From the CEO
Of all the columns I have written in the last six years, the one that received the most interest—as measured by the number of letters and e-mails I received—was my September column on APA's efforts to ensure psychologists are referred to as "doctor" in the media and in medical settings. Our work on that topic is an example of the role APA plays in ensuring psychology is recognized for not only its rigorous training requirements but also for its many scientific and professional contributions to society.
Our need to remain vigilant was recently demonstrated again with the release of the Institute of Medicine (IOM) report "Retooling for an Aging America: Building the Health Care Workforce." The report concludes that the nation's health-care system is not prepared to cope with the rising numbers of older patients. It states that high-quality care will require the nation to enhance health-care providers' competence in geriatric issues, increase the number of geriatric caregivers and specialists, and improve the way care is delivered. The report does not, however, mention the vast and valuable contributions of psychologists in this area.
The omission is astonishing. As I wrote in a Sept. 17 letter to IOM, psychologists provide more than 50,000 hours of care each week to older Americans in health-care facilities, community-based practices, long-term care settings, assisted-living facilities and hospice. Many psychologists are independent, licensed health-care providers under Medicare. In addition, in 2003 we articulated Guidelines for Psychological Practice with Older Adults (2003). We are also proud to count among our ranks geropsychologists, those psychologists whose clinical, research and academic endeavors focus on older adults. Their acumen is especially useful in differentiating normal from pathological changes associated with aging and clarifying which problems may be reversible, such as those caused by treatments or medications.
Interestingly, the IOM report identified several areas of concern in older adult care—areas where psychologists have been engaged for some time. One is the report's call for more interdisciplinary teams of health-care providers. APA and psychologists have been working in this area for the past decade, culminating with this year's release of "Blueprint for Change: Achieving Integrated Health Care for an Aging Population" (www.apa.org/pi/aging/blueprint.html). The document, a product of Dr. Sharon Stephens Brehm's APA Presidential Task Force on Integrated Health Care for an Aging Population, recommends ways psychologists, other health-care professionals, individuals and families can work together to ensure appropriate, effective and integrated health care for older adults.
The IOM report also emphasized the need to help older people better manage their health conditions. Again, self-management is an area in which psychologists are well-versed. We help identify research-based interventions to help people start exercise programs, manage their stress, take their medications and more.
The IOM's exclusion of psychology is particularly striking given the decision by Congress to pass coinsurance parity for Medicare outpatient mental health services in July. Older adults and individuals living with disabilities on Medicare have had to pay 50 percent coinsurance for mental health services and only 20 percent for other outpatient services. That discriminatory requirement will be phased out by 2014.
The new mental health parity law passed in October is significant, too. This groundbreaking legislation will greatly expand Americans' access to mental health care by requiring larger private group health plans to cover mental health services at the same level they cover physical services. Now that our nation's lawmakers formally recognize the importance of mental health care in Americans' overall health care, we hope that the IOM will expand its attention to this critical aspect of health care.
As I wrote to the institute, it is our hope that future IOM reports related to health care across the life span will recognize the important role that psychologists play as health-care providers. We also hope the future IOM committees will include psychologists among their members.
Our role now is to remain vigilant to ensure that happens.