Our strength is our diversity

Raymond D. Fowler

For me, one of the best things about APA is its diversity. APA members are involved in such a broad range of activities that it is sometimes easy to forget just how much we have in common and how often we share similar concerns. While it may appear at times that we are on very different paths, in truth, our paths interweave as much as they diverge and we depend on each other a lot more than we often realize.

Most of the time, the various constituencies work pretty independently in their own areas of concern, but our association is most vital when we share our different perspectives and coalesce around issues and challenges that stand to affect us all.

About five years ago, we demonstrated our collective effectiveness when we pulled together and worked to ensure psychology's place in the national health-care-reform proposal. Health-care-reform legislation did not pass, and some of the proposed plans were pretty bad, but through our efforts we achieved major strides in having psychology recognized as an integral part of the health-care-delivery system. And we learned valuable lessons about how important issues affect us all and how the success of psychology as a whole depends on the success of each of its constituencies.

We're in the same lifeboat

The failure of the Clinton health-care package, however, did not end the turmoil in the health-care marketplace. Today, psychologists across the nation are facing another major challenge. Rapidly evolving changes in the health-care-delivery system are deeply affecting our practitioners and their patients. It would be easy to label changes in health care as a "practice issue," but in reality it is an issue that affects each of us as individuals as well as affecting our constituencies, the organization as a whole and psychology at large.

That's why this issue of the Monitor features a special section on how changes in the health care system affect psychology and why each of the executive directors of the APA directorates has been asked to address in their columns how this crucial matter affects their own constituencies.

Our members who practice on the front lines of health and mental health care in independent practice and community facilities are the most immediately affected. But as you will see from the columns written by the executive directors, psychologists involved in education, research, public service and other aspects of psychology are facing direct and indirect effects of changes in the health-care market as well. To a degree, we all share the same fate and use the same lifeboat.

Psychology won't retain its status as a first class profession if any constituency among us is relegated to second-class status. Right now, psychology is the largest doctoral-level mental health profession and one of the fastest growing professions. On most campuses, it is one of the most popular electives and majors. But if practice viability erodes and psychology loses its desirability as a profession, the entire educational pipeline--from the undergraduate level on up--will be deeply affected.

Similarly, research monies that now support psychology could be redirected if our recognition as an important profession suffers. Our public interest agenda is also at risk if the pool of professionals eligible to serve our nation's diverse psychological needs dwindles. And, when the health-care system is not viable, it is the most needy that are the most affected.

Our strength in diversity

There is every reason for us to want health care to be fixed. It is a basic necessity both personally and professionally. To have a strong association, we need all our constituencies to be strong and vibrant, and appropriately recognized. When we are undervalued or excluded from reimbursement by managed care, it not only causes major disruptions to many of our members, it also says something to the public about the value of the profession.

Unless all of psychology is strong, we all lose. Practitioners have an interest in our scientific foundation and in education. Educators are concerned with both science and practice issues. And we all are concerned about how the science and practice of psychology can be utilized to improve human welfare.

More than 100 organizations in this country represent some aspect of psychology, but APA is the only association that represents every major dimension of American psychology from the core issues of science and practice to issues that affect human welfare. There is strength in our diversity when we are able to view important issues from each other's perspectives, appreciate our interdependence and work together on common concerns.

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