprehensive and coordinated psychological services for children: A call for service integration. Washington, D.C.: American Psychological Association Task Force on Comprehensive and Coordinated Psychological Services for Children: Ages 0-10.

Roberts, R., Attkisson, C., & Rosenblatt, A. (1998). Prevalence of psychopathology among children and adolescents. American Journal of Psychiatry, 155, 715-725.

Rollock, D., & Gordon, E. (2000). Racism and mental health into the 21 st century: Perspectives and parameters. American Journal of Orthopsychiatry, 70(1), 5-14.

Schoenwald, S. K., & Hoagwood, K. (2001). Effectiveness, transportability, and dissemination of interventions: What matters when? Psychiatric Services, 52, 1190-1197.

Shaffer, D., Fisher, D., Dulcan, M. K., Davies, M., Piacentini, J., Schwab Stone, M. E., Lahey, B. B., Blurdon, K., Jensen, P. S., Bird, H. R., Canino, G., & Regier, D., A. (1996). The National Institute of Mental Health (NIMH) Diagnostic Interview Schedule for Children Version 2.3: Description, acceptability, prevalence rates, and performance in the MECA Study. Methods for the Epidemiology of Child and Adolescent Mental Disorders Study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 865-877.

Sturm, R., Ringel, J., Bao, C., Stein, B., Kapur, K., Zhang, W., & Zeng, F. (2000). National estimates of mental health utilization and expenditures for children in 1998 (working Paper 205). Los Angeles, CA: Research Center on Managed Care for Psychiatric Disorders.

United States Department of Health and Human Services. (1999). Mental health: A report of the Surgeon General. Rockville, MD.

United States Department of Health and Human Services. (2001). Mental health: Culture, race and ethnicity. (A supplement to Mental Health: A report of the Surgeon General.) Rockville, MD.

United States Public Health Service. (2000). Report of the Surgeon General’s conference on children’s mental health: A national action agenda. Rockville, MD.

Weisz, J.R., Jensen, A.L., & McLeod, B.D. (in press). Milestones and methods in development and dissemination of child and adolescent psychotherapies: Review, commentary, and a new deployment-focused model. In E.D. Hibbs & P.S. Jensen (Eds.), Psychosocial treatments for child and adolescent disorders: Empirically based strategies for clinical practice, 2nd edition. Washington, DC: American Psychological Association.

Weisz, J., Donenberg, G., Han, S., & Weiss, B. (1995). Bridging the gap between lab and clinic in child and adolescent psychotherapy. Journal of Consulting and Clinical Psychology, 63, 688-701.

Wilson, D. B., Gottfredson, D. C., & Najaka, S. S. (2001). School-based prevention of problem behaviors: A meta-analysis. Journal of Quantitative Criminology, 17, 247-272.

Wolchik, S. A., Sandler, I. N., Millsap, R. E., Plummer, B. A., Greene, S. M., Anderson, E. R., Dawson-McClure, S. R., Hipke, K., & Haine, R. A. (2002). Six-year follow-up of preventive interventions for children of divorce: A randomized controlled trial. Journal of the American Medical Association, 288, 1874-1881.

Wolchik, S. A., & Sandler, I. N. (1997). Handbook of children's coping with common life stressors. New York: Plenum.

D.(16) Council voted to receive the report of the Early Mental Health Interventions Working Group titled Addressing Missed Opportunities in Early Childhood Mental Health Interventions: Current Knowledge and Policy Implications.

E.(17) Council voted to approve withdrawal of Council New Business Item #32C: Discrimination

Against Lesbian, Gay and Bisexual Military Personnel.

F.(28E) Council voted to approve the inclusion of $9,000 in the 2004 Final Budget for APA to establish a Working Group that would develop policy recommendations on same-sex families and relationships based on the extant literature that would prepare psychologists to respond appropriately to their clients, communities, and the media.

G.(38) Council received an update on the business pending item “ Rural Children’s Mental Health Services.”

H.(53) Council received an update on the new-business-in-progress item “ APA Ban on Department of Defense (DoD) Advertising in APA Publications.”

I.(54) Council received an update on the new-business-in-progress item “Proposed Resolution on Families of Incarcerated Offenders.”

J.(55) Council received an update on the new-business-in-progress item “Diversity in Course Content, Publications and Training Programs.”

K.(56) Council received an update on the new-business-in-progress item “Establishing a New Committee within the Public Interest Directorate, The Committee on Socioeconomic Status.”

L.(57) Council received an update on the new-business-in-progress item “Council Representation for Four Ethnic Minority Psychological Associations.”

M.(58) Council received an update on the new-business-in-progress item “Proposal for a Task Force on Gender Identity, Gender Variance, and Intersex Conditions.”

N.(59) Council received an update on the new-business-in-progress item “APA Endorsement of Children's Products (Marketing Peace of Mind to Parents).”

XIII. ETHNIC MINORITY AFFAIRS

No items.

XIV. INTERNATIONAL AFFAIRS

A.(60) Council received an update on the new-business-in-progress item “ Resolution on Culture and Gender Awareness in International Psychology.”

XV. CENTRAL OFFICE

A.(44) Council received as information the 2003 Report on Environmental Issues.

B.(17A) Council voted to approve the following motion:

Council wishes to express its deep appreciation to the APA staff for its ongoing service to the organization, and further wishes to applaud the decisions and actions taken by the CEO in giving the bonus provided to staff in December 2003.

XVI. FINANCIAL AFFAIRS

A.(18) Council voted to approve the revised Responsible Spending Policy.

B.(19) Council voted to approve the withdrawal of Council New Business Item #33C: Protection of Mortgage Reserve.

C.(27) Council voted to approve the Proposed 2004 Final Budget calling for a surplus of $633,700.

D.(27A) Council voted to endorse the decisions and actions of the Finance Committee and the Board of Directors of the APA regarding the retirement package of the former CEO, Raymond D. Fowler, PhD.

E.(27B) Council voted to postpone the following motion to its July 2004 meeting:

Council requests that any major financial or policy changes be reported to Council.

F.(45) Council received as information the annual review of the APA employee compensation package.

G.(46) Council received as information the revised Long-Term Investment Policy statement.

H.(47) Council received as information the minutes of the December 2003 Finance Committee meeting, and the July 29 and September 15, 2003, conference calls.

I.(61) Council received an update on the new-business-in-progress item “ Funding of Leadership Training Conferences on a Yearly Basis.”

XVII. COMMUNICATIONS CONCERNING OUTSIDE ORGANIZATIONS

No items.

On Friday morning, President Diane F. Halpern, PhD, and Chief Executive Officer Norman B. Anderson, PhD, presented their reports to Council.

On Friday afternoon, breakout sessions were held on the topic “What Is Important to Your Constituency?”

On Saturday morning, presidential citations were presented to Larke Nahme Huang, PhD, Deanna Yates, PhD, and Stephen Wright Mayberg, PhD, (not in attendance) for their dedication and hard work while serving on President Bush’s New Freedom Commission on Mental Health.

On Saturday afternoon, Representation and Information Sessions were held for the following topical areas: Education, Practice, Public Interest, Science, Finance, Priorities and Association.

On Sunday morning, the Affirmative Action Report was presented to Council.