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AACDP president’s messageAlthough the world is full of suffering, 
Laura Roberts, M.D., M.A. The American Association of Chairs of Departments of Psychiatry is dedicated to bettering the lives of people with mental illness, now and in the future, by supporting, strengthening, and serving the individuals who have been entrusted with the responsibility of leading psychiatry departments in all of the medical schools of the United States and Canada. AACDP is comprised of leaders who have felt the call to lessen the suffering associated with neuropsychiatric diseases and to address the accompanying burdens of stigma, disability, and disparity in our society. AACDP is an organization of leaders who envision a future in which mental illness is better understood, less widespread, less severe, and better treated. Moreover, AACDP exists because its members are leaders who believe in the value of shared wisdom, cooperation, and partnership in overcoming challenges inherent in fulfilling this vision. Most important, the people of the AACDP are leaders who believe in upholding the ethical commitments that serve as the professional foundation of our field. In accepting the role of president, my aim first is to nurture this sense of inspiration, commitment, collaboration, and promise-keeping that has a special role in the work of chairs of psychiatry. This aim is, in my view, accomplished through two means. The initial task is to articulate clearly the nature, meaning, and imperatives of our work as chairmen in academic medical schools. We advance and oversee multiple missions, whether conceptualized as the traditional "three-legged stool" of science, education, and clinical care, or a more modern academic perspective (see box) entailing five, interdependent, and overlapping domains of education; research and scholarship; clinical advancement and practice; community engagement; and professionalism. Our work is meaningful and has value to others because these five missions, yoked together, serve to diminish the impact of disease and improve public health directly and indirectly. Academic departments of psychiatry prepare the next generation of clinicians and scientists, build new knowledge in diverse areas encompassing the basic neurosciences, educational methods, evidence-based clinical care, and community health. These departments work each day to enhance the care of patients with neuropsychiatric disease, behavioral disorders, and co-occurring conditions and to introduce practical and valuable programmatic initiatives into communities, helping to achieve aims of significance to those very communities. Our departments are a platform for supporting greater advocacy and more progressive public policy, based in scientific evidence and in the ethical principles of beneficence, fairness, respect, and compassion that characterize the profession of medicine. Finally, the faculties of our departments, along with others, are responsible for transmitting and embodying the human values and ideals of the profession of medicine and charged with helping to make certain that psychiatrists fulfill this obligation. In essence, as leaders of departments of psychiatry in medical schools, we are entrusted with work that, if done well, can bring benefit to the many millions of individuals living with mental illness now and endeavor to bring substantive improvement to the lives of others in the future. This is what we as chairmen do and this is why it matters. I think one's feelings waste themselves in words; The second task, from the perspective of the AACDP, is to translate into practical actions these positive qualities of inspiration, commitment, collaboration, and promise-keeping that reside in the leaders who populate our organization. In simple terms: how can the AACDP assist its members, the chairs, to better fulfill their duties at their home institutions and their more extensive responsibilities as leaders across the nations of the United States and Canada? Answering this question was a focus of the AACDP over the past 2 years as our group was led most ably and astutely (and with exceptional humor and charm) by my predecessor, Peter F. Buckley, Chairman of Psychiatry at the Medical College of Georgia. As he wrote in his President's Message, "The role of chairs" is all encompassing. This has placed a dilemma for AACDP as to where and how to focus its organizational efforts." Indeed, the need for directed efforts by the AACDP has heightened in just the past few months, as awareness of mental illness and its impact have been increasingly recognized, e.g., as reflected in recent parity legislation mandating greater access to clinical care for psychiatric disorders, and as new issues have been introduced into our profession, e.g., changes in board certification requirements for psychiatrists. Stresses on the profession of medicine have also grown. These include significant budgetary cuts on all levels, changes in standards and methods for reimbursement, widespread use of the electronic medical record, controversy regarding academic-industry relationships, uncertain NIH funding, and worsening shortages of general and subspecialist physicians. In the face of these changes and pressures, AACDP is stepping forward and stepping up. Our organization has directed its efforts toward four principal targets or objectives in support of our members. Professional development. The first objective is supporting the professional development for our members through skill- and expertise-building activities, collegial interactions, and consultation with experts in key fields relevant to our work. We host conferences, meetings, and retreats that center on administrative, research, regulatory, policy, and clinical topics. We learn about the structure and strengths of one another's departments and confer on "best practices" based on experiences in other nations, regions, and institutions. We sponsor fellowship and mentorship programs to help chairs at all stages in their careers. Examples of the themes of recent meetings include responding to Hurricane Katrina, leadership development, NIH and DHHS policy approaches, public-academic partnerships, conflict of interest policies, curricular initiatives by the Association of American Medical Colleges and the American Board of Psychiatry and Neurology, and mental health parity legislation. The AACDP is one of four societies in psychiatry that sponsor the journal Academic Psychiatry. Academic Psychiatry publishes new knowledge and innovation in psychiatric education; seeks to advance the field of academic psychiatry; fosters clinical excellence, professional development and leadership of psychiatrists throughout academic medicine; and assists all who are involved in preparing the psychiatrists of the future. The other sponsoring societies are American Association of Directors of Psychiatric Residency Training (AADPRT), Association for Academic Psychiatry (AAP), and Association of Directors of Medical Student Education in Psychiatry (ADMSEP). Liaison/networking and advocacy. Our members serve as liaisons to numerous professional societies and advocacy organizations. These include:
In addition, we have a formal relationship with the Association of Administrators of Psychiatry, a professional group comprised of executive administrators who serve in our departments in roles equivalent to "Chief Operating Officers." Perspective/Policy development. The third objective involves a renewed emphasis by our organization in the area of perspective and policy development. We have decided to undertake a survey of members regarding salient issues in overlapping roles, relationships with the pharmacology industry, and conflicts of interest. A policy statement will be developed and vetted within the organization, once the perspectives of our members have been clarified through an empirical study. Other topics for perspective/policy development include access to psychiatric care, professionalism imperatives in psychiatry, and destigmatization of mental illness. Enhancing the AACDP. Our fourth objective is active and ongoing review of how the AACDP can be a more effective and influential organization in modern psychiatry and a greater resource for our members. This is of increasing importance as the departments we serve become more diverse and the individuals who fulfill these roles come from different backgrounds and skill sets. It is my great honor to serve the AACDP, and I welcome the interest and fully engaged participation of all chairs in the United States and Canada. We do much, and we have much more to accomplish in the years ahead. Five Missions of Academic Psychiatry* In academic psychiatry, leaders are people who can help our field generally, and departments of psychiatry specifically, to fulfill their commitments in multiple mission areas. Most traditional academic organizations define three core missions of research, education, and patient care, but I believe we actually assume responsibility for five overlapping areas. The first two areas encompass education, preparing the next generation of physicians-in-training and developing innovative specialty and subspecialty educational initiatives, as well as research and scholarship, the generation, translation, and application of new knowledge for the benefit of society. A third mission area is clinical advancement and practice, which involves creating new diagnostic and therapeutic approaches and providing state-of-the-art clinical care for patients from all backgrounds and walks of life. We are also responsible for community engagement, working to partner with, serve, and improve the health of our communities, locally and globally. We are charged with fostering professionalism, and the companion endeavors of supporting professional development and ensuring the ethical expression of our profession in everyday life. Taken together, these commitments support the growth of expertise and skill among faculty and trainees. What is more, they help in an unending way to enhance the strengths of today's early career leaders to carry the duties for our profession and its stakeholders moving forward. A leader with vision in academic psychiatry, in my view, is one who is able to recognize the interdependent nature of these mission areas and to yoke them together to bring about a better future. Laura Weiss Roberts, M.D., M.A. *Excerpt of upcoming editorial in Academic Psychiatry (in press, March/April, 2009) |
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