Psychological practice in the 21st century requires that we change our traditional ways of practice to take advantage of the new possibilities in society. With advances in neuroscience, genetics and collaborative health care, psychology is more relevant than ever. Now is the time to embrace these opportunities by collaborating with other disciplines and integrating scientific and technological advances into our practices. Here are some principles that I believe can guide us to the future of psychology health services practice.
1. From mental health to health care providers: Providing integrated health care. If you ask someone off the street what a psychologist is, most people will say that we are mental health professionals. In fact, that is how most of us are trained. But to succeed in the future, psychologists need to broaden their perspectives to be full partners in the health-care system. This requires us to practice with our medical colleagues and in medical systems of care.
Currently, primary-care providers treat over 70 percent of mental health problems without assistance from psychologists or any other mental health providers. Primary-care providers are the de facto mental health system due to managed-care policies and over-reliance on medications. Research indicates major health problems, such as diabetes, heart disease and obesity, are due to psychosocial and lifestyle problems—issues that are not effectively addressed by the medical profession. Minority, underserved, and elderly patients suffer even more within these systems of care. Ours is the profession that knows the most about human behavior and how to change it, yet psychologists are often not involved in preventing and treating these problems because we are not seen as an integral part of the health-care team. We have to change that.
2. Integrating technology into practice. To participate in integrated health-care systems, psychologists will be required to use electronic health records (EHR) and other technological advances. There are many EHRs in the marketplace, and it is unclear if there will be one standard developed. At Baylor College of Medicine we have two EHRs, one in our private clinics and a different one in our community health clinics and hospitals. Using them to document psychological interventions requires knowledge and skill in accurately communicating to a variety of health professionals, while protecting sensitive and confidential patient information.
3. Meeting the needs of our diverse society. Our society is becoming much more culturally and ethnically diverse, and psychologists need to provide services to all. While many Americans are fortunate to have health insurance, the U.S. Census Bureau estimates that nearly 47 million Americans, or 16 percent of the population, have no health insurance—and this number is on the rise.
These people often use emergency rooms and community health centers for their care—again a place where psychologists frequently do not practice. We need to ensure, through education and policy changes, that psychologists are properly trained in using multicultural principles to work with these populations, and that psychologists are included in funding for these services.
4. Applying basic and applied scientific evidence to inform our practice. It is clear that evidence-based practice is our future. APA has developed a number of policies on evidence-based practice, and most programs teach graduate students these methods. In addition, we also need to integrate basic scientific evidence, such as neuroscience, couple and family process research, into our regular practice.
It is important to remember that psychologists provide much more than mental health services, and future psychologists need to broaden the scope of their practices to provide services to larger venues in schools, communities, organizations and businesses.
These are my views. Let me hear from you about yours. I hope to speak personally with many of you this year, so don't be surprised if you get a phone call or an e-mail from me. I want to know how APA can better serve your needs. Contact me anytime via e-mail.
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