When I took office as president of the American Psychiatric Association last year, I selected “Our Children: Our Future” for my presidential theme. I chose this theme for many reasons, personal as well as professional, but primarily because I thought the time was politically and scientifically ripe for psychiatrists to launch a concentrated effort toward achieving a mental health system in this country that offers appropriate, high quality, and flexible care to any child who needs it. I have been heartened by the growing strength of advocacy groups of patients, their families, and concerned citizens, and together we are bringing our message to federal and state legislators. I believe that if we continue in this path, by the year 2000 we will come close to achieving our objective. As psychoanalysts, you have important contributions to make to this effort.
The many recent developments in child analysis are fascinating, offering important insights into child development and human interaction. But in a time of scarce economic resources, such as we now find ourselves in, I fear that child analysis may not continue to exist as we've known it in the past. Given the constraints imposed by third-party payers and the proliferating managed-care plans, only a select few families are able to afford—both in terms of finances and of time—the commitment that child analysis requires.
This is truly regrettable; child analysis has made a profound contribution to our understanding of human behavior. Thus, it is essential that child analysis not only survive but be allowed to flourish and add depth to newer treatment approaches in child psychiatry.
Psychoanalysts have always been flexible and creative in their study of the human mind and approach to patient care. As we face perhaps even more difficult economic times ahead, it is more important than ever that this flexibility and creativity be used to adapt and modify knowledge and research findings in child analysis to improve and enrich the more encompassing field of child psychiatry and thus benefit so many more children. I am confident that my colleagues in child analysis will rise to such a challenge.
Thank you for giving me this opportunity to share my thoughts with you. APA looks forward to continued fruitful collaboration with the American Psychoanalytic Association.