Circular Letter #662 - Fall 2022

#662

DATES OF FUTURE GAP MEETINGS:

2023

April 20–22

Hyatt Regency, Greenwich, Connecticut

November 9–11

Sonesta Hotel, White Plains, New York

2024

April 4–6

Sonesta Hotel, White Plains, New York

November 14–16

Sonesta Hotel, White Plains, New York

Message from the President

Greetings.

Hope everyone had a wonderful holiday and a bright start to 2023. I’ve taken some time to reflect on our Fall GAP meeting and to start looking ahead to the new year. For me, highlights of the Fall meeting at the Old Greenwich Hyatt Regency were the opportunity to work and play in person with our GAP colleagues, the outstanding plenary session on “Psychedelics in Psychiatry” presented by our outgoing GAP Fellows and the extremely productive retreat, “Reimagining GAP”.

Attendance at the recent retreat was three times larger than expected reflecting an overwhelming active interest by the membership in the present and future mission, organization, and operation of GAP. Under Mary Barber’s skillful leadership, discussion was wide-ranging and spirited with scores of topics discussed. The challenge after such a productive interaction is to use the ideas presented by the members to begin crafting a template for GAP’s future. Let me take a minute to speak to a few of the many important topics raised by members.

GAP OFFICERS:

President

Calvin R. Sumner, M.D. docsumner@gmail.com

President Elect

Robert P. Roca, M.D. rroca2@jhmi.edu

Secretary

Sy A. Saeed, M.D. saeeds@ecu.edu

Treasurer

Gail E. Robinson, M.D. gail.robinson@utoronto.ca

The Executive Committee met with Mary and several members of the Planning, Marketing and Communications Committee on December 19 to review the retreat. It was clear to all that there is a strong desire among GAP members to more effectively share and interact with the broader GAP membership beyond the members of one’s own Committee. This reinforced the principle that the strength of GAP is in its total membership. GAP is more than just an organizational framework within which small nodes of Committee interest and expertise operate. The challenge going forward is to create opportunities to better utilize the strength of the assembled GAP membership to address critical issues at the interface of psychiatry and society. Look forward to some activities at the Spring meeting to facilitate these broader membership interactions.

One of the recurring themes from members was a recommendation that GAP affirm and practice the organization’s commitment to equity, diversity, and inclusion. It certainly makes sense since organizations that embrace diversity can better adapt to changes in the environment and respond by providing innovative contributions. To support GAP’s growth, I have appointed a sub-committee of the Steering Committee and charged them with drafting a GAP vision statement for equity, diversity, and inclusion (EDI Statement). The group of seven Committee chairs under the leadership of Roberto Lewis-Fernandez will develop an EDI Statement that affirmatively states GAP’s commitment to walking the walk and not just talking the talk. Through systematic integration of a variety of perspectives, GAP will be better able to

Message from the

President Continued. generate substantive contributions to our profession and society in response to complex problems in an increasingly diverse world.

Consistent with this theme, I have supported a recommendation from the Systems Innovation and Transformation Committee and the Social Justice Committee to jointly conduct a GAP survey of current member attitudes and organizational performance in the areas of equity, diversity, and inclusion. The EDI Statement and the attitude and performance survey will serve as a guidance document for the continued growth of GAP through substantive, transformative and sustainable change.

During the retreat, there were several questions about GAP finances. Although expenses continue to rise GAP will maintain active member dues for the coming year at $995. Those at the retreat clearly stated that for prospective new members recently out of training, the amount of the members’ dues could be a barrier to becoming a GAP member. This has been a recurring theme and we’ve finally been able to make some progress in supporting early career psychiatrists. With the Board approval of the Early Career Psychiatrist (ECP) program at the Fall meeting, each year GAP will offer up to three new members who are within five years of training a dues reduction to $495 per year for three years. The ECP program will be supported through the charitable donation of the Justin McCarthy family. This program will be for new members who were not GAP Fellows and is in addition to the current early career dues reduction available to former GAP Fellows.

At the retreat, several members asked for more transparency in GAP finances. At the Spring 2023 GAP meeting, Gail Robinson, Frances, and I will set aside time to meet with any members who have specific questions or would like to have more information on GAP finances.

No retreat would be complete without discussions of operational issues such as meeting logistics and finances. Many factors impact how GAP meets and when GAP meets. Although there was a diversity of opinions at the retreat, the preponderance of sentiment was that GAP will continue to meet in person twice a year. GAP is contracted for one more meeting at the Hyatt and the prevailing opinion was that we should identify a different place to meet. Frances resourced over 30 properties in the northeast and around the country near major transportation centers. Considering all of GAP’s requirements for a meeting venue and the venue’s willingness to negotiate a financially reasonable contract, the Executive Committee supported the selection of the Sonesta Hotel in White Plains, NY for the Fall 2023, Spring 2024 and Fall 2024 meetings. Let’s hope we can find a meeting home as accommodating as the Renaissance had been. See you all in April.

All the best,

Calvin R. Sumner, MD, MA, LMAPA

UPDATE FROM THE FELLOWSHIP SELECTION COMMITTEE

The Committee selected 14 new Fellows for the 2023–2024 rotation. We look forward to the opportunity to welcome them in person in April.

Sally Huang, MD

Stanford Adult Psychiatry Residency Program

Kevin Patrick Kennedy, MD

UCLA Psychiatry

Sean Lynch, MD

Icahn School of Medicine—

Mount Sinai Beth Israel

Alexander McClanahan, MD Medical University of South Carolina

Maria Ghanbari Motlagh, MD

Yale School of Medicine, Department of Psychiatry

Marcus Moreno, MD

Yale School of Medicine, Department of Psychiatry

Vinh-Son Nguyen, MD

Baylor College of Medicine— Menninger Department of Psychiatry and Behavioral Sciences

Shelby Powers, MD

Duke University School of Medicine

Samuel Rosenblatt, MD

Temple University of Psychiatry

Ivy Song, MD

UC Davis Health

Maya Torain, MD

Hospital of the University of Pennsylvania

Laura van Dyck, MD

The Mount Sinai Hospital, Psychiatry

Joshua Wortzel, MD

Brown University School of Medicine, Department of Psychiatry

Update from the Publication Board Meeting

Present: Drs. Adler, Appel, Casoy, Drescher, Dube, Erlich, Landess (remote), McIntosh

Remote: Robinson, Jackson, Wong, Sumner

1. Since April 2022 committees may have been active but reviews sent to us have slowed down considerably.

2. Update on Manuscripts:

a. There were only 4 approved manuscripts in the past six months (3 to Journal of Nervous and Mental Disease).

i. Adolescence: Stigma and Pregnancy (Published 9/22).

ii. Women and Gender: Roe v Wade fallout.

iii. College Student: Covid Fallout.

iv. Professional and Ethics: Vaccine Hesitancy (Psych Times).

b. CL submitted a manuscript that is undergoing revision.

3. The Psychiatry and Law committee completed and had approved an outstanding series of short pieces introducing MH professionals to the major legal issues facing us that will be on a website.

4. The Planning, Marketing and Communications Committee is gathering all websites that currently house GAP products as we redo the GAP website to maximize visibility of GAP products. All Chairs are encouraged to review and send Frances Bell updates on their committee membership and work.

5. We have entered the Blog world with a series of approved pieces that will/have appear in Psychology Today as a GAP Blog: Gender Affirming Care (LGBT); What happened to adolescent therapy (Psychotherapy); why your brain needs a workout (Aging); Weighing in with two more in the works and 13,000 hits in one month. Jack presented to the membership the following information:

How Does the Blog Work?

• Any GAP member

• Blog Writing Group all welcome—perhaps Zoom meeting in new year

• Publications Subcommittee: Jack, Carol, Tom and Amy Franklin

• Approval by David Adler and GAP President Cal Sumner

What We’ve Done Since First Post on September 28 (post twice a month) > 13K:

• Tom Franklin on Adolescence >3K

• Sehba Husain-Krautter and Bob Roca Aging: Why Brain Needs a Workout almost 7K

• Jack Dresher Puberty Blockers about 1,500

• Jeff Freedman—Letter-writing to newspapers, almost 2K since last week

• Upcoming: Chris Heath How to talk to family members about difficult topics during holiday gatherings

Audience:

• General Audience interested in Mental Health Issues

• Mental Health Professionals

• Journalists (blog makes GAP products more accessible)

• Policy Makers

Purpose:

• Show people what psychiatrists think about in a think tank

• Address topical issues: abortion, immigration, addiction

• Publicize recent GAP publications

Format: Take a Look at Posted Blogs

• 400 to 1800 words

• Offer a vignette or summarize recent news story outlining issue/problem

• Minimize first and second person (“we think that you”) approaches—makes unwarranted assumptions about your reader

• Links to research that supports your opinions— as many links as you think are helpful

• Be persuasive rather than polemical or didactic • When appropriate, offer some solutions

What We Need:

• Volunteers—1, 2 or more committee members willing to write

• Inventory

How to Get Started: Contact Jack Dresher About Possible Blog Topics

6. For the retreat David Adler put together a spreadsheet of all committee productivity since our last retreat in 2016 which will be updated and circulated to the membership in the post meeting circular.

& LEADERSHIP

and Virtual Meeting

Members attending: Victor Buwalda, John Lauriello, Farooq Mohyuddin (virtual), Britta Ostermeyer (virtual), Jorge Petit, Sy Saeed, John Santopietro, Stu Silver (virtual), and Tobias Wasser.

Fellow attending: None

Guests attending: Aliya Jones

APPROVAL OF THE AGENDA

The following agenda was approved:

• Welcome and Introduction

• Approval of the Agenda

• Minutes from Spring 2022 meeting

• Current Projects

• International survey on psychiatric administration and leadership, and the effects of COVID-19 pandemic on the needs of psychiatric administrators.

• Follow-up on the survey of residency training directors

• APPI Textbook of Psychiatric Administration and Leadership

• Current Status of the textbook perspectives

• Meetings Presentations

• Possible presentation at international congresses and the APA

• Committee membership and leadership discussions

• Potential Guests at the Spring 2023 Meeting

• Other business

• Adjourn

APPROVAL OF MINUTES (Committee Chairs Report) from Spring 2021 meeting

Approved as previously recorded and submitted

WELCOME AND INTRODUCTIONS

After the introductions and a special welcome to Dr. Jones as a firsttime guest to our committee, the minutes from the Spring meeting were approved as submitted electronically.

Sy provided an update from the general membership meeting this morning and emphasized the importance of the retreat, “reimagining GAP” scheduled for Saturday at this fall meeting. He mentioned that everybody was invited, and encouraged, to participate. It will be about reimagining GAP, in an ever-changing world with the availability of new technologies and expanding field of psychiatry. It will also address practical areas like dues, number of meetings per year, location of

COMMITTEE REPORTS

ADMINISTRATION & LEADERSHIP Continued. meetings, etc. For virtual attendees, a Zoom link has been provided and was also included in the agenda. We exchanged notes on changes in our roles/ responsibilities and what is going on in our communities. We discussed several areas including continued impact of COVID-19; current mental health crisis (e.g., CNN study that 90% fear that we have a mental health crisis); workforce shortages; closure of mental health care delivery systems across the nation; role of the leadership in the current healthcare systems; how non-profit systems feel isolated in the current macroeconomic environment with the difficulty that non-profit organization are not in competition with for-profit organizations as they work for the most vulnerable, the very critically mentally ill patients; role of the behavioral health “service lines” in the changing healthcare environments; and how we need to advocate for behavioral health. We also discussed some keywords/phrases, including common threat, value proposition, service line, bent the cost curve, wellbeing, diversity, and inclusion, etc.

CURRENT PROJECTS:

• International survey on psychiatric administration and leadership (VB & JP) and the effects of COVID-19 pandemic on the needs of psychiatric administrators. We discussed whether the survey still had added value and if it was not too out of date, as we lost a lot of time on the process. The questionnaire was based on the previous published work of our committee when we surveyed an American sample. The international survey was first disseminated in 2019. The members of GAP also filled out the survey at one of the GAP meetings. The survey has been previously reviewed by the GAP publication board and an IRB exemption has been secured. We also collaborated with the International Initiative for Mental Health Leadership (IIMHL). In the meeting today, it was agreed upon that we will request the IIMHL to participate again. If the IIMHL agrees we will disseminate the survey and finalize the analysis before the next GAP Spring meeting. If not, we will discontinue this international survey project.

• Follow-up on the survey of residency training

directors (FM, VB, TW and BO). The idea was to work on a basic handbook for residents on administrative issues. Stu previously reviewed over 200 residency training programs websites to get a “feel” for what the training programs offered in training on administration and leadership to their residents, both in didactics and electives. We developed a survey for the training directors after this review. It was decided to send out the survey in February. FM and TW will meet the directors at AADPRT in March to bring it to their attention again and to ask them to fill it out. We hope to have the very preliminary data at the Spring meeting. JL will also inform Dr. Girkin, the new training director at Jefferson, about this project.

• APPI Textbook of Administrative Psychiatry. This project is finished, and the textbook promotional materials and order forms are now available at the APA website. The print copy is anticipated to be out between February and May 2023, hopefully by the next GAP Spring meeting. While the textbook is not a GAP publication, many committee members were heavily involved in writing chapters. GAP is acknowledged in the book. Also, GAP’s immediate past president wrote a review of the textbook which is on the cover. Saul Levin, APA CEO and Medical Director, wrote the introduction and mentioned the connections of the textbook to the committee and GAP.

• Meetings Presentations. Possible presentations at international congresses and the APA. When the textbook book is out, we could submit a symposium at the Institute of Psychiatric Services or for the APA annual meeting, like we did on a special theme issue on papers we published on administrative subjects in Psychiatric Quarterly.

• Other ideas for future committee projects. Britta suggested to start a workgroup to write an article on administrative psychiatry. The administrative psychiatry project would be rather pertaining to the role of psychiatry in university/ health care systems, service line organization (keep psychiatry/psychology/psychiatric SW together), and to ensure that psychiatry (the highest trained mental

COMMITTEE REPORTS Continued.

ADMINISTRATION & LEADERSHIP

Continued. health specialty) sits at the head of the table. First do a literature search and gather material for a longer paper on how administrative psychiatry has evolved over the years. John Lauriello suggested that writing papers is better than composing a book. A title for the article could be “What does the administrative leaders in 2030 look like?” The approach of writing a paper is also useful for working towards a session/ presentation at a conference. In this morning’s general session, we also learned about blogs when Jack Drescher described GAP agreeing to do 24 blogs a year for Psychology Today. Jack asked for subjects and the subcommittee of the Publication Board can help. We can write a blog on psychiatric administration with an appealing title that attracts attention. Stu mentioned that today it is important to know that there is an electronic interaction with patients. Our papers tend to be backwards looking and we need more forward-looking visions, e.g., writing about what is the ultimate role of the psychiatry interface of mental health and between computer and patient. Doctors are busy with algorithms, but the psychiatrist has the expertise to master the f2f interaction. Psychiatry is saving the interpersonal relationship for those who need it the most. We, psychiatrists, are a scare resource! Farooq mentioned that a blog about the online explosion needs to be addressed and how we psychiatrists integrate this into our daily work. Other topics to cover can include workforce issues, quality, automation, use of artificial intelligence in mental health, etc. We can also work on a new theme issue for a journal that include topics that cover the new landscape for psychiatric administrators and leaders. We agreed to exchange ideas on topics to write about through email. We also have an option available through GAP to invite consultants to our committee at future meetings.

COMMITTEE MEMBERSHIP AND LEADERSHIP DISCUSSIONS

Sy informed the committee that Brian Hepburn had indicated to leave GAP. This means that the committee can invite new members, starting as guest to a future meeting. In the past we have considered inviting: Ken Rogers, Lumig Li, and Laura Roberts. Sy followed up from the discussion in our previous meetings

regarding his desire to step down from this committee and to start another committee on “Telepsychiatry, Health Technologies, and e-Behavioral Health”. A formal proposal for this new committee was discussed at the GAP board meeting yesterday afternoon and the board approved it. The initial concept was previously discussed at the board in 2019.

Britta was proposed to be the new chair of the committee and was elected unanimously. She asked the help of the members to run the committee.

Committee members thanked Sy for his years of leadership and mentorship. Under his leadership many projects have been successfully completed.

Victor reported that he also planned to join Sy in his new Committee on “Telepsychiatry, Health Technologies, and e-Behavioral Health”

OTHER BUSINESS:

None.

ADOLESCENCE

Present: Daniel Becker, Gordon Harper, Aaron Krasner, Jean Wittenberg

Virtual: Lois Flaherty

Guest: Stephan Carlson in person

Virtual Guests: Jack Crookall, Liwei Hua, Mayank Gupta

Ittleson Consultant: Natasha Vianna

The Committee had a very successful and exciting meeting. We have been welcoming new guests over the course of the pandemic and continue to extend invitations to others who can increase our depth of knowledge and though as well as our level of energy. We are reviewing a range of topics before deciding on any specific one, having just completed a long project on teen mothers and stigma. We are continuing to develop the teen mothers project by creating publicfriendly products for their information and education as to the harmful effects of stigma on this vulnerable population. Sectors to be addressed include policy makers, educators, child protection workers, family doctors, and the general public.

FOCUS OF WORK ACCOMPLISHED

DURING THE MEETING:

Discussion about new projects. Discussion about modern platforms for communication of our work including blogs, social media, etc.

We have published a paper on the harmful impact of stigma on adolescent parents and their children in JNMD in August 2022 and have a book on the same topic in press with Springer.

The Committee has been meeting virtually once a month.

FOCUS FOR NEXT MEETING:

Continuing discussion and reflection on which new projects might be of greatest interest and benefit for us to pursue.

Discussion about possible collaborations inside and outside GAP on our teen mothers project as well as on other new projects. This begins with a blog in Psychology Today which we hope will be published soon—for that many thanks to Jack Drescher, Carol Bernstein and Thomas Franklin. We are now in the process of determining where we will direct our attention and efforts for new projects.

AGING

Members present: Susan Lehmann, Sebha Husain

Krautter, Helen Kyomen and Bob Roca

Guest: Ebony Dix joined

Remote: Maureen Nash

We discussed:

1. Blog posts:

a. Why Your Brain Needs a Workout has been visited nearly 7,000 times and is the most visited GAP posts thus far. We discussed further posts:

i. Susan and Ebony expressed an interest in creating a blog post on the pros and cons of early diagnosis of Alzheimer’s Disease using some of the new non-invasive approaches (i.e., blood tests and imaging). They will have a draft by mid-December.

ii. Bob and Sebha agreed to create a post to follow-up on the “workout” blog; the new one will look at the evidence for and against the

value of “mental exercise” as a way to preserve cognition/forestall cognitive decline. They will have a daft by mid-December.

iii. We also discussed a blog post on ways to reframe in a more positive way the otherwise difficult experience of cognitive loss for both patients and caregivers. There have been some moving testimonials about this. Another approach would be to put something together to assist caregivers in their work with a person living with dementia. This might include advice on dealing with “sundowning”, wandering, etc. This blog post will require further refinement before being written.

2. A photo-essay project

a. We are considering a photo-essay featuring photos of older adults (e.g., over 65) accompanied by their answers to one or both of the following questions:

i. What is wisdom, and do we grow wiser as we grow older?

ii. Tell me what you think/how you feel about being ___ (your age)

b. We would need to work out the practicalities of getting good portraits. Ideally, they would be taken by a professional photographer. Sehba’s husband, a professional photographer, has volunteered his services.

c. We will also need to explore legal/liability issues

3. Writing up the “disclosure of dementia diagnosis” research done by Helen and her student.

a. Helen will explore writing up the study on the emotional impact of disclosure of the diagnosis of dementia done by her and her student and presented as posters at the Annual Meeting of AAGP and American Geriatric Society.

4. Revising the chapter on older adults for the next edition of Fred Stoddard’s GAP book on Disaster Psychiatry.

a. Helen is taking the lead, and we aim to have a first draft by no later than January.

5. Inviting Ebony back as a guest for the April Meeting, with a plan to recommend for membership at that time.

COMMITTEE REPORTS Continued.

ARTS & HUMANITIES

Members attending: David Sasso, Chair, Anish Dube, Andy Lustbader, Ken Weiss, Helena Winston Fellow attending: Christopher Magoon

We spent Friday morning reviewing our overall mission as a committee and brainstorming about new avenues for topics and products.

Regarding our ongoing history video project, Ken Weiss will redistribute the current script and seek comment on how to move it forward.

We discussed possible topics for ongoing writing projects, in particular the opportunity to publish on the GAP blog hosted on Psychology Today.

We had a fascinating conversation via zoom with critically acclaimed classical composer Julia Adolphe, who shares interests in creativity and the arts and the experience of mental illness and treatment among creative professionals. She has produced a podcast on the topic and is currently in a fellowship program at the Boston Psychoanalytic Institute. We will follow up with her to see if there are potential points of collaboration (on her podcast, joint writing projects, etc.). Finally, we congratulate our fellow, Christopher, on the completion of his GAP fellowship and an excellent job on the fellow plenary, and we are excited to welcome him back over the next two meetings as a Ginsburg Fellow.

CHILD COMMITTEE

Member’s Attending: Dorothy Stubbe, Eunice Yuen, Susan Daily, Gabrielle Shapiro, Cynthia Pfeffer, Jonathon Dowben

GAP Fellow: Janet Baek on parental leave

Dr. Barry Sarvet has requested to step down as co-Chair and Dr. Eunice Yuen will take the position of co-Chair with Dr. Dorothy Stubbe.

Member’s Transitioning to Emeritus Status: The Child Committee acknowledges the enormous contributions of our emeritus members: Drs. John Schowalter, Peter Tanguay, and Ted Shapiro. We acknowledge their valued mentorship, contributions and friendship over their many years on the Child Committee. We will seek to acknowledge and honor them with a small gift.

Members to be invited: The Child Committee discussed colleagues to invite to join the Committee.

FOCUS OF WORK ACCOMPLISHED DURING THE MEETING:

The committee completed and submitted an article to the GAP publications board, Clinical Considerations in Working with Children of Color: Past, Present, and Future. The burden of systemic racism and health inequality for Children of Color and their family’s needs to be acknowledged and addressed in the provision of mental health treatment by child and adolescent psychiatrists. The article highlights the advances and ongoing challenges for child and adolescent psychiatrists in confronting issues of racial disparities in children’s mental health care more fully. The article will be submitted to the Journal of Child and Adolescent Psychiatry.

PLANS FOR BETWEEN-MEETINGS WORK: Child and adolescent mental health has been identified as a national emergency by multiple organizations. This large-scale epidemic is a challenge for communities, pediatric and mental health care providers, healthcare systems, and especially the children and families that are suffering. The Child Committee is considering an article addressing these issues. The details and outline will be the focus of our between meeting work.

CLIMATE

Present: Elizabeth Haase, co-chair; Janet Lewis, co-chair, Beth Mark, member, John Sullenbarger, ECP guest, Emily Schutzenhofer, resident guest, Josh Wortzel, Child Fellow

Unable to attend: Alex Yoon, fellowship applicant, Ferdnand Oswuagu and Andrew Olangunju

CURRENT PROJECTS: Curriculum study

This study aims to demonstrate the didactic effectiveness of a three hour climate curriculum. In our prior project, we demonstrated that there was resident and training director interest in climate education which increased with increased awareness of/exposure to information about climate mental health effects. However, because we aimed to show that a majority of residencies were interested

COMMITTEE REPORTS Continued.

CLIMATE Continued.

in this area and did not get an adequate percent of residencies responding, the study was limited. This current project does not have that limitation as we only need an adequate number of residents to show the material is learned. Difficulties of this project included study design validity, that much of the material to be studied and vetted comes from outside of psychiatry, and the making of the videos that will be used. We anticipate it will proceed slowly.

Target journal: Academic Psychiatry

Help requested: study design

States-of-mind paper

This paper, which is of great interest to us, aims to describe states of mind arising currently in response to the climate crisis, rooting them in natural metaphors which we believe are grounding both for lay use and use by psychotherapists aiming to help patients struggling with climate overwhelm as well as the demand for rapid change, whether through the need for a just transition in employment or through the emergent nature of the climate poly crisis. We anticipate this project will be completed by one year from now at the outside, preferably by July.

Target Journal: Academic Psychiatry

Other publication targets: Twitter, American Psychologist, Psychology Today blog, Psych Times

RETREAT

The climate committee participated in the retreat. In the Ethics and Justice group, we highlighted the need for a revision of the mission statement to define and include core GAP values in addition to intellectual inquiry—highlighting particularly the values of care, duty to warn, sustainability, and equity broadly conceived—as well as the need for an institutional self-assessment to see if we are actually living those principles. In the meetings group, we highlighted the need for anticarboniferous meetings to meet global warming targets for 2030 and the use of one zoom meeting per year as an optimal solution for this, as well as the use of our carbon footprint paper model to determine the optimal location for the meeting from both an equity and sustainability perspective.

In the working together group, we highlighted the need for social and environmental justice in the focus of our products and our interpersonal interactions as we respond to the dual challenges of the coming decades: emergent chaotic processes of change and the climate polycrisis/metacrisis.

The Climate Committee would like to express its continued gratitude to GAP for its support of these innovative ways of thinking and the import of climate change for psychiatry. At the same time, we were quite taken aback by what was felt to be a patronizing and dismissive tone taken by a female senior member of GAP who presented the meeting group discussion about changing the GAP meeting structure to improve our carbon footprint. We feel the need to highlight that the callous indifference towards the lives and wellbeing of hundreds of millions reflected in this stance— as it was perceived by a number of us, not only on our committee—reflects poorly on GAP leadership. We would suggest a reparative conversation about this with this individual were she to be open to it.

COLLEGE STUDENT

Members attending: Brunhild Kring (Chair), Francesco Peluso, Malkah Notman, Helene Keable, Alexandra Ackerman

Not attending: Meera Menon, Lorraine Siggins, Ludmila de Faria

Fellow attending: Isobel Rosenthal

PROJECT TITLES:

1. Psychological Development & Identity Formation in the Age of Social Media

Francesco Peluso & GAP College Student Committee

Here is a summary of key issues under discussion: What are the favorable and unfavorable conditions for emotional development and identity formation presented by social media? For example, opportunity to feel understood by peers, finding community online for isolated students or students who belong to certain social or identity minorities, staying in touch with family and friends across geographical distances, lack of in-person collective experience, certain feeds from social media can become “echo chambers” restricting exposure to different perspectives; the role of psychiatric

COMMITTEE REPORTS Continued.

COLLEGE STUDENT Continued.

self-diagnosis inspired by internet-based questionnaires and chat rooms (ADHD, autism, gender, anorexia, tics, trauma, My Mental Health); seductive social media algorithms are “hacking” the human mind, creating addictive behavior in vulnerable youth while serving capitalist marketing and mercantile interests;

2. Tele-Mental Health for College Students

Ludmila de Faria & GAP College Student Committee

This paper has been approved by the GAP Publication Board, and submitted for publication to the Journal of Medical Regulation. The committee continues to respond to editorial requests by the Journal for Medical Regulation. Resubmission is due in January 2023.

3. The Fallout of the COVID-19 Pandemic on College Students

Brunhild Kring & GAP Student College Committee

This paper has been approved by the GAP Publication Board. We are in process of submitting it to The Journal of Nervous and Mental Disease.

Anticipated Audience: General psychiatrists, family doctors, medical regulators and policy makers.

FOCUS OF WORK ACCOMPLISHED

DURING THE MEETING:

We discussed paper #1 and developed our ideas and hypotheses. The work on paper # 2 and # 3 is taking place in smaller subcommittees in between the semiannual GAP Meetings.

PLANS FOR BETWEEN MEETING WORK:

Our committee will be meeting monthly via Zoom. January and March 2023.

FOCUS FOR NEXT MEETING:

1. Welcome our Committee’s GAP fellows

2. Update GAP website

3. Continue to work on the paper about Psychological Development & Identity Formation in the Age of Social Media

Any ways in which members can be helpful? (e.g., suggesting guests, recent references relevant to topic, etc.

Attend scheduled zoom meetings; reflect on the influence of social media on the development of college students, write assigned paragraphs

CONSULTATION-LIAISON PSYCHIATRY

Members Attending: Viswanathan, Saunders

By Zoom: Pinkhasov, Gondim-Sales

PROJECT TITLE:

Clinical Controversy Article. Drawing the line between post-acute adequate of COVID-19 and functional neurologic disorders: A Daunting Clinical Overlap or Irrelevant Conundrum?

This project is anticipated to be completed by December 2022.

The Committee has submitted this manuscript to Journal of Nervous and Mental Disease.

Any ways the Publications Board might be helpful: The Board has been very helpful with the review process.

FOCUS OF WORK ACCOMPLISHED

DURING THE MEETING:

1. Nearly finalized the manuscript incorporating much of the feedback from the Publications Board

2. Began discussing a new manuscript on ECT in medical catatonia patients—disparities due to differing laws in different jurisdictions

3. Began discussing a new manuscript on Literature Review of psychiatric complications of TAVR. How many times have you met virtually since November 2020? Five times.

FOCUS FOR NEXT MEETING:

1. Resume work on a previous manuscript on ethical and decisional capacity issues raised by a patient with suicidal ideation who refused a lifesaving cardiac pacemaker.

2. Work on a new manuscript on ECT in medical catatonia patients—disparities due to differing laws in different jurisdictions.

3. Work on a new manuscript on Literature Review of psychiatric complications

COMMITTEE REPORTS Continued.

CULTURAL

Present: Francis Lu, Kenneth Fung, Roberto LewisFernandez

Via Zoom: Ladson Hinton, Pablo Farias

Fellow: Kelsey Wong

Guest: Ana Gomez-Carrillo, Ittleson Consultant

During the meeting we discussed a case study that Kelsey Wong is preparing for Clinical Psychiatry News. We also discussed a paper that we were finalizing for Lancet Psychiatry entitled: “Integrating Neuroscience in Psychiatry: A Cultural-Ecosocial Systemic Approach”.

We also meet via Zoom with members of the National Neuroscience Curriculum Initiative to discuss potential collaborations, including possibly writing articles together or preparing curricular materials as part of the NNCI documents, sharing authorship with the GAP Committee. Before the next in-person April meeting, we will meet 2 to 3 times by Zoom to continue to discuss the case with Kelsey and the potential collaboration with the NNCI folks.

GENDER & MENTAL HEALTH

Attending: Carol Nadelson, Leena Mittal, Natalie Feldman, Kara Brown. By zoom: Sophie Grigoriadis, Nkechi Conteh, Nirmaljit Dhami

Completed revisions on a paper on the role of language in women’s mental health. Almost ready to submit. We started work on a blog about pregnancy and bipolar disorder. Our paper on the Physical and Psychological Impact of Overturning Roe v Wade was in press (since published in Dec). Nkechi is now a full member and Natalie will stay on with our new financial support as a former Fellow.

LGBTQ+

Attending: Stewart Adelson, Joanne Ahola, Kenn Ashley, Mary Barber, William Byne, Flavio Casoy, Alexis Chavez, Jack Drescher, David Lopez, Lorraine Lothwell, Marlin Mattson, Scot McAfee, Chris McIntosh, Alan Schwartz, Andy Tompkins

PROJECT TITLE:

Collaboration with Yale Youth Equity Science in Global Health Partnerships.

Describe “state of science” regarding treatment of gender dysphoria and sexual orientation conversion efforts, relation to culture wars, to be completed

November 2023, with the first draft mostly completed. This will be targeted to practicing psychiatrists, advocates and legal scholars. This will be submitted to a first tier psychiatry journal.

FOCUS OF WORK ACCOMPLISHED DURING THE MEETING:

We completed most of the first draft of the manuscript.

PLANS FOR BETWEEN MEETING WORK:

Revision of manuscript in preparation for next meeting. How many times have you met virtually since November 2020? 5-6

FOCUS FOR NEXT MEETING: Completion of this manuscript.

MILITARY & VETERANS

Present: David Benedek, Robert Koffman, Harold Kudler, Elspeth Ritchie, Andrew Stone (GAP Committee on Terrorism and Political Violence)

1. Opportunity to Write a GAP Blog on the Psychology Today Website: GAP members and Committees are invited to contribute a 400–1000word blog for publication. Vignettes make for effective blogs. The Publications Subcommittee edits and reviews all submissions. Final approval rests with Dr. David Adler and GAP President Cal Sumner. GAP submits two blogs/month, every other Wednesday.

2. An Organized Campaign by Extremist Groups to Radicalize Service Members and Veterans at Time of Separation from Service (Andrew Stone led this discussion): Andrew shared a history of extremist groups seeking to recruit military members and veterans dating back at least a far as the Civil War. He pointed out that 15% of those arrested at the U.S. Capitol Building on January 6, 2021, had a military connection. Might it be possible to identify those at increased risk for radicalization and intervene early? A public health approach focused on individual and family wellbeing at time of separation and during transition to civilian life may be helpful in this. DoD, VA, Unit Organizations, Auxiliary Organizations, and Veteran Service Organizations could each play a role in intervention. The Center for New

COMMITTEE

American Security might also be helpful. Assessment and intervention would need to begin long before transition/TAP. An ongoing study of “The Social Determinants of Hate” being undertaken between the Center for the Study of Traumatic Stress (CSTS) at the Uniformed Services University of the Health Sciences (USU) and the University of Pittsburg may help shed light on key issues and possible solutions. Dr. Stone will develop a blog on this issue which will also help the Committee focus next steps.

3. Mounting a Time-Sensitive Response to a Serious Threat to VA Research Programs:

As per the news story at this link https://prospect. org/health/va-research-verges-on-breakdownwithout-congressional-action/ the Justice Department is seeking to enforce a recently re-interpreted rule which would prohibit VA research from being conducted in partnership with private medical schools. Prominent VA researchers are reportedly leaving VA to steer clear of this. Congress is currently debating the VA Infrastructure Powers Exceptional Research (VIPER) Act of 2021 (H.R. 5721) which would remedy this problem but it’s not clear that it has the support needed to pass. The Committee voted unanimously to advocate for VIPER [and, with subsequent approval by GAP President, Cal Sumner, joined nearly 90 academic, medical, and scientific societies in co-signing a letter to Congressional leaders in support of its passage]. Dr. Kudler has agreed to develop a blog on this issue.

4. Partnering with the Society of Uniformed Services Psychiatrists (SUSP) (a District Branch of the APA) to Help Military Psychiatrists Transition to Civilian Life and Careers:

Committee Members Drs. Ritchie and Bradley recently provided a panel discussion for SUSP to address this issue. How might our Committee leverage its unique military and civilian experience to help ensure a “good landing” as military psychiatrists transition to civilian life? Suggestions included creating a mentorship program for SUSP members and recruiting one or more early career DoD psychiatrist(s) to join the Committee(see

Item 8, below). Another idea is to offer a GAP grand rounds presentation at Walter Reed and/ or other DoD training sites (Dr. Benedek’s “Global Grand Rounds”? Suggested topics included the History of GAP (including the role of WWII military psychiatrists in developing the DSM) and lessons learned in OEF/OIF/OND. Dr. Ritchie suggested that the Committee develop a formal letter to the SUSP President with request for distribution to all SUSP members proposing such projects.

5. Response to the War in Ukraine: Can the Committee, engage and support both Ukrainian and Russian clinicians as they endure the effects of war from their respective sides of the battleline? We have already shared highly valued CSTS fact sheets developed for this conflict and available in both Ukrainian and Russian. Dr. Kudler has been participating in weekly Town Hall meetings with Ukrainian and Russian psychotherapists since February and has submitted a presentation on that process to the next meeting of the International Psychoanalytic Association. The European Congress for Neuropsychology is among organizations providing training on TBI and other relevant issues. Dr. Benedek has provided training on Combat Stress Control for responders through Project ECHO with Dr. David Riggs of the Center for Deployment Psychology. The Dean of USU holds that sharing such expertise is a legitimate part of the school’s mission. Dr. Ritchie will check with the Borden Institute, publisher of a text she edited, Combat and Operational Behavioral Health, to see if it can be shared electronically with responders overseas. Dr. Stone noted that the nonprofit, MedGlobal ( https://medglobal.org ), has been training Ukrainian health professionals on treating survivors of trauma. Committee members will explore opportunities to provide further support and training. Dr. Eric Vermetten was mentioned as a possible partner in this.

6. A Video History of Military Psychiatry in OEF/ OIF/OND: Military historian Michael Doidge, Ph.D. and U.S. Army Major Aaron Wolfgang joined us to help address the challenge of creating a video history that would collect and disseminate key lessons learned in both the military and VA in the

COMMITTEE REPORTS Continued.

MILITARY & VETERANS Continued.

years following September 11th, 2001. Dr. Ursano of USU has endorsed this idea. They advised that the success depends on asking the right questions Dr. Doidge has offered to formulate a list of questions for us based on successful strategies in the literature. One possible frame for our project is that military psychiatrists know more about the beginning of the combat stress story and VA psychiatrists know more about its long-term consequences. Major Wolfgang suggested that young and upcoming psychiatrists might prefer to access our findings through YouTube videos and brief texts which could be accessed online and/or incorporated into didactics from their attendings. SUSP could play a role both in producing/funding and disseminating our products. We may also want to include interviews with military support organizations such as Semper Fi and Veterans Organizations such as Team Red, White and Blue and discuss special topics relating to humanitarian deployments (such as to Haiti). We must clearly articulate (1) What information we want to collect, and (2) How do we want to get this into people’s hands? Firsthand accounts of experience in working down range and with detainees and POWs (e.g., Abu Ghraib and Guantanamo) could help our work “fly off the shelf.” We might best begin with just a few select interviews (at an estimated $2,000/interview for videography/ production) and share these with prospective audiences, publishers, producers. In a subsequent session, we were joined by GAP Public Relations advisor, Amy Franklin, who suggested that we might best capture the attention of military and VA psychiatrists and policy makers by developing a series of blogposts and other brief articles based on our interviews. She suggested that we start with just 4 interviews and offer them as a blog through GAP’s established relationship with Psychology Today. Then, based on the number of views and any feedback received, we can pitch our plan to other outlets/funders to create an entire series. Possible sources of funding include the National Endowment for the Humanities, various DoD history programs, and VSO’s.

7. Psychedelic-Assisted Psychotherapy: Dr. Koffman provided an update on the status of policy, research and clinical efforts. On the day prior to our Committee meeting, the Congressional Psychedelics Advancing Clinical Treatments (PACT) Caucus put forward a bill to increase knowledge on this topic. The Senate is considering moving Schedule I psychedelic agents to Schedule II to improve their availability for research. Dr. Koffman suggests that GAP create a subcommittee on Psychedelic Assisted Psychotherapy under an appropriate standing Committee.

8. Recruiting New Committee Members: Dr. Shannon Ford of the U.S. Army plans to attend as a guest at our April Meeting. Dr. Kudler will prepare a brief statement which can be shared with the SUSP and with the APA Caucus of VA Psychiatrists seeking nominations (including self-nominations).

9. Getting (and Making Good Use of) a GAP Fellow for Our Committee: We have repeatedly applied for a GAP Fellow. The video history project could strengthen our argument for having a Fellow. We could include a request for funding a fellow to be shared with the President of SUSP in concert with our request for their support in producing pilot interviews for the video history. Doctor Kudler will take responsibility for developing that paragraph.

NEUROPSYCHIATRY

The Committee has been meeting at least monthly on Zoom. We are nearing completion of a manuscript about a newly-recognized neuropsychiatric condition called D-MER (dysphoric milk ejection reflex).

PLANNING, MARKETING & COMMUNICATIONS

Attending: Bob Boland, John Looney, Jack Bonner, Harvey Ruben, Harsh Trivedi, Seth Powsner, Mary Barber, Lois Flaherty (by Zoom).

Saul Levin and Uma Naidoo unable to attend.

This GAP meeting, its 151st, was significant for its improved in person attendance and for the Strategic Retreat held Saturday 11/19 led by Mary Barber of our committee. We had a full agenda.

COMMITTEE REPORTS Continued.

PLANNING, MARKETING... Continued.

First, we met for an hour with the GAP PR consultant, Amy Franklin, and reviewed her work to date and plans for the coming year. Amy has been instrumental in the design and implementation of the new GAP web site, the initiation of the Psychology Today GAP blog and in a number of media placements and events. Her work primarily with the Media Committee is much appreciated and is considered by that Committee to be a long-range investment in enhancing the impact and visibility of GAP products and members for psychiatry, mental health more broadly and for society at large. She will continue her work next year which will also include media training for GAP members. Later in the day we met with Jack Drescher and Carol Bernstein, co-chairs of the Media Committee, who expressed their strong support for Amy and an active PR effort. Concerns were raised about cost and how to measure outcomes. These are ongoing concerns and every year we will revisit. We discussed a possible outside source of funding for PR which would then be less of a burden on operations.

Related to GAP’s visibility we looked at the new web site which is a major upgrade from the old site. Seth Powsner walked us through its various elements, noting a need for a protected Membership list page. Keeping it current and relevant to the outside world is a challenge as well.

The Dear Abby award will be given in the Spring at our meeting April 20-22. 2023. There were 4 nominations from GAP members and we selected Representative Jamie Raskin from Maryland for the award. His memoir, Unthinkable, about his son lost to suicide has made him one of the nation’s leading advocate for mental health care. Harsh Trivedi will reach out to him. We would buy books and make a donation for whatever charity he might designate. The date for his talk is Friday April 21 from 5 to 6:30. We will also reach out to Jeanne Phillips (Dear Abby) to attend. The Dear Abby award is presented now every 2 years.

We reviewed the agenda for the Strategic Retreat, “Reimagining GAP”, for Saturday with Mary Barber who will facilitate. The report on the Retreat will be in a separate communication but as these notes are written after the event, I just note that it was extraordinary that there were well over a hundred

attendees (we expected far fewer) in person and virtually. Mary did a superb job. Our committee will be involved in a number of follow up actions.

Fund raising has been an essential task for our committee with John Looney taking the lead and being a rainmaker for GAP. Three phases for fund raising were discussed. The first, which is mostly complete, raised nearly a million dollars for the GAP Fellowship which is now endowed through restricted gifts in perpetuity. The second, is raising funds for Early Career Psychiatrists (ECP’s) to subsidize their dues and bring in a younger cohort to GAP. The third, which was discussed at some length, was the possible linking/branding of committees themselves or their products to donors. For example, a new committee on Telepsychiatry is being formed and several prospects for branding were raised. The need for GAP to raise funds other than through member dues and donations is an ongoing challenge.

We discussed the much revised proposal for an outside GAP Advisory Board initiated by Lois Flaherty which did not receive support from the GAP Finance Committee and Board at this meeting. We still feel the idea has merit and will keep it on the agenda for future meetings when the timing may improve.

Lastly, we discussed the composition of the committee itself and the need for younger members, perhaps a fellow or 2, more diversity. The Chair indicated his desire that April will be his last meeting as Chair. We need more youth and fresh ideas. This committee is the only GAP committee that looks to the health of GAP as a whole.

PSYCHIATRY & COMMUNITY

Members attending: Minkoff, Adams, Dragatsi

Virtual: Balfour, Flaum, Hackman, Myrick, Feldman, Goldman, Le Melle

Fellow: Sam Jackson

The Committee voted to invite Sam Jackson to become a member. He accepted the invitation.

FAST TRACK PROJECTS:

OpEd on Roadmap submitted to Amy Franklin and she is reviewing.

COMMITTEE REPORTS Continued.

PSYCHIATRY & COMMUNITY Continued.

Psychology Today blog on Roadmap and Homelessness was submitted and approved, is receiving a lot of positive attention.

PROJECT TITLE:

9 Roadmap to the ideal Crisis System (2021)

Our ongoing work is disseminating this work, enhancing our website to promote this work www. crisisroadmap.com and creating supplemental materials for this work, which can be put on our website and disseminated to other forums. The Committee will be working on this for the coming year.

FOCUS ON WORK ACCOMPLISHED

DURING THE MEETING:

Update on Roadmap website, review of progress on Roadmap Learning Community facilitated by Balfour, Minkoff, and Jackson. Draft evaluation by Jackson completed. Jackson and Goldman working on an intermediate length piece about populations in frequent crisis with complex challenges, such as people experiencing homelessness. Hackman, Le Melle, Baker and Feldman working on a training curriculum about Ideal Crisis Systems for medical students, resident and psychiatrists. Balfour and Goldman working on a special issue of Psych Clinics of North America that will be built on Roadmap -discussed potential chapter.

PLANS FOR BETWEEN MEETING WORK:

We meet monthly.

FOCUS FOR NEXT MEETING:

Continue following the thread of the various projects that we are under way building on the Roadmap and crisisroadmap.com.

PSYCHIATRY & THE LAW

Members Attending: Jacob M. Appel (co-chair), Peter Ash, David Cash [consultant], Richard Frierson, Abhishek Jain (guest) Phil Resnick, Renee Sorrentino (guest)

Members Attending Virtually: Jackie Landess (co-chair)

Regrets: Susan Hatters Friedman, Debbie GiorgiGuarnieri, Richard Martinez, Alan Newman, Debra Pinals

FUN GREETINGS

• Members offered updates on their lives over the past six months.

• Rick F. appeared in the documentary Con Girl, where he was referred to by the staff as “The Talent” (which henceforth may be his GAP nickname)

• We welcomed Beesh Jain and Renee Sorrentino as first-time guests; they were invited to return again in Spring 2023 as second term guests, at which time a decision will be made regarding full membership on the committee and in GAP.

NEW FELLOW:

Jacob informed the committee that he has reached out to the fellowship committee about having a new fellow join the committee in the coming year.

ADMINISTRATIVE BUSINESS:

• The updated contact list (for internal committee use) was updated and circulated via email.

• Copies of completed chapters and chapters in progress will be sent via email to the guests, Beesh and Renee, for their review and feedback.

• The question was raised on whether or not GAP should work to expand its public profile and the possible reasons for doing so (e.g. increased awareness of GAP products, increased fundraising), but the consensus of the committee was that this was not a priority.

OLD BUSINESS / PREVIOUS PROJECTS:

• The publications board recently sent around a document with recent publications by each committee noted. Both Peter and Jacob independently contacted David Adler at the publications board to offer corrections, as multiple GAP projects were inadvertently not included.

• Jacob noted the death of former committee member David Kapley.

CURRENT PROJECT: Psychiatry and the Law Website

• Jackie described the current website project to the guests and updated the committee on the status of various chapters.

• Jackie noted that we have a web address, that GAP agreed to pay for the site, that it will be linked to the GAP site and that her cousin will design and upload the content.

• We will check which program (e.g., wordpress) the site is to use so it is compatible for transfer to other servers if necessary.

• The site will be a living document, so that material can be added to it. New chapters will require publication board review, but updates/revisions to existing chapters generally will not.

• Some chapters have been approved by the president, others by the publications board, still others are with individual committee members for review.

• The chairs will clarify with David Adler the details of the process for presidential approval.

• The goal will be to have the chapters completed and the site up-and-running before the next meeting.

• Phil noted the importance of an easily searchable site with keywords.

• The suggestion was made that users of the site be able to send responses, comments, suggestions for updates to GAP; this feature will be available on the site and Jacob agreed to monitor in perpetuity.

• Peter noted the importance of screening the chapters for bias, gender balance, etc.

• Phil emphasized the importance of making others aware of the website as a resource.

• We may wish to contact program directors about the site in a format they can then forward to their trainees; we could also contact APA/local chapters or AAPL about contact info for trainees who are also APA and/or AAPL members.

NEW BUSINESS

Blog invitation:

• All GAP members and committees have been invited to submit posts to the GAP blog.

• The committee discussed the possibility of individual committee members or teams of members writing posts for the GAP blog on Psychology Today.

• The ideal approach would be for committee members or guests to write potential posts, to be published under their own names, but to circulate to the committee for feedback prior to forwarding to Jack Drescher and the Media Committee for approval.

Discussion of Potential new projects

• The committee picked up on its discussion of potential future projects.

• Jacob advocated for a more traditional project like a book or possibly an article; Peter noted the merits of an article

• It was noted that the committee last left off this discussion in April discussing the possibility of a book on the 8th Amendment.

• Jacob read the list of possible projects discussed prior to the choice of the current project. These included a book on impairment for duty, which might be divided into chapters based both upon profession and then on common issues between professions; an article on the hazards of forensic psychiatry (violence, burnout, etc.); or a project related to corrections.

• New topics that were proposed for discussion included:

- an article on the use of social media in forensic

- a project related to inequity or structural bias in forensics

- a project related to the decent legal issues in reproductive rights as they related to forensic psychiatry (but law in this area thought to be fast-moving and beyond the scope of expertise of some committee members)

• The Committee will reconvene in April 2023

COMMITTEE REPORTS Continued.

PSYCHIATRY & THE MEDIA

Present: Carol Bernstein, Jack Drescher (chairs) Jeff Freedman, Chris Heath

Zoom: Peter Kramer, Gail Saltz

Fellow attending: Ashvin Sood (Zoom)

Guests: John Burton, MD, possible new member, former GAP Fellow, Co-Chair, Committee on Public Information of APsaA, podcaster Amy Franklin, APA Publicist

GAP Blogs on Psychology Today.com

• Possible online Zoom training for GAP members

• Media training (Saltz, Drescher, Franklin)

• Letter-writing (Freedman)

• Tik-Tok (Sood)

• Blog writing (Drescher)

• 30th Anniversary of Listening to Prozac (Kramer)

Blogs: 4 published to date, 5 in inventory which gets us through February with 2 blog postings per month; many committees expressed interest in doing Blogs.

Online Zoom Trainings: Will discuss details further with entire committees at our January Zoom meeting.

Audience for blog: practicing psychiatrists, psychiatry resident, psychologists, training directors, general public and other mental health professionals.

Audience for online training: GAP members

FOCUS OF WORK ACCOMPLISHED

DURING THE MEETING:

• Some editing of blog submissions

• Discussion of publicist’s value to the organization

• Discussion of branding

• Plans for between meeting work:

• The Media Committee regularly uses Zoom meetings between retreats.

• Focus for next meeting: Evaluating impact of Blog and evaluating online Zoom training sessions done to date

• Any ways in which members can be helpful? If committees could write more blogs and increase our inventory, that would be great.

• It would be also helpful if any new GAP publication is announced both on the Listserv and with a direct communication to the Media Committee in the hopes that we can publicize event.

PSYCHIATRY & RELIGION

Members attending: Brian Fallon MD, Salman Majeed MD, Keith Meador MD, Joseph Merlino MD, Jenifer Nields MD, Michael Norko MD, MAR (chair), James Phillips MD, David Saunders MD, PhD

Fellow attending: Hunter Neely MD

PROJECT INFORMATION

1. Faith Communities and the Well-Being of LGBT Youth (White Paper on the importance of faith communities in efforts to reduce suicide and other negative mental health outcomes for LGBT youth)

Project leader: Dr. Norko

The booklet remains available for free download on the GAP home page. Dr. Norko has updated The resources and data for 2022, but this needs to be professionally set. Hard copies of the version on the GAP website are also available from Dr. Norko. A reporter from the National Catholic Reporter has expressed interest in describing the booklet in a future article. Dr. Norko continues to reach out to various faith communities to make them aware of the product.

Work accomplished during meeting: Reviewed current status.

Plans for between meeting work:

If interest warrants, Dr. Norko will fund the setting of the Revised edition. If funds become available for printing the second edition, that can also be done. Dr. Norko will continue to promote the product to faith communities. Dr. Merlino suggested contacting the Matthew Shepard Foundation, which supports the continued touring of the play “The Laramie Project” as part of its educational efforts. They offer assistance and support to educational and religious institutions.

COMMITTEE REPORTS

2. Dear Abby Religion-Spirituality and Mental Health survey

Project Leaders: Dr. Saunders, Dr. Norko, Dr. Meador

Fast track: journal articles

Potential journals: J Sci Study Religion, J Rel & Health, and JNMD

Anticipated audience: practicing psychiatrists, psychiatry residents, training directors, Psychologists & other MHPs

Any ways in which the Publications Board might be helpful: not yet

Work accomplished during meeting: Reviewed current status of project. A grant request to the Templeton Foundation was not accepted. Dr. Saunders has submitted a grant application to NIH, which is current in the review process. The next review phase will take place in March 2023. We are working on two papers now: 1) Description of people who identify as spiritual but not religious (SBNR) but also say they are affiliated with a religious tradition in terms of religious practice and beliefs; 2) Religion-spirituality and mental health, comparing respondents who identify as religious but not spiritual, SBNR, both religious and spiritual, and neither religious nor spiritual. Other papers being planned are: 3) Spiritual-religious practice during COVID; 4) LGBTQ+ and mental health/ religion-spirituality.

Plans for between meeting work: Draft the first paper by April 2023.

3. Biographical Essays on mental health attributes of major religious figures: “Un-Diagnosing St. Joan”

Project Leader: Dr. Phillips

Fast track: series of journal articles

Potential journals: current paper has been submitted to World Psychiatry

Any ways in which the Publications Board might be helpful: already approved by Publication Board

Work accomplished during meeting: Reviewed current status. World Psychiatry rejected the

submission. It is now in review at Philosophy, Ethics, Humanities in Medicine (PEHM), but it has been there for many months now. We also discussed a number of possible subjects for the next biographical essay in this series.

Plans for between meeting work: Dr. Phillips to inquire with managing editor of JNMD if they Might consider the manuscript as a theoretical analysis submission, as an alternative to PEHM.

4. “Meditations: January 14th, 2025”

Project Leader: Dr. Nields

Fast track: a creative writing piece about a possible trajectory of recent world events

Potential journals: room

Any ways in which the Publications Board might be helpful: reviewed by David Adler but not sent to Publication Board since the piece represents a single author and not a GAP committee per se.

Work accomplished during meeting: Reviewed status. room has rejected the piece.

Unfortunately, it was keyed to the anniversary of the January 6 insurrection and has become untimely.

Plans for between meeting work: This project will not be pursued further.

5. Psychedelics and religion

Project Leader: Dr. Neely

Description: As part of the GAP fellows research on psychedelics in psychiatry for the November 2022 meeting, Dr. Neely has been interested in a separate project of exploring the use Of psychedelics in palliative care / end of life, with implications for religious/spiritual experience.

Work accomplished during meeting: Reviewed status.

Plans for between meeting work: Dr. Neely will continue her research on the topic for our further discussion at subsequent meetings, especially as her current forensic fellowship nears completion next year.

COMMITTEE REPORTS

6. “Living in Fear”

Project Leader: Dr. Majeed

Fast track: Originally written as OpEd piece about anti-Muslim attitudes/behaviors/violence

Anticipated audience: general

Potential journals: Psychology Today blog.

Any ways in which the Publications Board might be helpful: Submitted to Board 4/14/21 and feedback reviewed and incorporated in further revision.

Work accomplished during meeting: We have been holding the manuscript for the next Unfortunate “right moment” when editors may be most interest in the piece.

Plans for between meeting work: With the discussion about the Psychology Today blog, we will be sending the latest version to Dr. Drescher for feedback about revising to fit the Psychology Today blog format. It is already in the right word count range.

7. “Pastoral intervention in dynamically-oriented therapy”

Project Leader: Dr. Nields

Fast track: A moving description of the challenges a patient from years ago faced, which may be re-developed for a psychotherapy journal.

Potential journals: TBD

Any ways in which the Publications Board might be helpful: not at this time.

Work accomplished during meeting: Reviewed publishing ethics of writing about a patient’s story, when the patient and his wife are both deceased and have no known heirs who might provide explicit consent. The patient and his wife had been pleased to share their stories with medical students in an educational format but was never asked to consent to publication of the story.

Plans for between meting work: Dr. Nields will share the piece with other committee members for their suggestions and input. Further discussion of the publication ethics.

Other projects on hold ( for possible future consideration):

a. Religious Literacy in Psychiatric Education

Project Leader: Dr. Nields

b. The decline in faith in medicine

Project Leader: Dr. Merlino

c. COVID effects on faith services

Project Leader: Dr. Nields

d. CBT, Yoga, Mindfulness for COVID anxiety

Project Leader: Dr. Fallon

PLANS FOR NEXT MEETING:

Winter interim Zoom meeting. We plan to meet next on January 28, 2023 at 11 am via Zoom.

PSYCHOPATHOLOGY

Present: Adler, Berlant (virtual), Brunette, Dixon, Edwards, Erlich, First, Oslin, Siris (virtual), Talley (virtual), Ethel Ginsburg

Fellow attending: Matthew Edwards

Fellow not attending: Liza Wagner

The Committee is working on two early stage projects for peer review publication with the topic

Chosen and first draft in preparation.

1. How do we understand the phenomenon of increasing mental distress among young adults and what can we do about it?

2. Whether DSM-IV Axis IV and its importance in addressing social determinants of health

This is planned to be completed in 2023. The target audience will be practicing psychiatrists, psychiatry residents, training directors, psychologists/other mental health, and the general public.

To be submitted to: Journal of Nervous and Mental Diseases or Psych Services

FOCUS OF WORK ACCOMPLISHED DURING THE MEETING:

We are in that wonderful time of idea creation and wide-ranging discussion that always leads to interesting topics and ultimately manuscripts. The best of GAP! We look forward to who will be selected as the first Adler Fellow of our Committee.

The next meeting will be scheduled by Zoom to continue working on our new topic.

COMMITTEE REPORTS Continued.

PSYCHOPATHOLOGY Continued.

FOCUS FOR NEXT MEETING:

We will welcome a new Ginsburg Fellow and continue drafting of our new manuscript on reviving aspects of the prior DSM-4 Axis 4 and its importance for the social determinants of health to be addressed.

PSYCHOPHARMACOLOGY

Present: Baron, Gross, Pine, Sumner, Jeanne Alexander via Zoom, Scott Aaronson via Zoom

We are near completion of the Psychedelic paper and hope to submit to the Publications Board in January. It is an invited paper from John Oldham.

PSYCHOTHERAPY

Present: Tom Franklin, Andrew Gerber, Kiki Kennedy, Eric Plakun

Virtually: Cliff Arnold, Eve Caligor, Daniel Knoepflmacher, Jeff Katzman, Susan Lazar, Randy Welton and Frank Yeomans

Guests: Meiram Bendat, JD, PhD – update Wit v. UBH

FOCUS OF WORK

ACCOMPLISHED

DURING THE MEETING:

• Committee’s “Mission Statement” is currently on the GAP website, members discussed ways to update and improve the statement.

• Tom Franklin offered perspectives on GAP’s Psychology Today Blog Project. He clarified submission and publishing process for blogs. Members shared ideas/suggestions for potential blogs to write this year. Members agreed to the in 2023.

• Wit v. UBH—Meiram Bendat explained that the request for an “En banc” review has yet to be determined; he explained policy implications should it be denied.

• Membership: we discussed our committee make-up and 2 potential new members interested in joining our Committee; plans were made to meet virtually with potential members this winter.

• Project ECHO—Randy Welton and Jeff Katzman described this innovative “hub and spoke” method of education and detailed a plan for how to bring this online for psychotherapy education and supervision;

ideas from Committee members was entertained and further discussion will continue at future meetings.

• Members discussed the future focus of the Committee’s work and how to reach identified goals.

PLANS FOR BETWEEN MEETING WORK:

• Meet virtually with 2 potential new members

• Virtual meeting scheduled for January 2023

• Update CoP’s mission statement for the GAP website

• Gather more information for Project ECHO

• Identify a Blog topic and lead writer for The Psychology Today Blog Project

How many times have you met virtually since November 2020? We have met 7 times since November 2020. (January 2021, April 2021, July 2021, November 2021, February 2022, June 2022, October 2022)

FOCUS FOR NEXT MEETING:

Our next meeting will be a virtual meeting in January 2023 with a plan to:

• Update on potential new Committee members

• Finalize revised CoP Mission Statement

• Update on Wit v. UBH

• Identify potential Blog topic and author(s)

• Update on Project ECHO

RESEARCH

Members present in person: Harper, Rahmani, Swift, Kramer

Visitor present in person: Belfort

Fellow present in person: Satodiya

Guest present in person: Kramer (Patti)

Members present virtually: Keith, Beahrs, Josephson, Copans

Guest present virtually: Beahrs (Claudette)

Member absent: Swann (family and personal commitments)

COMMITTEE REPORTS Continued.

RESEARCH Continued.

Our most important endeavor was rediscovering the interpersonal connectedness we experience when working together. This interconnectedness is the foundation of our work, the basis for our creativity, and the foundation of our trust and respect for each other. We rediscovered “conversational thought,” which has been absent in virtual committee meetings. By the end of our morning session on Friday, it was clear our group is still a living human entity.

Dr. Erin Belfort, visiting for the first time in person, but a visitor on multiple occasions virtually, was considered and unanimously elected for committee membership; and unanimously elected as well to GAP at the meeting of the Steering Committee on November 19, 2022. Dr. Belfort is a family psychiatrist by training and experience; the Child & Adolescent Psychiatry Training Director at the Maine Medical Center; and Associate Professor of Psychiatry at Tufts University School of Medicine. She is the psychiatrist for the Gender Clinic at Barbara Bush Children’s Hospital, at the Maine Medical Center. Lastly, she is a Distinguished Fellow of the American Academy of Child & Adolescent Psychiatry.

Dr. Ritvij Satodiya, our Fellow for the past two years, entirely virtually until this meeting, was awarded an Ethel Ginsburg Fellowship by the GAP Board of Directors. He will thus have two additional meetings subsidized by GAP as a member of the Research Committee. Dr. Satodiya is Clinical Instructor, Department of Psychiatry, New York University Grossman School of Medicine; and currently at Emory University completing a Forensic Psychiatry Fellowship.

Regarding our ongoing project, initiated prior to the virtual hiatus as a result of COVID, “Utilizing Context in Psychiatric Practice,” Dr. Harper reviewed, Know Me, Know My World: What are we doing with context, the potential first chapter of an edited book, with Dr. Adler (Chair, Publications Board). Dr. Adler encouraged us to proceed along the lines suggested by the chapter. We re-established our relationship, with respect to this project, with Oxford University Press. Our previous editor with Oxford has retired and is living happily with her husband in Arizona. Oxford assigned a new editor from the Medicine Section with whom we will be working.

Other less ambitious projects are being developed

including potential op-ed publications and contributions to the GAP Blog on the Psychology Today website.

We discussed future virtual meetings, prioritizing the schedules of our early/mid-career members. We decided the next virtual meeting would be on Wednesday, November 30, 2022, at 10:00 AM Eastern Standard Time for one hour. Future meetings will be for one hour with the frequency to be discussed further at the November 30th meeting.

I have asked Dr. Harper to coordinate further meetings of the editing group, editing assignments, as well as communication with Oxford University Press. As Dr. Harper will be participating in the upcoming IACAPAP meeting, returning December 9, 2022, those activities will begin shortly thereafter.

Last but not least, Yajaira Paparone, who has been a Contributing Member for several years, is reuniting with us and will be joining the January Virtual Call, and attending the next Non-Virtual meeting. For those of you who do not know her, she trained with a very prominent Family Psychiatrist. Welcome back, Dr. Paparone!

SOCIAL JUSTICE

Present: Kenn Ashley, Hugh Cummings (guest, promoted to member at the meeting), Ali Haidar (guest, promoted to member at the meeting), Alex Harris (guest, promoted to member at the meeting)

1. We collaborated on a Google Doc and came up with the following (which has been sent to Frances Bell) for the website:

About the GAP Social Justice Committee

Within GAP, the Social Justice Committee will work to raise attention of members to relevant issues at all phases of discussion and dissemination, ranging from membership practices to committee meetings to GAP’s deliverables. The Social Justice Committee will propose a series of recommendations designed to improve the organization’s attention to diversity, equity, non-exclusion, anti-racism, and issues of broad social justice. Outside of GAP, the Social Justice Committee will work to influence policy related to topics of relevance to social justice in the theory and practice of psychiatry.

CURRENT AND PLANNED PROJECTS INCLUDE:

1. A survey of membership to better understand demographics, considerations, and membership observations and needs, including feedback from GAP Fellows and recent GAP Fellowship alumni

2. A review of GAP products from the beginning of the organization in order to determine and disseminate:

a. What was GAP doing at the time?

b. What was going on in society and culture?

c. How did the GAP products influence what happened next?

3. A plan to conduct interviews with longtime GAP members to better understand their perceptions regarding the importance and impact of social justice in the products and discussions of the organization

2. Social Justice view of GAP: Project proposal

What was GAP doing? What was the parallel of cultural ferment? How did GAP products influence?

a. 1946: post-Truman, government foisted racist views on the country

i. Highways to disrupt communities

ii. Projects

iii.Psychiatry: Post-war, rising of NIMH

b. 1963: deinstitutionalization

a. What is GAP thinking along the lines of social justice? Did they have an impact?

GAP Products: Resources—The Group for the Advancement of Psychiatry (ourgap.org)

Leverage the wisdom of the elders: Social Justice in Action

Would be nice to interview all of the Presidents

Could help identify major areas of outcome regarding GAP projects, products, and influence

Interview the older members of the group and find out what they were doing, what they had in mind, and the impact they perceived

Looking at the GAP reports, social justice seems to have been a motivating force of the organization, and we will want to take an agnostic view and find out “did it get lost?”

This committee will review the GAP products and categorize them

Consultation: Take the story, reimagine it to a more successful/productive conclusion future

Clearly, nonjudgmentally assess the past and then construct a product that helps productivity Move things forward (product: Findings of “facts”— evidence)

STATED preferences vs. WORK in action

a. Historical overview will help understand what GAP has done over the last 75 years

b. We can look to see if this matches with stated values (to present to the steering committee)

Multiple ways of telling a story

a. Evidence/facts

b. Interpretation

c. Reaction from the system

Deliverables:

a. Lessons learned

b. From leadership: What is their articulation of goals for GAP?

c. How do the historical goals / record match the practices and goals of the organization?

d. Jane would like to write a blog post

3. The committee began work on a survey for the membership regarding demographics/identities

SYSTEMS INNOVATION & TRANSFORMATION

Present: Wes Sowers, Manish Sapra, Mardoche Sidor, Anna Skiandos, Hunter McQuistion,

Virtual: Jules Ranz, Bruce Fage, Deepika Sastry, Nubia Lluberes, Rachel Zinns, Sosunmolu Shoyinka

I. The meeting began with introductions and personal updates

II. Review of the progress of sales on the Seeking Value Book

a. There have not been very significant sales of the book so far, still a little more that 100.

b. There has been limited follow through on promotional efforts identified at our last meeting

c. Hunter had a review published in the Journal of Psychiatric Practice.

d. Sunil Khushilani described his book on Quality processes and LEAN principles and interface with Value

COMMITTEE REPORTS Continued.

SYSTEMS INNOVATION Continued.

e. We agreed to focus on a narrower number of specific ideas with some accountability added

1. Market to Public Psychiatric Fellows—Wes

2. Taking Issue Column in Psychiatric ServicesManish and Rachel

3. Make use of GAP Blog Posts: Michelle (incarceration), ask all authors to write a chapter summary. Wes and Julie

4. Seek podcast opportunities - all

5. Outreach to non-psychiatric target audience?

III. Working with Peer Professionals/Workforce

a. This needs to be part of a broader workforce development initiative, along with our work with NPs

b. Agreement in principle to pursue a joint meeting with peer support organizations and Peer professionals

c. Begin by collecting names of desired participants for a dialogue. Wes et al.

IV. Workforce Overview

a. Major rethinking of what the future MH workforce should look like should be considered.

b. Review the work of the Annapolis Coalition to see where we might differ, or find deficits, especially with regard to our current focus on NPs and peer professionals—All

V. Collaboration with MHRNPs

a. Following our initial conversation with NPs, two subgroups were formed: Training and Leadership

b. Leadership has not gelled, but Training has had a couple of meetings.

c. Problems in training were identified:

1. Variable quality of NP competence and training

2. Lack of opportunities for clinical experience and supervision

3. Lack of Standards and Accreditation of training programs.

4. Limited involvement of psychiatrists in supervision and training.

d. There is some conflict between independence and autonomy of NPs and Collaboration with Psych MDs

e. NP Community Psychiatry Fellowships

1. Julie described his work in establishing Fellowships for NPs

2. Some NPs are participating in Community Psychiatry fellowships (Ohio, Pennsylvania)

3. In NY, Julie has found that NPs are most eager to learn clinical skills rather than systems issues

4. General agreement that in reaching for our professions' mutual interest in the safety and wellbeing of our patients, our Committee's role is to support psychiatric nurse practitioners in the development of their identity and assist that evolution with the knowledge, skills, and experience of psychiatry.

5. Agreed to plan to use a portion of the Spring meeting to meet again with NP leaders to determine their views on the issues that they need help with and how psychiatrists could help- Hunter and Julie

6. Agreed to schedule an interim meeting in January/February to plan for NP meeting

VI. Integrative Community Therapy (ICT)

a. Ken Thompson joined the meeting to describe ICT and its origins

b. We discussed this and other mutual support modalities as part of a workforce plan

c. Considered the role and training of facilitators in these processes.

d. Noted tie in with peer supports as well.

e. Place in the parking lot for the time being until an overall workforce plan is developed

V. Anti-Racism and the SMART (Self-Monitoring of Anti-Racism Tool)

a. Discussed initiative to have GAP committees use the SMART to enhance anti-racism activity

b. Described meeting with GAP President Cal Sumner and his support of this process

c. Agreed to address this in the retreat occurring the following day. (Self-awareness and intentional anti-racism was identified as a major element of re-inventing GAP and the SMART was acknowledged as one method of moving this forward)

d. Continue to work with Social Justice Committee to move this to the committees.—Sosunmolu

IN MEMORIAM

William Sledge, MD

William Sledge, MD, the George D. and Esther S. Gross Emeritus Professor of Psychiatry at the Yale University School of Medicine, passed away on December 20 at the age of 77. At Yale, William was as a transformative educational leader for the Department of Psychiatry. He led the Yale Psychiatry Residency Program, initially as Director of Graduate Education (1980-1986) and then as Associate Chair for Education (1990-1996). An innovative educator, his article on the “track system,” that enabled Yale psychiatry residents to pursue academic interests during residency training, contributed to the establishment of “research tracks” in many residency training programs.

William also was an impactful clinical leader. He led the Connecticut Mental Health Center (CMHC) Outpatient Division (1987-1989), served as CMHC Clinical Director (1989-1996), and Acting Director of CMHC (1994). During this period, he studied peer counseling and alternatives to inpatient hospitalization for individuals with chronic mental illness. He characterized roles that intensive outpatient treatment programs and supervised transitional units might play in preventing hospitalization. From 1996-2018, William served as the Medical Director of Yale New Haven Hospital Psychiatry. During this time, he facilitated the consolidation of the Yale New Haven Hospital Psychiatry and the Yale Psychiatric Institute, and then served as Medical Director of the new Yale New Haven Psychiatric Hospital. Along the way, he also served as Interim Department Chair (2007-2009), and Deputy Chair for Clinical Affairs for the Department of Psychiatry (2009-2018). For his work, William was recognized with many honors, including the Stephen Fleck Award, given to individuals who represent the highest values of academic psychiatry.

William had broad clinical interests. He was a graduate (1986) and active member of the Western New England Psychoanalytic Institute. He also was an important contributor in the field of aerospace psychiatry, leading to a listing in Who’s Who in Aviation and Aerospace. In addition to serving as the Chair of the Committee on Psychotherapy for GAP, William was active in the American Association of Directors of Residency Training and the American College of Psychiatry. Remarkably, he found time to serve as Head of Calhoun College (19952005) alongside his wife Betsy, a long-term writing tutor in Silliman College, who served as Associate Head. They distinguished themselves as effective leaders of life within Calhoun College, bringing an array of outside luminaries to the College to enrich the lives of the students. William nurtured a breadth of passions outside of work. He was a pilot and an avid SCUBA diver. He had many stories of exploring wrecked ships on the East Coast and swimming with sea lions in Antarctica.

William grew up in Greensboro, Alabama and played varsity football at Washington and Lee University, graduating Phi Beta Kappa. He attended medical school at Baylor College of Medicine, where he was influenced by the surgeon Michael DeBakey and the psychiatrist Hilda Bruch. He arrived at Yale for psychiatry residency in 1972, after completing an internship at the University of Pennsylvania. He then spent two years at the U.S. Air Force School of Aerospace Medicine and the University of Texas, San Antonio. William returned to Yale in 1977 to join the faculty.

In addition to his wife Betsy, William is survived by three daughters, Ann, Margaret, and Katherine, and six grandchildren. A celebration of his life will be held on Saturday, April 1 at 1:30 pm at the United Church of Christ in New Haven, CT.