President’s Corner - John L. Santa, Ph.D.
April 2006

Defining NATSAP In Order To Advocate Effectively

I recently had the opportunity to attend a meeting of the National Association of Psychiatric Health Systems (NAPHS). Elliot Sainer of the Aspen Corporation has been a long standing member of NAPHS and encouraged contacting them particularly with regard to important political issues such as the pending possibility of a federal regulatory bill (the Miller bill) that might have extremely adverse effects on all of our programs.

Rosemary Tippett, our new director of public relations, contacted the NAPHS offices in Washington, and they were quite receptive to forming an alliance to help advocate on behalf of mental health care and in particular to mitigate the potential impact of ill conceived regulatory efforts such as the proposed Miller legislation. Rosemary was invited by Mark Covall (Executive Director of NAPHS) to attend their annual meeting and set up a time for their Youth Service Committee to meet with NATSAP representatives (including Rosemary Tippett, Jan Moss and myself). At this meeting we learned about the importance of forming relationships with other national behavioral health organizations.

It became quickly clear that as representatives of NATSAP we needed to explain who we were and how NATSAP might relate to them. It turns out that defining NATSAP to an interested outsider is not entirely simple, but I think it is essential to develop a succinct definition of who we are and what sets us apart in order to create an effective public relations effort for our profession. We began our attempt to introduce NATSAP by explaining that we are an organization of nearly 170 member programs serving over 15,000 young people and their families every year. Our programs primarily serve the private paying market. Most of our programs offer a level, scope, and length of treatment that has been defined as outside the responsibility of managed care insurance companies and school systems. We have come together both as a trade organization and a professional organization to define practice standards, support innovation in care, educate our employees, and to serve as an advocate and voice for all of our programs.

We explained that our programs are not acute care hospitals, or hospital based residential treatment centers. Our members come from a set of alternative approaches to psycho-social-educational treatment of disturbed youth. The approaches emphasize creating environments or communities that provide a safe containment of children who cannot be contained in their homes either emotionally or behaviorally.

Parents who place their children in NATSAP programs are desperate. Their children have been seen by outpatient therapists, psychiatrists, and school learning specialists. They typically have elaborate psychological workups, numerous DSM IV Axis I diagnoses, and a large percentage have tried to solve the diagnoses with multiple trials of medication coupled with months or at times years of therapy. In spite of all efforts by concerned parents these youngsters continue to struggle and fail in the tasks expected of normal adolescents. They are often failing at school, overwhelmed emotionally, and exhibit ruptured social and family relationships. Conventional educational and mental health services have failed. Parents realize that these promising children are headed for a train wreck. If these youngsters continue on such disrupted paths they will fail to become functional adults.

Our children typically exhibit a serious lack of executive function, of emotional control, the ability to delay gratification and plan for a realistic future, and finally the ability to understand that they are not entirely the center of the universe. They exhibit many symptom clusters, but the common denominator is a gross lack of maturity. Such children need containment, nurturing and a non-pathological intervention that encourages them to develop a more mature, appropriate, and successful approach to life. Our schools and programs have evolved to offer an integrated, holistic, psycho-social approach to children and their families. NATSAP programs are committed to providing ethical and appropriate service to youth and their families. Our programs provide care that includes a range of competent professionals including psychiatrists, psychologists, social workers, educators, and wilderness instructors.

We put considerable energy into defining ourselves and setting ourselves apart by creating a consensus on ethical principles, common practice standards, and a collegial professional identity. This common definition and purpose make it possible to provide a description of NATSAP that hopefully applies to all of our programs. Such a definition is the first crucial and essential step in creating the ability to promote our organization and provide an advocacy on specific issues that effect all of us.

Our meeting with NAPHS taught us a number of things about how to go about advocacy projects. We realized that public relations and advocacy depends on establishing relationships. I have to say that NATSAP is incredibly fortunate to have Rosemary Tippett, MSW as our representative. She has a truly remarkable ability to form close relationships based on integrity, intelligence, and personal warmth. We must be proactive and cultivate a constant awareness of who we are and the good things we accomplish. Second, we are more powerful than we think, particularly if we enlist a broad grassroots effort from all members and as many of our satisfied parents and students as possible. Third, we must continue to create alliances with like minded groups that can broaden the impact of a professional association, and create an awareness of NATSAP. Finally, we must develop a clear focus for each advocacy effort.

We need the help of all member programs to create an effective public relations program for NATSAP. In a few months we will ask each program to fill out a detailed questionnaire that will help us create the data to allow politicians, and other organizations to understand our programs better. We need information that more completely describes who we serve, the positive impact and outcomes we create, the actual incidence of problems and risks in our work, and the economic impact we have in our communities. Personally, I hate filling out surveys, but if NATSAP is to become an effective voice and advocate for our profession we need someone in each organization to take the time to fill out the survey.

We also encourage all programs to invite community leaders as well as state and federal legislators to visit and see who we are. As you do this make certain to identify your program as a member of NATSAP, an organization that advocates for quality care for troubled youth. When you invite a guest to campus create a news release for your local papers and be sure to copy the release to NATSAP so that it can be posted on our web site.

Invite your local media to visit, interview, and write a story that highlights the positive impact of your program and make sure to note that you belong to NATSAP an organization composed of programs committed to high standards of care. Again, send us a copy of the story.

Finally, NATSAP needs to create a “grass roots” response plan. When we have an issue that demands action we need to create a clear, simple message and then programs must forward the same message to their respective legislators.