Science Directions

Health-care reform is once again occupying center stage on Capitol Hill and across the country. APA has been clear that health-care reform must be about more than insuring the uninsured. Before us is the opportunity to transform the way health care is delivered and improved for everyone.

We know that behavioral factors contribute to six of the 10 leading causes of death. Treatment success rates for some mental disorders are comparable to, or even better than, those for many physical conditions. Psychological and behavioral research dramatically enhance our capacity to prevent and treat mental and substance use disorders. The understanding of behavioral variables is also critical to achieving such health-care goals as preventing and treating diabetes, cardiac disease, obesity, HIV/AIDS and cancer.

Clearly, the success of any health-care reform effort will depend on psychological and behavioral science. This is why APA has included among its eight health-care reform priorities the goal of increasing federal funding for basic and translational psychological and behavioral research and training, both to develop and to evaluate empirically based treatments to improve health care.

As APA CEO Norman Anderson, PhD, noted in the May Monitor, patients enjoy improved access to care and are more likely to adhere to their treatment plans when psychologists are members of interdisciplinary, integrated health-care teams. The research evidence already shows that this type of integrated health care improves outcomes in depression and diabetes. There can be little doubt that the same will be found for other conditions and diseases.

For psychological science to deliver on its promise, the federal funding agencies must grow their support for psychological research. We cannot leave it to a single agency or institute to serve as the token home for behavioral science. At the National Institutes of Health, for example, every component institute, office and program should include within its portfolio substantial support for and integration of psychological science. NIH cannot accomplish its own mission without doing so.

Responsibility for developing, supporting and promoting health-related psychological science goes beyond the institutes of NIH. It rests also with the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, the Department of Defense, the Department of Veterans Affairs and others.

The delivery of quality health care also depends on regulatory policy that is informed by psychological science. The Food and Drug Administration, for example, plays an integral role in such areas as nutrition, over-the-counter and prescription drugs, medical devices, vaccines, tobacco and health-related consumer products. The effectiveness and quality of the FDA's oversight responsibilities will be improved by increasing its integration of behavioral science throughout its programs.

Psychologists must step to the plate as well. There are few issues relating to health-care reform that cannot benefit from psychological science. Omnipresence should be our goal. The entire spectrum of psychological science—from biological to social, qualitative to quantitative—needs to participate. It will improve health care, and it will lend a needed sense of coherence and purpose to our science.