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Statement to the American Psychiatric Association [APA]
The Washington Psychiatric Society asks that the APA give its priority to the reason that the APA was formed 164 years ago: to explicate, to promulgate, and to advocate the humane care and effective treatment of people with psychiatric illnesses. Unless the APA is the authority as to the clinical needs of people with psychiatric illness, it loses its foundation, a foundation that is crucial to reaching its other advocacy interests.
The Washington Psychiatric Society asks that the APA give its priority to the reason that the APA was formed 164 years ago: to explicate, to promulgate, and to advocate the humane care and effective treatment of people with psychiatric illnesses. Unless the APA is the authority as to the clinical needs of people with psychiatric illness, it loses its foundation, a foundation that is crucial to reaching its other advocacy interests.
In recent years we are seeing an erosion of the foundation
on which we are standing. Some examples:
1. A substantial development since DSM-IV was published [1994] is the huge expansion of youth being given the diagnosis of bipolar disorder. The APA, despite a request from this District Branch to do so, has not provided leadership on when children and adolescents should be given the bipolar diagnosis.
2. A substantial development since DSM-IV was published [1994] is the expansion of ADHD
diagnosis in adults. The APA, despite a request from this District Branch to do so, has not provided leadership as to when the ADHD diagnosis should be given to adults.
3. In 2005, the federal government changed the sleep classification in this country, ICD-9-CM, by adding more than sixty new sleep disorders. Sleep complaints are among the most common symptoms of psychiatric patients. While a few modifications in the printing of DSM-IV-TR were made a couple of years ago, the APA has been silent as to the usefulness of ICD-9-CM’s 81 sleep disorders.
4. About two decades ago, the South Florida District Branch and this District Branch successfully move that the APA develop practice guidelines. These guidelines are not being kept current.
5. American psychiatry’s only unique etiology, relative to other medical specialties, is mental trauma. On October 17, 2007, the Institute of Medicine released its report on the management of PTSD that stated: “The evidence is suggestive but not sufficient to conclude efficacy of SSRIs in general populations with PTSD.
The available evidence is further suggestive that SSRIs are not effective in populations consisting of predominantly male veterans with chronic PTSD.” For the months since the IOM report, the APA has provided no leadership in responding to this statement, a statement that is so important clinically and is related to our special interests in seeing the veterans are well served.
6. Council on Addiction Psychiatry reported in 2007 that the online buprenorphine course on the APA website “is quite out of date.”
The Washington Psychiatric Society asks the American Psychiatric Association to make explicating, promulgating and advocating for the clinical needs of people with psychiatric disorders its highest priority. Within the American Psychiatric Association’s membership is the expertise to arrive at an authoritative consensus as to the clinical needs of the people with psychiatric disorders. We ask that these resources be utilized to the fullest degree possible to enhance the APA’s clinical, authoritative foundation – so as to enhance the humane care and effective treatment of people with psychiatric disorders, the reason the APA was founded.
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