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A Psychiatrist's Guide to Advocacy

Edited by Mary C. Vance, M.D., Katherine G. Kennedy, M.D., Ilse R. Wiechers, M.D., M.P.P., M.H.S., and Saul Levin, M.D, M.P.A.

  • ISBN 978-1-61537-311-6
  • Item #37311

Description

Overcoming fear, ambivalence, and inertia to act on behalf of self or others can be difficult even for mental health clinicians who are accustomed to helping patients overcome challenges. A Psychiatrist’s Guide to Advocacy explores the diverse definitions of advocacy and helps to identify methods and opportunities for advocacy by mental health practitioners. The editors argue for a greater culture of advocacy among psychiatrists in order to effect broad and lasting systemic and structural change. A noteworthy example is the push for insurance coverage parity between mental health and other medical care. However, legislative advocacy is just one of the many types explored in the book; advocacy takes many forms, including patient-level advocacy, organizational advocacy, education and research as advocacy, and media-targeted advocacy. Also addressed are specific issues of advocacy for special populations, including children and families, older adults, LGBTQ patients, and veterans. Taken together, these chapters represent a practical toolkit for mental health advocacy in its myriad forms.

In prose both compelling and accessible, the volume

  • Identifies five of the most pressing systemic problems in mental health care (lack of access to quality payer-covered, evidence-based mental health care; the psychiatry workforce shortage; lack of parity for mental health care compared with other forms of health care; the stigma against both consumers and providers of treatment for mental disorders, including substance use disorders; and high rates of physician burnout) and explains how advocacy at different levels can address these issues.
  • Describes the essential factors needed for effective advocacy, with emphasis on pathways to mentorship, providing examples of what integrating advocacy into the psychiatrist’s career path looks like and identifying strategies to encourage lifelong advocacy
  • Delineates the advocacy needs of diverse patient populations, including children, families, and older adults; LGBTQ, non-native, and substance-using patients; veterans and military service members; and more
  • Includes four substantive interviews with advocacy role models who embody and embrace the advocate's mission, expressed in actions and on platforms that are diverse and illustrative
  • Includes learning objectives that tell readers what they can expect to master by the end of each chapter, allowing for focused reading and easy review

A Psychiatrist’s Guide to Advocacy is a call for action and a blueprint for change, providing clinicians with the foundation for recognizing their opportunities and embracing their roles as advocates.

Contents

Foreword
Part I. Understanding Advocacy
Chapter 1. What Is Advocacy, and Why Is It Important?
Chapter 2. Conceptualizing Advocacy
Chapter 3. Where Do We Fit In? Advocating for Our Patients and Our Profession
Chapter 4. How Do I Become an Advocate?
Part II. Practicing Advocacy
Chapter 5. Patient-Level Advocacy
Chapter 6. Organizational Advocacy
Chapter 7. Legislative Advocacy
Chapter 8. Education as Advocacy
Chapter 9. Research as Advocacy
Chapter 10. Engaging the Popular Media
Part III. Advocacy for Special Populations
Chapter 11. Advocacy for Children and Families
Chapter 12. Advocacy for Older Adults
Chapter 13. Advocacy for LGBTQ Patients
Chapter 14.Advocacy for Foreign-Born Patients
Chapter 15.Advocacy for People with Substance Use Disorders
Chapter 16.Advocacy for Military Service Members
Chapter 17.Advocacy for Veterans and Their Families
Chapter 18.Advocacy for Patients in Medical Settings
Chapter 19.Community and Public Sector Advocacy
Chapter 20.Advocacy for People with Mental Illness at Risk for Criminal Justice Involvement

Contributors

Steven J. Ackerman, Ph.D.
Rohul Amin, M.D., FAPA, FACP
Bachaar Arnaout, M.D.
Daniel S. Barron, M.D., Ph.D.
Jessica S. Bayner, M.D.
Rebecca Weintraub Brendel, M.D., J.D.
Kristin S. Budde, M.D., M.P.H.
R. Dakota Carter, M.D., Ed.D.
John Chaves, M.D.
Joan M. Cook, Ph.D.
Gary Epstein-Lubow, M.D.
Thomas N. Franklin, M.D.
Andrew J. Gerber, M.D., Ph.D.
Falisha Gilman, M.D.
Jessica A. Gold, M.D., M.S.
Stephanie V. Hall, M.P.H.
Ayana Jordan, M.D., Ph.D.
Katherine G. Kennedy, M.D.
Jennifer Kononowech, L.M.S.W.
Debra Koss, M.D., FAACAP, DFAPA
Harold Kudler, M.D.
Saul M. Levin, M.D., M.P.A., FRCP-E, FRCPsych
Luming Li, M.D.
Myra Mathis, M.D.
Danna E. Mauch, Ph.D.
Eric Plakun, M.D.
Debra A. Pinals, M.D.
Allison Ponce, Ph.D.
Michelle B. Riba, M.D., M.S.
Michael Rowe, Ph.D.
Kaila Rudolph, M.D., M.P.H.
Adam J. Sagot, D.O., FAPA
Melanie Scharrer, M.D.
Jennifer Severe, M.D.
Jeanne Steiner, D.O.
Allan Tasman, M.D., DFAPA, FRCP
Kenneth Thompson, M.D.
Mary C. Vance, M.D., M.Sc.
Ilse R. Wiechers, M.D., M.P.P., M.H.S.
J. Corey Williams, M.D.
Eric Yarbrough, M.D.
Kimberly Yonkers, M.D.
Kara Zivin, Ph.D., M.S., M.A.

About the Authors

Mary C. Vance, M.D., M.Sc., Assistant Professor of Psychiatry and Scientist, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, Maryland

Katherine G. Kennedy, M.D., Assistant Professor, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut

Ilse R. Wiechers, M.D., M.P.P., M.H.S., Associate Professor of Clinical Psychiatry, University of California San Francisco, San Francisco, California; Assistant Clinical Professor of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Associate Director, Northeast Program Evaluation Center, Office of Mental Health and Suicide Prevention, Department of Veterans Affairs, New Haven Connecticut

Saul M. Levin, M.D, M.P.A., FRCP-E, FRCPsych, Chief Executive Officer and Medical Director, American Psychiatric Association; Chair, Board of Directors, APA Foundation; Clinical Professor, George Washington University School of Medicine and Health Sciences, Washington, D.C.

Advocacy for patients and for the profession is now an essential part of the identity of psychiatrists. This volume is the DSM of advocacy for our field. It defines, categorizes, and operationalizes advocacy for the psychiatrist in training as well as the practitioner. Whatever one’s specialty or subspecialty it is a guide for our role as advocate. A must read.—Steven S. Sharfstein, M.D.



Advocacy is a responsibility for psychiatrists to a greater extent than any other medical specialty. Our patients are stigmatized, barriers to treatment are common, our treatments are under-supported, our research is under-funded relative to their public impact, and the illnesses that we treat remain the most disabling medical conditions in society. Further psychiatric disorders, such as addictions, remain the only medical conditions that, by definition, put patients in conflict with the criminal justice system.

Psychiatry has struggled to develop a coherent advocacy base and this has hindered the ability of our field to reduce the public health burden of psychiatric disorders.

The rabbinic scholar, Hillel the Elder, famously articulated the essence of advocacy two millennia ago, “if I am not for myself, who will be for me? If I am only for myself, what am I? If not now, when?” Every psychiatrist must ask themselves this question.

In A Psychiatrist’s Guide to Advocacy, Dr. Mary Vance, from the Uniformed Services University of the Health Sciences; Drs. Katherine Kennedy and Ilse Wiechers from Yale University; and Dr. Saul Levin, from the American Psychiatric Association provide an outstanding resource for psychiatrists who want to stand up for themselves, their profession, and their patients.

The role of advocate may not come naturally to psychiatrists, who are engaged in the most private of medical specialties. But this book begins by helping psychiatrists understand their role as advocates. It then introduces different types of advocacy and highlights the advocacy needs and strategies for specific psychiatric populations. It is presented in a clear, thoughtful, and useful style.

This is an important book for psychiatry and for psychiatrists. I recommend it highly.—John H. Krystal, M.D.


Colleagues: it is not enough to apply what has been learned without endeavoring to improve on what we offer patients. Research and science represents one path to change the world for the better for our patients but another powerful approach is advocacy, to learn why and how to work to change policy, to expand resources, to alter society in order to reduce the risk of psychiatric disease, facilitate early recognition and intervention, and expand resources for access to quality care. While psychiatric care is itself a form of advocacy, recent changes in mental health parity legislation, in destigmatization, in awareness and support of mental health care overall are testimony to the power of expanded advocacy. This volume is a clarion call and blueprint for action.—Jerrold F. Rosenbaum, M.D.


As psychiatrists, we can provide powerful advocacy for our patients and our profession and help improve mental health systems of care.The authors of this excellent book describe effectivestrategies and tools for all psychiatrists who are interested in advocacy.—Renee Binder, M.D., Distinguished Professor, University of California San Francisco, Past President, American Psychiatric Association


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