Ad: Janssen Neuroscience (Resource: 2020 U.S. Transparency Report)

The process is resilience – ‘adapting well in the face of adversity, trauma, tragedy, threats, or significant sources of stress.’ As much as the process of resilience is about adaptation, it can also be an opportunity for profound personal growth, sometimes called post-traumatic growth. Often this process starts with taking a fearless personal inventory. 

with the world can have in shaping their lives, and therefore more willing to consider how our own “stuff” can get in the way of helping those who come to us seeking relief. But my experiences with my own blind spots, as well as observing, teaching, and clinically supervising others over multiple decades, continues to confirm that merely being in the helping professions and trying to be a generally good person does not automatically translate into greater awareness. At minimum, we have an ethical obligation to assess our own biases, our assumptions about those who are “other,” and the impact this has on how effectively we perform in our roles as helpers.

Bias lives in all of us and it plays out in our personal and professional lives in many ways. As researchers, we may be aware of the arduous task of recruiting a diverse subject pool, recognizing that generalizing results to the larger population when your subjects do not reflect the community is more than just a pitfall of doing human research.

As clinicians, claiming color-blindness in your patient interactions is not something to boast about but rather highlights your inability to see how dismissive that can be to your patients’ experiences.

As educators, neglecting to train your students to be aware of the impact social determinants of health and mental health have on the patients they treat leaves them unable to impact this destructive cycle.

As a program administrator, lamenting the lack of a diverse applicant pool and looking to your human resources department to change that reality, certainly will not result in a more diverse work force.

As a systems administrator, requiring participation in diversity trainings without a willingness to review and adjust structurally racist aspects of your organization, will continue to thwart a diverse, equitable and inclusive work environment.

Recently, our department competed for and won the College of Medicine-Tucson (COM-T) Diversity, Equity, & Inclusion Departmental Achievement Award. This was noteworthy not only because it was the first time that COM-T offered this specific recognition, explicitly demonstrating the shift toward greater accountability, but also because it gave our faculty, staff, and trainees an opportunity to celebrate our significant accomplishments to date. But of course, we are not done. This taking stock also offered clarity about how much is still ahead of us as we strive to live out our stated commitment to very deliberately choosing to be anti-racist and being compelled to take actions to end racial inequities in our daily lives and the lives of our patients, students, and colleagues. We very publicly have resolved to ensure our behaviors as healers, educators, and administrators meet these ideals.

This past year and a half has brought about many changes in the ways we interact with others, in particular with our patients. Additional areas of disparities have come to the fore, challenging us to further examine how we provide effective services, including ways to address new access to care issues.

In my current role, I have the tremendous opportunity to keep these realities front and center, to not allow those who I can reach with my words claim they didn’t know. I am acutely aware that as a Black woman in an academic medical center and as a psychologist in a department of psychiatrists, those who are not interested or want to dismiss the message will do so with impunity. It is however my sincere belief that movement, even incremental, leads to change. The voices that are willing to both ask the questions and consider their own part in maintaining the status quo are gaining momentum.

No matter how tired, stressed, or frustrated we are, disparaging comments about a patient’s commitment to treatment, communication skills, or worthiness of our time and effort, have no place in our practice. We must strive to lead by example, always, leaving no room for questions about our willingness to reflect on our contribution to disparate treatment of some in our society. We must commit to be open to such introspection, certainly in our chosen profession but ideally also within other parts of our lives.

So, let us give some hope to that medical student. The question was a real one, one that reflects that we owe our future physicians clarity about our roles in leading change, both by our words and actions.

I would challenge you to ask yourself this (simple) question:

About the Author: Dr. Harrison-Monroe is Clinical Associate Professor and Vice Chair of the Department of Psychiatry, University of Arizona College of Medicine and has been a faculty member and clinical supervisor since 2005. As the Chief of Behavioral Health for the Department of Psychiatry, she oversaw both inpatient and outpatient behavioral health services, overseeing the construction and program development of the Behavioral Health Pavilion for the Department. She served as the Director of Community Outreach & Clinical Development for the Department of Psychiatry and was responsible for the development of educational initiatives to reduce stigma within underserved communities on a local and statewide basis. She also served as Director of the Early Psychosis Intervention Center (EPICenter), where she oversaw clinical services for individuals in the early stages of psychotic illness and their families. For more biographical information and select publication references, CLICK HERE.

The American Psychiatric Association (APA) Division of Diversity and Health Equity established the MOORE Equity in Mental Health Initiative to educate and bring awareness to unmet mental health needs of marginalized communities and to honor Bebe Moore Campbell who was a mental health equity champion and a New York Times bestselling author who worked to raise public awareness of minority mental health needs. During July 2021, during the Bebe Moore Campbell National Minority Mental Health Awareness Month, APA hosted the inaugural MOORE Equity in Mental Health 5K Run/Walk/Roll where individuals and teams such as the AZ Psych Society Team Summer Heat helped raise over $85,000. Across the USA and four continents, there were 26 teams and individuals all running, walking, and rolling! Through a partnership with the APA Foundation, this initiative will support individuals and community organizations that have undertaken innovative awareness programs and/or have provided services to improve the mental health of young people of color through the MOORE Equity in Mental Health Community Grants Program. Please save the date to join this effort next on Saturday, July 9, 2022.

The MOORE Equity in Mental Health Community Grants Program will soon be announcing the grant recipients pending finalization of award contracts. Although this grant program award cycle has concluded until 2022, the APA Foundation currently has grant application cycles open supporting diversity through the Awards for Advancing Minority Mental Health and the Helping Hands Grants Program.

"Everything you do makes a difference. You just have to decide what kind of difference you want to make.” - Jane Goodall

The Arizona Psychiatric Society invites you to make the difference of leadership! Click below to submit an interest form in serving on an APS Committee, including the newly formed DEI Committee or Patient Safety Training Standards Work Force. Membership Committee, which supports the vital role of building and engaging the membership through outreach, events, and communication, chaired by Dr. Gagandeep Singh, is looking for members to help plan events, outreach, or membership activities for 2022. Members are also invited to submit their interest in serving as an executive officer for 2022-2023.

The Society thanks Senator Nancy Barto and Representative Regina Cobb, DDS, APS Lobbyist Alexis Glascock, APA Regional Field Director Marsi Thrash, and Government Affairs Chair Dr. Don Fowls, together with the members who attended the Arizona Psychiatric Society advocacy event for a great conversation celebrating advances in the 2021 legislation that supported mental health (including step therapy reform and the telehealth act) and how physicians can continue to contribute to improving mental health through advocacy. CLICK HERE for a listing of mental health advocacy resources shared during the online event. The Society also thanks the event sponsor, Janssen Neuroscience, for their support of mental health advocacy.

CLICK HERE to read the Psych News article on telehealth legislation adopted in 2021 in several states, key among them the telehealth omnibus act adopted in Arizona. For a white paper made available to all Arizona physicians by the Arizona Medical Association providing an overview of the telehealth legislation and its impact to Arizona physicians, CLICK HERE. This report provides Arizona physicians and medical practices with the key information needed for their practice of medicine together with information on how to gain access to telehealth tools for your practice. Although ArMA collects your contact information in order to provide access to the document, that information will not be reshared with any other organizations or used for any purpose other than allowing access to the white paper.

The Arizona Department of Insurance and Financial Institutions (DIFI) withdrew the first published Notice of Rulemaking around the mental health parity regulations to be developed to enforce the provisions of Jake's Law and in November of 2021 made available a preliminary draft of a second Notice of Rulemaking changes for comment by stakeholders. CLICK HERE to read the comment submitted by the Arizona Psychiatric Society. Resources around mental health parity have been developed by DIFI that can be shared with your patients to help them understand their rights around mental health parity. An update on the rulemaking progress is expected in early 2022.

CLICK HERE to access a SharePoint file of the Sunrise Applications submitted in 2022 together with Summaries. The Arizona Psychological Association submitted a Sunrise Application for 2022 that outlines a proposal to create a new specialty within the scope of practice for psychologists. This specialty would allow certain qualified psychologists to prescribe medications as an additional service within the practice of psychology pursuant to terms to be identified in state statute. If you would like to contribute to the work of the Government Affairs Committee opposing this effort, please contact Teri. Please watch for time-sensitive alerts and calls to action to follow at the first of the year.

In celebration of its 35th anniversary, PRMS is continuing an exciting contest for the 35^th Refer a Colleague referrer from November to the end of the year. The individual, group, or organization to provide the 35^th referral will earn a special $350 donation to their chosen behavioral health organization. Please find a complete list of qualifying organizations here.

As you are aware, regulations have been recently finalized that require certain patient protections to address concerns about surprise bills. These protections not only address emergency care but include disclosure requirements for all uninsured or self-pay services, and will, at some point in the future also include patients with insurance. These regulations formalize some of what psychiatrists/providers already do when communicating fees to patients seeking care or for whom psychiatrists/providers are providing care. The APA has developed a summary of the key requirements along with links to templates for your use. 

If you have any questions, please contact Maureen A. Maguire, JD,

Associate Director – Parity Compliance and Enforcement.

The APA submitted comment letter to Secretaries Yellen, Walsh and Becerra at the Department of Labor expressing concerns with Interim Final Rule Requirements Related to Surprise Billing: Part II implementing the No Surprises Act (NSA) on December 6, 2021. CLICK HERE to read that letter.

APA hosted a virtual congressional briefing to highlight the mental health disparities experienced by diverse communities and how the COVID-19 pandemic has exacerbated these disparities. The briefing was moderated by APA President, Dr. Vivian Pender, and included presentations and insight from expert panelists Dr. Bernardo Ng and Dr. Glenda Wrenn, who are APA Members, as well as Dr. Lisa Cooper of John Hopkins University. The panelists answered questions from the audience regarding topics like cultural competency in medicine, social determinants' relation to mortality, and how Congress can reduce disparities experienced by diverse populations. The recorded briefing can be accessed here.

APAPAC is the political arm of APA – the voice or the organization on Capitol Hill and how we get mental health champions elected to the U.S. Congress. 2021 APAPAC members receive(d) an APAPAC member e-mail signature badge to celebrate their support. CLICK HERE to join APAPAC and receive your APAPAC e-mail badge and/or to sign-up for APA Advocacv Alerts.

The November 2021 APA Assembly was held virtually on November 6-7, 2021. Arizona was well represented at the Assembly, with Arizona Assembly Representatives (Drs. Gretchen Alexander and Jason Curry present. as well as Dr. Jasleen Chhatwal, attending as APA Assembly ECP Chair, and Dr. Magnolia Swanson, Area 7 RFM Assembly Rep. While the Annual Meeting APA Assembly is planned to happen in person in New Orleans in 2022, the November Assembly is currently projected to continue as a virtual event for budgetary reasons.

CLICK HERE to view the full APA Assembly Notes, with details of the specific position statements and action papers, awards, and APA reports that were part of the APA Assembly.

CLICK HERE to view the recently published fifth annual Janssen U.S. Transparency Report (summarized on the infographic above). The report continues to demonstrate our commitment to responsible business practices that put patients first, including how we invest our resources, price our medicines and support access for patients.

Now as always, the report reflects our fundamental belief that people should have access to the medicines and vaccines they need:

• For 2020, the average net price decline of our medicines: -5.7%.

• At the same time, we continued to increase R&D investment — to $9.6 billion — over twice what we spent on marketing and sales.

• In 2020, the rebates, discounts and fees we provided totaled $29.4 billion, more than half the list price of our medicines.

• Nevertheless, in the health system, patients are facing higher exposure to costs with rising deductibles, cost-sharing and direct costs at the pharmacy counter.

• That’s why this year, for the first time, we break down those discounts by channel – to drive a more informed conversation about who should benefit from those savings.

• To advance policies that bring better health for patients (physical as well as financial) we offer solutions to reduce healthcare disparities, expand affordable access and foster innovation.

We issue this report each year because we believe open dialogue and partnership are essential to expanding affordable access for patients today and providing greater hope for patients tomorrow, and we are committed to being part of sustainable solutions that put patients first.

The report and one-page executive summary are available on our Janssen U.S. website at janssen.com/ustransparencyreport.   CLICK HERE to download the one-page infographic.

WE SHARE THANKS AND CELEBRATION with the residents and leadership of the Arizona Psychiatric Residency Programs and their supporting faculty and administrators for all three programs participating in 2022 as 100% Clubs! Arizona is proud of the high standards held by these residency programs, the residents, faculty, and administrators alike, and celebrates their pursuit of excellence in psychiatry and contributions to the community.

If you are interested in converting your practice to virtual care, we can support you in this process. For more information call Abraham Barton at 602-577-4385, Abraham.barton@faspsych.com, or Mark L. Rubin, MD at 480-848-6139, Mark.rubin@faspsych.com for confidential information.

Update to Part 1; The Nevada Psychiatric Association Psychopharmacology Update in February of 2022 will be a Hybrid Model; attend in person, or online; same price. 

On September 22nd, MGH announced that it will be offering Virtual Curbside Consultations as part of their upcoming Psychopharmacology 2021 virtual meeting…at an additional fee of $125 per 1 hour group session, or $600 if all six sessions offered are purchased. These used to be included in the in-person conferences.

CLICK HERE for highlights of notes taken at the 3 conferences mentioned in the APS Summer Newsletter. As it is a total of 7 days of conference time, content is abbreviated.

Joseph D. Bloom, MD, Thomas E. Hansen, MD, and Amela Blekic, MD

Journal of the American Academy of Psychiatry and the Law Online December 2021, JAAPL.210055-21; DOI: https://doi.org/10.29158/JAAPL.210055-21

Journal of the American Academy of Psychiatry and the Law Online December 2021, 49 (4) 618-622; DOI: https://doi.org/10.29158/JAAPL.210033-21

It is an honor to share the publishings of our Arizona Psychiatric Society members. We invite members to share their recent publications. To submit, please contact Teri.

CLICK HERE for more information on the American Psychiatric Association Fellowship opportunities. Deadline for APA Fellowship applications is January 31, 2022, with the exception that SAMHSA MInority Fellowship deadlines have been extended to February 14, 2022.

WITH OUR BEST WISHES FOR A HAPPY AND HEALTHY HOLIDAY SEASON, AND WITH THANKS FOR ALL YOU GIVE AND PROVIDE TO OUR COMMUNITY. If you have not renewed yet, please take a moment to continue your membership today. Thank you to all who have renewed for 2022.