Barton Blinder, MD PhD’s Responses to Questions Posed by Steve Koh, MD MPH MBA who is Assistant Professor, Dept. of Psychiatry, Director Community Psychiatry Fellowship Program at University of California San Diego, Consulting Faculty, Balboa, Naval Hospital

1) What are your future plans to work with younger APA members to ensure their involvement now and in the future?

For over three decades, I have been a member and worked diligently on the clinical faculty at University of California, Irvine teaching seminars on eating disorders, integrating psychotherapy and pharmacotherapy, obsessive compulsive disorder, and the history of psychiatry. In addition, I have actively been involved in the clinical and psychotherapy supervision and mentoring of Residents, frequently involving them collaboratively in research projects and encouraging their interest in innovative treatments and activities in providing service to the broader community through consultation to medical clinics, and patient based support groups. As a child psychiatrist and past Director of Eating Disorder Research and Treatment at University of California, Irvine, I have encouraged Residents and Fellows to be involved in multidisciplinary collaborative care with health professionals that support and extend our efforts in psychiatry. I have also tried to encourage an in depth understanding of the history of psychiatry with its pitfalls and misadventures. Along with my colleague, Joseph Mawhinney, MD (Area 6 APA Representative and Chair of APA Access to Care Workgroup), I have worked diligently to involve Residents and Fellows in understanding the multiple roadblocks we face in achieving parity and extending the best that we can offer of our medical psychiatry competence and training to the community. The first of two items I would like to specifically mention are an Action Paper in the APA Assembly that I co-authored with Dr. Mawhinney which we hope will create a special APA commission to study and implement curricula and changes in residency education that will emphasize integrative and collaborative care and the expanded role of the psychiatrist in multiple medical settings. Secondly, it has been my privilege to be the Editor of the APA Workgroup Access to Care Newsletter, which has been circulated widely and will continue to inform all of our members of progress in this area.

2) How will you work to ensure that APA stays relevant in mental health care in the coming decade with changes to healthcare and advances in science?

For many years I have been an active member of the APA Scientific Program Committee. In that capacity, I reviewed the workshops, new research, and Resident and Fellow poster contributions. Every effort was made to encourage innovative projects and concepts related to diagnosis, treatment, and the providing of care to the community. I have edited four textbooks over the years involving advances in child and adolescent psychiatric diagnosis and treatment, eating disorders, and most recently Integrating Psychotherapy and Pharmacotherapy: Dissolving the Mind-Brain Barrier.
As noted previously, I am involved and committed to advancing access to care to the entire community, removing roadblocks and determining how best to work with evolving concepts of access to care organizations and integrative care and medical home models. I have served in the past as chairman of a major psychiatric in-patient department in a large general hospital and was actively involved in consultation liaison service with colleagues in multiple medical specialties. I am very sensitive and aware of the skills and competencies that are necessary and we must teach and develop to collaborate effectively with our medical colleagues for the benefit of all our patients. A short paper on my website entitled The Changing Face of Psychiatry: Demons, Molecules, and Genes might be of interest to you.

3) What concrete steps can be taken in increasing psychiatric workforce to meet the demand?

The education and clinical training for Residents and Fellows in the next decade must emphasize the critical role of the psychiatrist in expanded medical settings, understanding of integrated and coordinated multispecialty and multidisciplinary treatment, and partnership with related health professionals will be essential. In all areas promoting access to care, quality diagnosis, treatment, and patient safety will be paramount. Promoting a joint MD/MPH degree during medical school training would be a great step forward. In retrospect, I wish I had pursued an MPH in my career. Educating the public and lobbying national and state legislative bodies to recognize the shortage of psychiatrists (child and adolescent psychiatrists, adult general psychiatrists, and subspecialty areas such as geriatrics, veteran’s medical services, and consultation liaison) in providing the specialized diagnosis, treatment planning, and care necessary for a healthy society should be an ongoing major effort of the APA at every level. Taking a critical and broad view of collaborative and partnership efforts with health professionals such as psychiatric nurse practitioners, medical social workers, and health planning and coordinating professionals will be an important focus of study and recommendations.
Please consult my website for detailed discussion of APA priorities, my educational and professional background, experience, and reasons that I feel I can best represent all of us as President of APA.

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