Psychiatr News June 15, 2007
Volume 42, Number 12, page 1
© 2007 American Psychiatric Association

Ruiz Urges Colleagues to Keep Up Demands
Catherine F. Brown

Advocating for humane care is not an option; it's a professional and
moral imperative for all psychiatrists, says APA's outgoing president.

In a voice filled with passion and urgency, APA President Pedro Ruiz,
M.D., instructed colleagues at APA's 2007 annual meeting last month in
San Diego that they-along with him-must continue to work toward
achieving the "promised land" for people with mental illness through
eradicating barriers to mental health care and establishing a system
in which high-quality, humane care is available to all.

"My fellow psychiatrists," said Ruiz at the meeting's Opening Session,
"we must have the courage to do it. We must provide humane care. The
future and image of APA and our profession depend on it. We must do
it, and we will do it together with the National Alliance on Mental
Illness [NAMI], Mental Health America, and any other advocacy group
that has the courage to do it with us."

He spoke with particular intensity about mentally ill people who exist
on the fringes of society and evoke little empathy from Americans
living comfortable lives. Among them: people who have no health or
mental health insurance, members of minority groups who cannot get
culturally competent mental health care, homeless mentally ill
individuals, mentally ill people who are warehoused in jails and
prisons because of inadequate community mental health services and
resources.

Ruiz continued, "It is our social responsibility, as psychiatrists and
citizens, to ensure that humane care will not just be a privilege for
some, but a right for all human beings who live in the United States,
as well as in every country in the world.... What are we going to do?
How much inhumane care do we have to observe in our daily practices
and society at large before we say enough is enough?"

Ruiz himself reached that point many years ago, and his term as APA
president gave him another national platform to continue his efforts
to right these wrongs.

To an audience of about 1,000 psychiatrists and guests, he spoke of
the many initiatives and actions he had undertaken during this past
year to follow through on the theme he had selected for his
presidency: "Addressing Patient Needs: Access, Parity, and Humane
Care."

Ruiz reminded his audience that at last year's annual meeting he had
said that addressing the three prongs of his presidential theme
required APA to build "strong, genuine" partnerships with patient-
oriented advocacy groups. He got to work on that task immediately by
inviting Suzanne Vogel-Scibilia, M.D., the president of NAMI, to
address the Board of Trustees at its July 2006 retreat and meeting. He
and Vogel-Scibilia went on to plan a formal APA/NAMI leadership
meeting that took place last December in which common issues and goals
were identified (Psychiatric News, January 19). Both organizations
appointed individuals to a work group to turn plans into action.

That professional ethics and values were central to Ruiz's presidency
was evidenced in numerous ways throughout this past year. One was the
selection process of DSM-V's leadership. At a time when medical
researchers were being criticized for using funding by sources that
had a vested interest in the studies' outcomes, Ruiz wanted "the most
transparent and ethically driven policy that one could humanly design"
for selecting leadership of DSM-V. The results were a rigorous
screening process that all nominees of the DSM-V Task Force and
working groups had to undergo and the creation of a conflict-of-
interest disclosure form "that is second to none in the medical
field."

Another example was Ruiz's visit to Guantanamo Bay Naval Station last
November. One reason that he accepted the invitation from the
Department of Defense to visit the camp-marking his first return to
Cuba since leaving there at the age of 21-was "to pay respect" to the
psychiatrists and other health care personnel who were working there
under "the most difficult and challenging circumstances. As your APA
president, the well-being of even one APA member is as relevant, or
even more important, to me than any political ideology, including my
own."

He was among the APA leaders who opposed the participation of
psychiatrists in the interrogation of prisoners and detainees, which
led to the approval of an official position statement to that effect
last year (Psychiatric News, June 16, 2006).

Paralleling Ruiz's initiatives to strengthen APA's relationship with
advocacy groups were initiatives to do likewise with the National
Institute of Mental Health, National Institute on Drug Abuse, and
National Institute on Alcohol Abuse and Alcoholism.

Ruiz noted that the two psychiatrists in line to succeed him as APA
president-Carolyn Robinowitz, M.D., and Nada Stotland, M.D., share his
commitment to achieving humane care and have the personal and
professional qualities needed to do so. "Thus, let's continue to use
our principles, let's continue to use our values, and let's continue
to operate our APA within a framework of social responsibility."

Nonetheless, the end of Ruiz's term as president does not mean it's
time for him to step aside and let them and others carry on the
battle.

"I am not planning to fade away," he declared to a standing ovation.
"As long as there is a mental patient without access to health and
mental health care, without full and comprehensive parity of
psychiatric care and without receiving proper humane care, and who is
still living in the shadows, whether in this country or in any other
part of the world, I will return and join you in the trenches again,
again, and again."

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