Tuesday, 8 May
Since Saturday, I’ve been at the
American Psychiatric Association’s annual meeting in
Philadelphia. The first symposium I was involved in was about
cross-cultural issues in the use of psychotropic medications in
children. There was a great deal of discussion, and colleagues from
the US, Canada and New Zealand gave their perspectives on the
cultural and policy influences on prescribing.
Next, I was guest at the Assembly of the APA
where business is conducted. Of particular interest was a
presentation from Paul Summergrad MD on the role of psychiatry in
health reform, integrated care and how psychiatrists can work with
primary care colleagues. It is interesting how we share many of the
same issues with the US – the need to protect funding for the most
vulnerable populations, and not allowing monies for our patients to
be swept off into other fields of medicine.
John Oldham MD, outgoing President of the APA,
gave a very touching talk about
the work he had done over the last 12 months to ensure psychiatry
is part of the "house of medicine”. He talked about the patient’s
right to quality treatment, the importance of integrated care, and
how we have to maintain a high quality of education and
The new APA President is Dilip Jeste, a
psychogeriatrician. His theme for his presidency will be pursuing
well-being across the lifespan. Both Dilip and John stressed the
importance of the Mental Health
Parity Act which was passed in 2008 in the USA, and how
subsequently they have been able to use this as a powerful lever to
halt policy or practice that would have a negative impact on mental
health users and carers, and to deliver better services. It’s
encouraging to hear that, given what has been achieved over here
with parity of esteem through the Health and Social Care Act, and I
hope that this will ensure we achieve the best for our patients –
whatever the challenges and challenges in health care
I also attended a really positive meeting of
European leaders and APA leaders. The emphasis was on integrating
better with primary care and public health, and brain migration
across the world.
In between lectures and meetings, I’ve had the
opportunity to observe Philadelphia society. It is a city full of
history (see my photo of Benjamin Franklin!) but like every city it
has its problems – including homelessness. The hotel I am
staying in is next to the equivalent of one of our magistrates’
courts so, as a forensic psychiatrist, I feel quite at home!
Through the window I’ve been watching life outside the court unfold
– people hovering outside and waiting, some entering and not
returning, and relatives pacing up and down outside.
I’ve also had time to watch a bit of
television. At least half of the adverts seem to be about
prescription medication, inviting you to go to your doctor and ask
for a named drug, and all accompanied by a roll call of a long list
of side effects. It’s interesting to watch, as I suspect few of us
read all of the small print on leaflets accompanying
medication in the UK. Then the rest of the adverts seem to be from
lawyers, telling you how to sue the doctors that have prescribed
the medication that’s given you one of these side effects!
It’s interesting how much the APA Congress has
changed over the years. In times past, the exhibition hall
resembled the set of a 1930s film extravaganza – lights, curtains
and glamour to advertise pharmaceutical companies and medications.
Now it is a more subdued affair, with many of the stands occupied
by competing health providers eager to show why working for them
would be better than working for their neighbour. There are also
some amazing NGO stands, which aren’t very flashy but show how they
are providing life-changing support for those with serious mental
illness and acquired brain damage.
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Dear Sue- enjoying reading your blog. You
paint a vivid picture of your hard work on our behalf, and it's
really good to be kept informed.
Thank you very much for your attendance at
our recent joint psychotherapy faculty event with RCGP and it's
good to hear that this has led onto to further discussion about the
involvement of the College in developing the newly extended GP
Consultant Medical Psychotherapist