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Flaum Named President of American Association of Community Psychiatrists

Wednesday, June 29, 2016

Hail to the Chief! We are pleased and proud to have a new President in the University of Iowa Department of Psychiatry. 

Clinical Professor Michael Flaum, MD, was installed recently as President of the American Association of Community Psychiatrists (AACP). The group met in Atlanta in May and Dr. Flaum took over the reins of leadership from Dr. Anita Everett, a Johns Hopkins psychiatrist who is now the President-Elect of the American Psychiatric Association. The AACP is about 500 members strong, and publishes the Community Mental Health Journal.

“It is a pleasure and an honor for me to serve in the role of president of this organization, which has been my professional ‘home group’ for the past fifteen years or so,” says Flaum. “And for me at least, it is really important to have such a group, to know who ‘my people’ are, and to be able connect with them, both personally and professionally. I have found that through the AACP.” 

So, what exactly is Community Psychiatry? Dr. Flaum wrote in a recent AACP newsletter article that he gets that question all the time—often from psychiatrists. 

The discipline has traditionally focused on the most severely mentally ill and on the health systems that are required to ensure that this population, which was once housed in state hospitals, is well cared for in the community. In his article Dr. Flaum quoted a former AACP President who provided a broader and more eloquent definition: “Community Psychiatry is a branch of psychiatry in which psychiatrists employ person-centered and recovery-oriented practices in clinical care. It emphasizes prevention of illness and the importance of creating healthy environments. It strives to create a political will to provide security and respect for all members of the community. Community psychiatrists facilitate collaboration and provide leadership for the creation of comprehensive and fully integrated services for all members of society, but particularly for those members who have greatest need.”

To “unpack” that definition a bit further, what exactly do the terms “person-centered” and “recovery-oriented” mean? The former refers to the idea that the provider includes the patient in the decision-making process when it comes to, for example, choosing medications, or selecting psychotherapies, or deciding on living arrangements. The latter refers to paying attention not only to symptom reduction, but also to a much broader conception of functioning, personal autonomy, growth, and place in society.

As an aside, some people cite the origins of the recovery movement in the work of an Englishman named John Thomas Perceval, who was the son of Spencer Perceval, England’s Prime Minister from 1809 to 1812. In his mid 20s John became quite ill, with erratic behavior and religious delusions, and spent about three years in mental institutions. When he recovered he wrote a book (in an era of long titles) called A narrative of the treatment experienced by a Gentleman during a state of mental derangement designed to explain the causes and nature of insanity, and to expose the injudicious conduct pursued towards many unfortunate sufferers under that calamity. Perceval became a champion of the rights of the mentally ill. His book is available onAmazon.

Dr. Flaum argues that the core principles of Community Psychiatry should not be limited to this sub-discipline. He believes that person-centered and recovery-oriented practices, an emphasis on prevention, and the facilitation of integrated services should be core principles for all psychiatric practice. This is an inspiring vision, and one that is worthy of an AACP President. Prevention and integrated services will indeed move rapidly to the fore as the nation’s health system shifts towards a Population Health focus. On the issue of person-centeredness and a recovery orientation, there is much for general psychiatry to learn, though there is also a balance to be struck with the disease-oriented approach that has brought powerful treatments to bear on what were once thoroughly intractable disruptions of mental life. Dr. Flaum is no stranger to the disease perspective, having authored more than 60 papers on the syndrome and the biology of schizophrenia.

“Those of us who call ourselves community psychiatrists know deep in our bones that there is much more to the treatment of serious mental illness than medications and maybe a little psychotherapy,” says Flaum. “Treatment involves helping people find ways to make their lives optimally meaningful, gratifying, and productive in ways that they choose. We know we must strategize with them about steps to take to get there, identifying and bringing together their natural and professional supports into a functional network. We recognize that physical health is a core part of mental health, not just as a nice soundbyte, but as a clinical priority. And we recognize that making and maintaining an interpersonal connection is the vehicle that drives all of this work.” 

Congratulations President Flaum! We are glad to have you out there representing for our department, and advocating for those members of society who have the greatest need.