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National Coalition Colleagues:
I
am hoping our members and friends will be interested in some recent developments
and initiatives of the National Coalition. Over the last few years it has been
increasingly clear that the threats posed by managed care and industrialization
of health care falls unequally on health care professionals. Despite the
roadblocks and outright interference in quality health care that doubtlessly
plague the practice of physical medicine, the obstacles placed in the conduct of
psychotherapy are uniquely and particularly disruptive. In addition to the
"usual" problems of denial of benefits and low reimbursement, managed care and
industrialized health care directly threaten the practice of psychotherapy by
its direct assault upon those aspects of practice that are most important. The
National Coalition has identified these essential aspects of psychotherapy in
its recent position paper as 1) privacy, 2) access, 3) quality, and 4) choice.
See below for link to obtain this document.
While we psychotherapists have struggled with the problems of managed care for a
number of years, we have found that our natural allies, that is, our
professional organizations, have increasingly become muted or fallen silent in
defense of our craft. Our organizations have instead promoted other ways of
inventing what we do, for example, "niche" practices, integrated health care,
and coaching, as more lucrative and/or successful ways to deliver services.
While these and other ideas for practice have their merits, most patients want
and need "talk" therapy, "depth" therapy. They need and benefit from
psychotherapy that helps them improve their relationships through a personal and
important relationship with a psychotherapist. Our
professional organizations, however, with few exceptions, have taken the path of
compromise and accommodation, and this includes compromising on privacy,
quality, access and choice for patients.
We are now faced with both a danger and an opportunity in the public sphere. The
forces of reform appear to be ascendant and there is an increasing "push" for
universal access to health care. Many of the ideas and values advocated by
grassroots organizations and public policymakers are laudable, but make no
mistake about it. Grassroots organizations, again with few exceptions, little
note or care about psychotherapy and tend to view mental health and substance
abuse issues (when these issues are even considered) in terms of "access" to the
latest drugs. Policymakers, by and large, fall in the same camp, with the
exception that many of them have become enamored of sweeping "solutions" such as
Health IT legislation that purport to bring
vast savings, albeit at the cost of loss of privacy.
Lately, healthcare reform has begun making some strange alliances. Businesses
are eager to shed their cost of health insurance under the banner of reform. Big
Pharma is eager to have drug company profits protected in any new legislation.
Insurance companies are eager to have health insurance mandated as a way to
increase profits and their hold on the market. Managed care is only too eager to
"manage" universal health care. We are facing a "perfect storm" of reform and
the "petty" concerns of psychotherapists will
easily be washed overboard unless we act now to ensure that our voices are
heard.
We must announce to our professional organizations that the science and practice
of psychotherapy, of "talk" therapy, is both worthwhile and meaningful, but only
so when patients have the necessary privacy, choice, access and quality for
psychotherapy to be successful. We must educate grassroots organizations and
policymakers that mental health and substance abuse care must have a seat at the
table in the healthcare reform debate. We must remain ever vigilant of the
newfound allies of reform.
We are asking you, our members and friends, to become partners in this fight for
mental health and substance abuse care. We are asking you to take our White
Paper and distribute it to organizations, groups and individuals. We are asking
you to work toward having the four principles of the National
Coalition embedded in any document, position paper, or law that addresses health
care reform. Please read, or reread, Essentials of Mental Health and
Substance Abuse Care. If you agree, take these ideas and use them in
advocating for health care reform. And let us know what you are doing and how
you are doing with this important project. We, the Board of the National
Coalition, cannot do this alone. You, our members and friends cannot do this
alone. We must reach out to organizations and individuals, professionals,
politicians, policymakers and the public to educate, urge and cajole into
developing a viable mental health and substance abuse care system that
recognizes psychotherapy as a core aspect of this care.
To that end, I will note that I have taken Essentials of Mental Health and
Substance Abuse Care to leadership of American Psychological Association
and several of its practice Divisions. I hope to be able to report to you soon
on any developments in getting my main professional organization to become a
more active supporter of psychotherapy.
Linked below find the latest iteration of the National Coalition's White Paper,
Essentials of Mental Health and Substance Abuse Care, and the
current membership form.
http://thenationalcoalition.org/White-Paper.pdf
http://thenationalcoalition.org/Memb.htm
William A. MacGillivray, PhD, ABPP
President, NCMHPC
7 Forest Court, Knoxville, TN 37919
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