Saturday, December 27, 2014

Organizational Fragmentation is Hurting Us

Mental health professionals are like cats. We are hard to herd. Perhaps this is due to our independent and autonomous nature, at which most of us seem to arrive after years of study and work as strong advocates of the individual. Perhaps this is an example of western philosophy taken to an extreme.

Whatever the source this has resulted in an unfortunate situation in which we have created a seemingly endless array of professional organizations with which we affiliate. These organizations appeal to narrow sensibilities or professional pursuits. Here are a few examples from the college mental health profession alone:
  • AUCCCD
  • ACCA
  • ACCTA
  • ACCCCS
  • AUCCCO
  • APA's Division 17 and its Commission on College Counseling
  • NASPA and its programs on mental health
  • ACPA and its programs on mental health
  • And professional organizations representing several disciplines within college mental health, such as APA, ACA, NASW, AMFTA, and those for psychiatry.
This is just a partial list. Other professions may have multiple associations as well, but often rely on a single one to speak on their behalf, such as ACHA or AMA for those in medical fields.

This degree of fragmentation is a major obstacle to advancing our specialty, which I believe it is. Due to all the voices, all the principles and customs on which these organizations were founded, it is next to impossible to form meaningful and potent alliances, position statements, and agenda for advocacy at any level. Attempts have been made, such as through HEMHA, but these may be limited in scope due to funding and staffing realities. Without appropriate funds and executive staff to carry out its goals, such efforts will always be quite limited in spite of the very best intentions behind them.

It is past time for us to correct this situation. Due to forces in the economics and politics of health care in the United States, some organizations are pursuing an agenda which often does not incorporate respect for other professions or their core philosophies, especially regarding youth and young adults. Trends toward pathologizing normal life experiences, such as bereavement, so that intrusive interventions may be deployed are but one example. Take note of the buzzwords associated with these efforts: evidence-based care, best practices, integrated care, and so on. As I covered in a previous post, these buzzwords mask another reality, which is integration without true integration, and selective review of research to support whatever may be called a best practice.

The professional organizations representing college mental health need to be consolidated in order to form a more active and potent and focused association. It is an irony that in our appreciation for diversity, we may have neglected the greatest diversity of all: the full range of our professional philosophies and service models. Without such a consolidation and re-calibrating of our efforts, this diversity will continue to suffer and may disappear altogether.