Psychiatry Advisor:  You have accomplished so much in your position during this past year.  Could you identify one issue during your experience as APA president that was most significant?

Dr Binder:  As you mentioned earlier, one of the issues that I focused on during this year was the criminalization of people with mental illness.  The closing of state psychiatric hospitals and inadequate funding of health centers have contributed to a tragedy in the United States.  We currently have an insufficient number of psychiatric beds.  So, the patients have not gone away; instead many of them are now living on the street and not getting treatment.  They are also committing minor crimes and winding up in the judicial system.  However, our jails and prisons are not equipped to handle people with serious mental illness.  As psychiatrists, these are our patients; therefore, the APA has focused on these underserved and marginalized individuals.  We have worked with Senator Al Franken and supported a bill focused on decriminalization. This legislation identifies alternatives to incarceration using diversion programs and training police officers in various techniques to de-escalate the situation so as not to provoke violence.

We recently conducted the National Stepping-Up Summit in April 2016, the goal of which is meaningful prison and mental health reform.   We partnered with counties and the judicial system to conduct training sessions for teams from each of the counties focused on what they can do to decrease the criminalization of mental illness in their particular communities.  That same month the APA and APA Foundation hosted the American Psychiatric Excellence (APEX) awards, at which time we honored those who have worked as advocates for individuals with mental issues in prisons and jails. Our award recipients included Senator Franken; House Minority Leader Nancy Pelosi; Miami State Senator Miguel Díaz de la Portilla; and Natasha Lyonne, Matt McGorry, and Dascha Polanco, cast members from the television show, “Orange is the New Black.” Of course, the actors are playing characters, but they spoke about how they have become spokespersons for this issue.  What is special about the show is that it provides the back stories of each of the characters.  These are women who have done terrible things, but they are also regular people. The significance of the program is that it reflects what is happening in society: there are many missed opportunities for intervention, including psychological intervention, that could have prevented their incarceration.

Click here for more research from the 2016 Annual Meeting of the American Psychiatric Association.