Public Policy Update

Often in the APA Education Directorate's Public Policy Office (PPO), we go back to APA's mission statement as a reminder of our objectives as well as for inspiration for designing the initiatives we promote on Capitol Hill. That mission is to "advance psychology as a science and profession and as a means of promoting health, education and human welfare."

To realize that mission, we seek to help people better understand the connection that mental and behavioral health has to physical health; the role of psychology in integrated health-care services; and the breadth of psychological research on the prevention and treatment of such health issues as chronic illness. PPO aims to put the best of psychology forward in offering viable solutions to some of our nation's most pressing problems in health care and other areas.

While there are many examples of work done in advocacy on behalf of our organization that embrace our mission generally, there are a number of initiatives that began as "seeds" but have "grown tall" in promoting psychology in a positive and public way.

Mental and behavioral health summits

What began as a one-time mental health summit initiative in 2000 at the Health Resources and Services Administration along with the Substance Abuse and Mental Health Services Administration, supported primarily by APA's Education PPO, evolved into a significant nationwide initiative that has improved the landscape for the treatment of mental and behavioral health of all Americans.

Education PPO shouldered the responsibility for seeking a $1 million appropriation in fiscal year 2000 for the National Health Service Corps to increase mental and behavioral health care to underserved communities by creating statewide or regional plans. The goal of this initiative was to expand access to quality mental health and substance abuse services while integrating these important services with primary health-care services. Our champions, APA members Herb Goldstein, PhD, and Nate Perry, PhD, sought the $1 million appropriation to support the first of wave of developing these plans by convening summits in states or regions. Visits, letters and meetings paid off, and House of Representatives and Senate appropriators included the funds to launch these summits. It was by no means an "easy lift" as lawmakers had to be convinced that the money would be put to good use and that expending a new $1 million on mental and behavioral health would result in something valuable.

The payoff for this $1 million initial investment was bigger and better than anyone imagined. With psychology as a catalyst and with APA taking the lead, the first wave of summits was convened, covering two regions and the state of Florida. By the end of the 2000 fiscal year, 25 states had participated in these mental health summits. And because of the level of interest and success, the program continued, and by the close of 2004, all 50 states had participated in a mental health summit. At each of the summits, participants were asked to focus on the key question, "How is it possible to create thriving, community-based settings for primary care, mental and behavioral health, and substance abuse services that can effectively engage consumers who are currently underserved?"

The summits have produced concrete outcomes. A South Carolina community recognized the incredible value of integrated health services and, as a result, its Choppee Community Health Center, which combines primary and mental health care, alcohol and drug abuse services, recreational opportunities and women, infant and children services under one roof, received its local level's "exemplary seal" of approval for a model of integrated care.

Another outgrowth of the summits is the "Over 60" Health Center in Berkeley, Calif., which integrates mental health care, substance abuse treatment and primary care in one place, so that those requiring service don't have to travel from place to place. It is the first community-based geriatric health center in the country.

What value were these summits? Not only did these summits provide a forum for addressing ways to increase opportunities for training in the provision of mental health services, as well as expanding access to mental health and substance abuse services in underserved communities, but they demanded a new collaboration between mental health and primary health-care providers. The summits resulted in the creation of permanent teams to implement the statewide plans. Evaluators of the program found that, even after two years, more than 80 percent of participating teams remained intact and continued to work toward implementing the state's mental health summit-derived plans to integrate mental and behavioral health care and primary health care.

Continuing successes

Another achievement is the Graduate Psychology Education Program (GPE), currently in its fourth year. While growth in appropriations has been difficult to come by in recent years due to federal spending that is in the red, Education PPO, with the leadership and commitment of APA members across the country, has still managed to ensure that the program survives and thrives. The GPE program requires an interdisciplinary approach that trains three or more types of health professionals in an integrated fashion that improves the quality and efficiency of health-care services to underserved populations.

Other success stories that come from the summits or from the GPE grantees are many and varied. In the end, APA put its weight behind small ideas and recognized the value in bringing stakeholders together. The mental health summits and GPE serve as examples of the benefit we all receive when we remember our "base."

When we promote psychology even in small ways, we can get big payoffs for the profession--like greater understanding of psychology in all its faces; greater access to mental and behavioral health services for individuals; and greater recognition and participation of psychologists as health providers in the context of our overall health and well-being. As these small programs take hold, grow and evolve, we realize big victories--both for the nation, and for psychology as a whole.

Jennifer Smulson is the senior legislative affairs officer in APA's Public Policy Office.