Three years ago APA's Practice Directorate created its health policy fellowship with the hope of encouraging psychologists to become involved in health policy. The goal was met with flying colors again this spring as the second and most recent fellow was named as the head of mental health and substance abuse for the state of Oklahoma.
The new Oklahoma Commissioner, Terry L. Cline, PhD, just finished his APA fellowship year last August at the federal Center for Mental Health Services (CMHS), which co-sponsors the fellowship.
CMHS is the major component for mental health within the federal Substance Abuse and Mental Health Services Administration. During his fellowship Cline worked in the CMHS Office of Managed Care (now called the Office of the Associate Director for Organization and Financing). CMHS created that office several years ago to study the effect of managed care, as well as the organization and financing of mental health services in general.
Cline, who grew up in Oklahoma, says he actively sought such a state policy position in part because of the eye-opening experience of the APA fellowship. He also says he got the Oklahoma directorship in part because his national work "was just the icing on the cake" to his range of local clinical and policy positions.
Previously clinical director of the Cambridge Youth Guidance Center,in Cambridge, Mass., and chair of the joint hospital governing board of the Cambridge Health Alliance (a Harvard medical school community teaching hospital system), Cline says nothing gave him the perspective on organization and financing for mental health services that his fellowship did.
During his year at CMHS, Cline was involved in a tracking system for public sector managed behavioral health, studies on the effects of consolidating funds from sectors such as welfare, education and mental health, research on the appeals processes in managed-care denials, and the Surgeon General's conference on children's mental health.
Being able to view mental health services from the national level was, "just an incredible opportunity," says Cline. "As a provider in Massachusetts, I really thought there was only one way to provide services and that was the way it was done in Massachusetts. What I learned was that there are many, many ways to organize and structure those services."
Adds David Nickelson, PsyD, of APA's Practice Directorate, "A goal of the program is for psychologists to apply their professional expertise to the development and evaluation of health care structure and services."
And this prominent success for the fellowship has particular meaning for many in APA, notes Russ Newman, PhD, JD, APA executive director for practice, because it is in great part a legacy of the first fellow, Catherine Acuff, PhD. Acuff died suddenly last year of a brain aneurysm. After her fellowship year in 1999, CMHS made her a senior policy analyst on its permanent staff, where she directed a national HIV/AIDS cost study.
"With the wealth of public policy experience she had gained in leadership positions in APA and the Connecticut Psychological Association, Catherine helped establish the fellowship as a solid, broadening experience," says Newman. "We felt fortunate that our first ambassador to the agency in this arrangement was such a seasoned political practitioner. And CMHS leadership confirmed the quality level of her work by placing her in a position with key research responsibilities."
Cline says that Acuff helped ensure that the fellowship was good for him by being "up front" before he took the position about its strengths, weaknesses and opportunities. And with her new office at CMHS just one door from his, she was a "great mentor," he says.
CMHS leadership also indicates Acuff and Cline have given the fellowship a good start.
Jeffrey Buck, PhD, CMHS associate director for organization and financing who was key in starting the fellowship, says, "Dr. Cline helped us in a number of important areas, including follow-up activities on the Surgeon General's Report on Mental Health and was really key in collecting information on public managed behavioral health care."
According to Director Bernard S. Arons, MD, "The appointment of Dr. Cline as Oklahoma commissioner symbolizes the benefits of the APA Fellowship Program to prepare our nation's leaders in the mental health field. Such fellowships provide invaluable hands-on experience and CMHS is proud to partner with the APA on this effort."
APA is currently screening applicants for the third fellowship, tentatively slated to begin in September 2001.