The Importance of Interprofessional Collaboration
Long time Capitol Hill colleague Peter Reinecke recently shared with us the Health Affairs report indicating that the number of psychiatric mental health nurse practitioners (PMHNPs) serving Medicare beneficiaries increased by 162% from 2011 to 2019, compared with a decrease of 06% for psychiatrists during the same period. Further, the proportion of all mental health prescriber visits provided by PMHNPs increased from 12.5% to 29.8%, and exceeded 50% in rural, full-scope-of-practice regions. The authors found that advanced practice nurses (APNs) “accounted for the largest contribution to treatment capacity growth during the pandemic.” Wyoming’s Mike Enright, California’s Linda Richardson, former APA President Carol Goodheart, and the National League for Nursing’s President and CEO Beverly Malone each possesses both a psychology and nursing degree.
The Institute of Medicine (now the National Academy of Medicine) has consistently urged that historical scope-of-practice barriers be removed in order to allow all nurse practitioners to function clinically at the fullest extent of their education and training. Economist Jeffrey Bauer estimates that by fully empowering non-physician providers, this could result in our nation’s health care costs being reduced by 32%; for an annual savings of $155 billion, without any objective evidence of adverse clinical outcomes.
At the Uniformed Service University (USU), the Psychology and PMHNP faculty have been working to provide their graduate students with increasingly joint academic experiences, early in their professional careers. Most recently, Abby Diehl, Patrice Shanahan, and Brent Donmoyer hosted a discussion on providing behavioral health evaluations pursuant to Command directives and on briefing/consulting with Command Officers. Earlier in the year, Tracy Sbrocco and Jouhayna Bajjani-Gebara provided an interdisciplinary clinical psychopharmacology course. Perhaps to state the obvious, for both professions their potential clients remain the same individuals and/or families, regardless by which profession their therapist might be trained. Thus, we would rhetorically ask: What insights can the different training models contribute? How would one evaluate the specifics? On the legislative front, we would ask: Has your State Psychological Association sought out and effectively utilized the unique expertise of your own local dual degree colleagues? The potential opportunities for success are endless, if one possesses vision and dedication. Former APA President Tony Puente would suggest seeking Medicaid reimbursement for supervising graduate and/or post-doctoral trainees.
Effective APA Advocacy at the State and National Level
Katherine McGuire, APA Chief Advocacy Officer: “There are three candidates running for federal office in open seats with impressive backgrounds of support for mental health. Congressman Markwayen Mullin (R-OK) is running for the Senate in Oklahoma. A member of the Cherokee nation, he is a longtime supporter of independent practitioners and behavioral health and was named a Psychology PAC Champion in 2018. He is joined by Congressman Tim Ryan (D-OH) who is running for an open seat in Ohio. Congressman Ryan has devoted his years in office to combating the opioids epidemic and suicide, including leading the Military Mental Health Caucus. Finally, a newcomer is Colorado State Senator Brittany Pettersen. She is considered a leading expert in Colorado on the opioid epidemic and fixing the behavioral health system. Her passion for mental and behavioral health stems from her own mother’s suffering from three decades of opioids and heroin addiction. We need strong champions for psychology on both sides of the aisle and it takes years to cultivate meaningful relationships with Members of Congress. This is why Psychology PAC is supporting Pettersen in her open seat race.
“The Georgia Psychological Association Political Action Committee hosted a program recently in Georgia for psychologists to get trained in advocacy and learn more about how to infuse psychology into policy making. Organized by Gayle Spears, Executive Director of GPA, the program covered recent state-level advocacy efforts including the passage of the Mental Health Parity Act in the Georgia legislature during this year’s legislative session. Speakers included State Representative Mary Margaret Oliver, who was an instrumental figure in the passage of this key legislation. The programming ended with former APA President Jennifer Kelly, longtime Georgia Federal Advocacy Coordinator, who co-presented with Alix Ginsberg, Senior Director of Congressional Relations, on the impact of her Presidential Initiative on Health Equity and what we can expect in the Fall related to mental health legislation. The all-day program on September 9th was called ‘Be at the Table -- Not on the Menu: How to Advocate for Your Practice and Profession’.”
Finally, it was very impressive to see Diana Prescott, candidate for APA President, hosting a Town Hall event to discuss APA/State Relationships, Advocacy, and Rural Health later on this month. When then-APA President Jack Wiggins created the APA Office of Rural Health, he was acutely aware of the importance of Rural America to psychology’s future.
“First you gotta believe it. Try to do it like the ninja kidz, ninja kidz”
(Ninja Kidz – Being Awesome!)
Aloha.