APsaA's president is enlisted in the Association's advocacy efforts as soon as he or she takes office. The president serves as APsaA's official voice in letters to Congress, press releases, and occasionally expert testimony. In the process of serving this function on your behalf, I have gotten something of a primary education in issue advocacy. My observations have led me to several new initiatives within the organization and a slightly different way of thinking about APsaA and advocacy.
APsaA has a proud history of impressive lobbying and advocacy efforts especially in the areas that most directly affect our practices and our patients—issues like privacy, patient's rights, and keeping a watchful eye out for unintended negative consequences of new health policies such as “comparative effectiveness research” or “pay for performance.” We have achieved an important presence on Capitol Hill in relation to these core issues. For example, in mid-December, Jim Pyles leveraged our long experience with privacy and practice related legislation into renewed attention by key senators to the need for including language protecting the right to private contracting in a final health care bill. We also provided the proponents of health care reform with a new argument for paying attention to one of our issues: Opponents to the health care bill were using the right to private contracting as an argument against the bill. Our added language would neutralize this objection and preserve the patients' option of obtaining mental health treatment without any record.
By the time you read this, the health care reform landscape will have changed many times since Washington was blanketed in an unprecedented snow, but the lesson lasts. This is exhilarating and vital work. Success turns on pulling the pieces together in a day or an hour, but it works only when it's founded on years of having established a presence, having legislative language for change or protection right at hand, possessing working relationships, and lots of documented background research. Such a presence in Washington not only advances our causes but reminds the broader community of the continued vitality of psychoanalysis.
I have come to think of the type of advocacy I described above, where our representative is right in the thick of legislation being developed, providing the research, arguments, and even the actual wording on a narrow but vital range of issues, as “primary advocacy.” We can only perform at this level on a very small number of issues, and privacy and the right to private contracting are currently our core issues
Members interested in following the work of the Committee on Advocacy Relations can contact its newly appointed chair, Kate Schechter, at .
There is a secondary level of advocacy which has also worked very well for us and is a common practice in Washington. A coalition of groups who share common goals join together and collectively write letters of support or opposition to legislation—or sometimes participate in the writing of legislation. The main tools in this type of lobbying are the “sign-on letter” and a constituent push. The sign-on letter is written by the coalition (staff or designated member) and then circulated to the member groups for their approval and imprimatur. The letter goes out to the key committee of legislators on Capitol Hill with signatures from 30 or 40 organizations, representing perhaps several hundred thousand people. An e-mail push is when the coalition contacts its member groups and suggests that the organization tell its members to write their representatives taking a particular position on a bill.
APsaA is a member of the Mental Health Liaison Group (MHLG) a coalition of 57 organizations that takes positions on a wide range of legislative efforts and appropriation bills regarding mental health in the broadest sense. Visit the MHLG Web site () and click on “Issue Statements” for a clear view of what this kind of work entails.
But as successful as these efforts have been, there has remained a gap in our advocacy efforts. There are issues and causes of great importance to many of us that we would like to support as analysts and as an analytic organization. But we don't have the resources to become the lead lobbyists in all these areas.
I began to notice that while primary and secondary advocacy efforts were going very well in our organization—well structured and obtaining results of which we can be very proud—there remained a gap in our advocacy efforts where we could accomplish much more.
There are issues we care deeply about—human rights, children's welfare, education, soldiers' and veterans' lives, gay and lesbian issues—which are not expressly and uniquely psychoanalytic.
Prudence L. Gourguechon, M.D., is president of the American Psychoanalytic Association.
An organization our size cannot achieve a primary level of legislative activism on every issue that interests us. Other organizations have focused a great deal of research and study on a wide range of issues and have developed legislative agendas and coalitions to promote their goals.
In some of these areas we have already developed important resources and “assets.” For example, we have a unique and impressive set of Association-approved position statements and amici briefs on a wide variety of gay rights issues. And we have a Soldiers and Veterans Initiative with a strong presence on our Web site, including position statements, resources, volunteer opportunities, reading lists, and more. A journalist has told me that we are the only mental health organization with a position statement on the damage done by the “don't ask, don't tell” regulation regarding gays in the military.
Nevertheless, I noticed that practical constraints made it difficult for us to participate fully in advocacy efforts regarding these important but non-core issues. And, it seemed to me that some of our terrific resources were not being fully used.
To fill that gap, I have created the new Ad Hoc Committee on Advocacy Relations (CAR). The idea is this. We will find organizations that do great work in legislative advocacy on issues we care about. We will piggyback on their research and policy experience and tentatively “borrow” their legislative agenda.
The committee will start with considering four issues. The four issues are gay rights, soldiers and veterans, children, and poverty. CAR will learn about the legislative agendas of selected organizations, trying to identify those that share our values and interests and take a broad and moderate point of view. The committee will come back to APsaA with recommendations about sign-on letters and other types of engagement. Over time, we hope the CAR members will introduce APsaA to these organizations, establish relationships, and make them aware of resources we can offer, such as position statements and expert opinion. A liaison effort has already begun with the Iraq and Afghanistan Veterans of America and the Human Rights Coalition. Other groups related to veterans, gay rights advocacy, children's issues, and poverty alleviation will be tagged and liaison efforts initiated.
Members interested in following the work of the Committee on Advocacy Relations can contact its newly appointed chair, Kate Schechter, at .
Note: APsaA maintains a non-partisan stance on social issues, and obtains approval from the Executive Council on specific policy positions.