I’m glad to see so many Registrants and Trainee Registrants have already checked out the National Register’s new Integrated Healthcare Training Series and have earned free continuing education from these video modules. Last week, we released the first three modules of this video series, which includes luminaries like Parinda Khatri, Neftali Serrano, Natalie Levkovich, Jeff Goodie, Kent Corso, Armando Hernández, Marlin Hoover, Jeff Reiter, and Bob McGrath. Take a moment and see what the buzz is all about. Below you’ll find two great segments from the series: The Behavioral Health Consultation with Parinda Khatri, PhD, and The Triple Aim with Kent Corso, PsyD.
Colleagues, I’m delighted to announce that we just launched our new continuing education website: CE.NationalRegister.org. You can earn more than 100 free CE credits on this site from archived issues of The Register Report. The site also introduces a tremendous new innovation: You now have the capability to electronically bank all of your CE certificates, regardless of where you earned them.
The summer of 2016 may very well go down as the “Summer of Outrage.” National elections are never the calmest of events, but this particular cycle seems to be marked by heated passion (to say nothing of unbridled invective) in degrees not seen for quite some time. And it’s not a uniquely American phenomenon. Outraged Britons have chosen to depart the European Union, a passionate decision that they apparently may be coming to regret. Their counterparts across the Channel are responding with outraged rejoinders of “good riddance,” a stance that is likely not in their best self-interest. But closer to home (and to the theme of this column), it seems that psychologists are increasingly joining the ranks of the outraged. Listservs seem replete with outraged comments about this thing or that, this insurer or that new therapy, this new drug or that new medical device. Why psychologists trained in rational thinking fall prey to this can be partly explained by understanding how popular discourse affects professional communications, and how the media we use shape both our messages and emotional responses. We have, for example, platforms like Twitter, which due to restrictions on the length of communications essentially guarantee that a post will be free of both nuance and context. The ability to broadcast such messages widely adds to the temptation of communicating unfiltered emotion to as large an audience as possible. The ease with which we can cut and paste electronic material allows us to alter original authors’ intent to fit our own points of view. More than ever, the airwaves seem to be full of commentators who encourage us to make decisions based on emotion, rather than reason. Though as psychologists we pride ourselves on being scientists and rationalists, we are as susceptible to the fads of popular culture as anyone else. Even so, I find this vulnerability to be a bit odd, since we as professionals spend so much of our time helping patients understand the roots of their emotions, the difference between emotional reasoning and rational thinking, and how unacknowledged emotions inflect our beliefs, actions, and words. Outrage is an understandable emotion of the disenfranchised: those who have no recourse to political, legal, or economic systems to address injustices or wrongs, or are barred from participation in governance due to constraints imposed by law, prejudice, or repression. For these groups, social media can be a powerful, and perhaps their only, mechanism of communication of grievances and ideas. The profession of psychology, however, has other options. We are, without being coy about it, the elite. We are among the most highly educated individuals on the planet, and we enjoy the benefits that education has bestowed on us....
According to a recent report in the journal Health Affairs, Americans spend $201 billion dollars annually on mental healthcare, far more than we pay for any other medical condition. It is quite appalling that we spend this much with so little to show for it. Recently, I attended the Senate Summit on Mental Health hosted by Sens. Chris Murphy of Connecticut and Bill Cassidy of Louisiana. The purpose of the event was to advocate for a comprehensive mental health reform act that promises to expand training of healthcare providers and increase funding and access to mental health services. But we must ask: Is psychology ready to meet these challenges?
From the desk of the Executive Officer, Morgan T. Sammons, PhD, ABPP: I felt that we could not wait to share what we are thinking and reading about the intersections between gun violence and mental health. As more information emerges about the victims who died at the Orlando gay nightclub and their families, I hope you’ll join me in the dialog about what we, as psychologists and as members of our society, can do to end the mass shootings that occur with such sad regularity in our country that they’ve become average.
Dr. Morgan T. Sammons, the National Register’s Executive Officer, attended a presentation on decarceration, given by Dr. Ron Manderscheid, the Executive Director of the National Association of County Behavioral Health and Development Disability Directors (NACBHDD). Learn more about efforts that are being made and that need to be extended to decrease the rate of incarceration among those who have a mental illness or substance use disorder.
With the passage of prescriptive authority legislation for psychologists in the state of Iowa, four states join the Department of Defense, Indian Health Service, and territory of Guam in extending prescriptive authority to appropriately trained psychologists.
Many Registrants are aware of a recent case in the U.S. Fifth Circuit Court entitled Serafine v. Branaman. Dr. Serafine ran for the office of Texas State Senator in 2010, describing herself in campaign materials as a psychologist, despite not being licensed as one. When challenged by the Texas State Board of Psychological Examiners, Dr. Serafine desisted from labelling herself as a psychologist, but when the election was over, she sued the Texas Board, claiming that her first amendment rights had been infringed. At hand, there are two issues with this case that pose threats to the profession of psychology. Read more.
Healthcare systems are not going to hire psychologists because of our belief, however well-founded, that our skills make us effective administrators, supervisors, or mediators. If we don’t have the skillset to be hired for one reason only—to provide effective interventions in the integrated environment—we aren’t going to be hired at all. And this means we must expand on our training to be more inclusive of the core skills other providers bring to the primary care environment.
When psychologists are not present in primary care, the de facto treatment in this country for most mental conditions is pharmacological, in spite of accumulating evidence that this strategy is suboptimal. Integrating psychological services into a healthcare delivery system where medications predominate can, I believe, lead to the implementation of more effective clinical interventions. As the U.S. healthcare system lumbers towards change, in part induced by the Affordable Care Act and in part by advances in our understanding of effective practice, it is essential to examine the evidence underlying our assumptions about effective mental health service provision.
Although youth incarceration in the U.S. has shown a welcome decline over the past decade, we still incarcerate more young offenders than any other industrialized nation—indeed, we are one of the few such nations to permit the solitary confinement of youth.
As psychologists and clinicians, we are routinely exposed to the effects of gun-related violence. Most of us have had to assist patients in dealing with the aftermath of gun violence, usually related to suicide. Some of us have had to negotiate with patients in crisis to surrender weapons. Others have had to make the very difficult decision to make authorities aware of a potentially dangerous patient with access to guns. Regardless of our personal feelings about gun ownership, gun violence is a national public health problem that demands our professional attention at the patient and societal level. President Obama’s initiatives to curb gun violence, announced in a news conference last week, contain a number of provisions that are of importance to psychologists, legislators, and advocates for mental health. Perhaps the most important to psychologists are the changes to HIPAA legislation that modify reporting requirements to the National Instant Criminal Background Check System (NICS). Changes to this regulation, under a rule that will go into effect February 6, 2016, permit institutions or legal entities that adjudicate incompetence, make commitment decisions, or make legal (not clinical) judgments regarding danger to self or others, to report such actions to the NICS. It is important to understand that this new HIPAA exception does not apply to clinicians, only to institutional and legal reporters. It is also important to note that this exception does not apply to individuals who voluntarily seek admission to inpatient facilities – in other words, the act of seeking help for a mental condition does not imperil an individual’s right to gun ownership. The link to the new HIPAA rule is found in the Federal Register. The President also proposed establishment of a $500 million fund to bolster access to mental health care. Although a detailed plan for allocating these resources has not been articulated, we anticipate funds for more effective screening for early intervention, increasing numbers of well-trained mental health providers, and enhanced suicide prevention efforts. Numerous healthcare and public policy entities, including the APA, have voiced support for this initiative. Also on the legislative front, numerous professional groups and advocacy bodies have joined 18 Senators in asking the Appropriations Committee's Subcommittee on Labor, Health and Education to hold hearing on proposals to lift a ban implemented in 1996 that prevents the US Centers for Disease Control (CDC) from spending federal dollars to study the effects of gun violence. In a society where gun-related deaths routinely are among the top 10 causes of mortality, a prohibition on funding to study this public health problem has no justification. In the last year for which complete data are available, 2012, the CDC reported that over 33,500 Americans died of gun related...