APA Committee Research Articles

Award for Distinguished Contributions to the International Advancement of Psychology: Judith L. Gibbons.

"APA's Committee for Global Psychology is pleased to present this award to Judith L. Gibbons. Dr. Gibbons is Professor Emerita of Psychology at Saint Louis University and throughout her career has exemplified the best of international scholarship, mentorship, editorships, professional leadership, and humanitarian service. Her scholarship focuses on international and cross-cultural studies of adolescent development, intercountry adoption, psychology of women and gender, and human-equine interaction. Dr. Gibbons has made extraordinary contributions to the publication of international psychology research, serving on numerous editorial boards and as founding editor of the journal International Perspectives in Psychology: Research, Practice, Consultation. Through this work, Dr. Gibbons has served as mentor to researchers from around the globe, particularly scholars from underrepresented parts of the world. She has served on numerous boards and as advisor to multiple international groups and committees, including as President of the Society for Cross-Cultural Research and the InterAmerican Society of Psychology. Dr. Gibbons has also served as Vice-President of the Board of Directors of Colegio Americano del Sur, a K-12 bilingual private school in Guatemala, and as a pro-bono monitoring and evaluation consultant for the Guatemalan nongovernmental organization SerNiña. In recognition of her ongoing commitment to global scholarship, publication, and mentorship; service to international organizations; and dedication to using psychology to help children, the Committee for Global Psychology presents to Dr. Gibbons the 2023 APA Award for Distinguished Contributions to the International Advancement of Psychology." This award honors an individual who has made sustained and enduring contributions to international cooperation and the advancement of knowledge in psychology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

HIPAA Compliance for Telehealth to Be Required Again on August 9

Back to table of contents Next article Government & LegalFull AccessHIPAA Compliance for Telehealth to Be Required Again on August 9Mark MoranMark MoranSearch for more papers by this authorPublished Online:31 May 2023AbstractHIPAA compliance is about more than just technology—it also means having physical or environmental and process security measures in place. A business associate agreement with a vendor may be necessary to ensure compliance with HIPAA.The federal Office of Civil Rights (OCR) in April extended the deadline for requiring telehealth compliance with the Health Insurance Portability and Accountability Act (HIPAA) by 90 days to August 9.At that time, health care professionals practicing telehealth must comply with HIPAA’s Security Rule and will no longer be able to use standard video technologies such as Zoom, Skype, or Facebook to meet with patients, as they had been allowed to do during the Public Health Emergency (PHE), which ended on May 11. Even before the new deadline, psychiatrists and other health care professionals need to pay attention to state rules about HIPAA compliance as well as the requirements of their institution, organization, or practice.“Best practices to ensure environmental privacy include clinicians connecting from a private space and letting patients know if there are others in the room with them,” said Shabana Khan, M.D. “This demonstrates to patients that their telehealth clinician values protecting their health information.”“OCR is providing this transition period to allow health care practitioners and practices to make necessary changes to ensure that their telehealth technologies are private and secure in a way that is adherent with HIPAA rules,” said Shabana Khan, M.D., chair of the APA Committee on Telepsychiatry. “Though OCR has provided this 90-day transition period through August 9, telehealth clinicians must also consider state rules and practice or organization requirements when deciding which technologies to use for telehealth services. We have this flexibility at the federal level, but an organization may require that their clinicians use approved HIPAA-adherent technologies.”HIPAA, which was signed in 1996 by President Bill Clinton, sets national standards for health information protections. The U.S. Department of Health and Human Services (HHS) established these standards to ensure protected health information (PHI) processed and utilized by “covered entities” is private and secure. OCR is responsible for implementing and enforcing this rule. HIPAA requirements cover a broad range of patient data and information, including making an appointment, conducting the appointment, and billing the patient’s insurance.HIPAA encompasses two major rules: the Privacy Rule and the Security Rule. The Privacy Rule protects all identifiable data of an individual patient; the Security Rule, a subset of the Privacy Rule, protects information that a covered entity creates, receives, maintains, or transmits in electronic form.So what does it mean to be HIPAA compliant when providing telehealth services? Importantly, it’s not just about technology. It also means having physical or environmental and process security measures in place to ensure that only those who are supposed to have access to patients’ information are able to get it.“Environmental privacy best practices include clinicians connecting from a private space and letting patients know if there are others in the room with them—for instance, a nurse or medical student who may be off screen,” Khan said. “Clinicians should also provide guidance to their patients on the importance of connecting to telehealth visits from a private space and avoiding public or semi-public settings. Clinicians can also ask patients if there is anyone in the room with them at the start of the visit. This demonstrates to patients that their telehealth clinician values protecting their health information.”Technology features that can help a HIPAA-covered entity meet compliance requirements include the following:Fully encrypted data transmission.Additional authentication and security through required passwords.Secure point-to-point connection.Private high-speed network.Administrative, physical, and technical safeguards for electronic protected health information.Audit controls.Breach notification.John Torous, M.D., chair of the APA Committee on Mental Health IT, said psychiatrists must use vendors of telehealth technology who can assure HIPAA compliance and have a signed business associate agreement (BAA).“Often you can use the same product (such as Zoom) without a BAA, but to make it HIPAA complaint, a psychiatrist needs to use the version of Zoom that requires the signature of a BAA,” he wrote in an email. “Regardless of the technology, being HIPAA complaint means the psychiatrist still has to offer reasonable physical safeguards (such as keeping computer passwords secure) and have process safeguards in place too (restricting access to patient files, creating plans for appropriate use of data).” ■ResourcesHHS Office for Civil Rights AnnouncementHIPAA & HIT: A PrimerSummary of the HIPAA Privacy RuleThe Security Rule ISSUES NewArchived

Disaster Psychiatry Needs You: How to Get Involved

Disaster Psychiatry Needs You: How to Get Involved

Ezra Griffith, M.D., to Receive Chester Pierce Human Rights Award

Ezra Griffith, M.D., to Receive Chester Pierce Human Rights Award

Telehealth Providers: Begin Planning Now for End of COVID-19 PHE

Telehealth Providers: Begin Planning Now for End of COVID-19 PHE

COVID-19 Public Health Emergency to End in May

COVID-19 Public Health Emergency to End in May

A Summary of Conscience in Reproductive Health Care: Prioritizing Patient Interests

At the 2022 Central American Philosophical Association meeting (Chicago, Illinois, February 23–26), there was an Author-Meets-Critics session on Carolyn McLeod’s (2020 ) book, Conscience in Reproductive Health Care: Prioritizing Patient Interests. The event was organized and chaired by Heather Stewart and sponsored by the APA Committee on the Status of Women and Kate Norlock, chair of that committee. There were four speakers, including McLeod and three “critics”: Javiera Perez Gomez, Alison Reinheld, and Jennifer Parks, who were all generous enough to provide McLeod with their comments beforehand. The sessions occurred over Zoom even though some speakers were present in person at the conference. McLeod kicked things off by providing a summary of her book, which was then followed by critical (and supportive!) comments by the critics in the order in which they’re named above. McLeod responded to their remarks and then Stewart led a Q&A session with our small but lively and intelligent audience. The content of what was said has been reproduced here.

What Every Psychiatrist Should Know About the Climate Crisis

Back to table of contents Previous article Next article Climate ChangeFull AccessWhat Every Psychiatrist Should Know About the Climate CrisisDavid Pollack, M.D., Elizabeth Haase, M.D.David PollackSearch for more papers by this author, M.D., Elizabeth HaaseSearch for more papers by this author, M.D.Published Online:25 May 2022https://doi.org/10.1176/appi.pn.2022.06.6.36The APA Committee on Climate Change and Mental Health is identifying the key components of curricula on climate-related issues. The following list describes the broad scope of mental health concerns related to climate change, organized by the following:The neuropsychiatric consequences of exposure to various climate vectors, such as heat, air pollution, and neurotoxicant exposure.The array of anxiety and mood symptoms/conditions that arise from acute disasters and long-term exposure due to repeated climate harms.The indirect effects of the ever-increasing sense of foreboding, fear, anxiety, and hopelessness that derive from growing climate awareness within the general population, with special emphasis on the impacts on children and youth.This list should be considered and included in any climate and mental health–related curriculum program for professional trainees at the graduate medical education and continuing medical education levels, for example, psychiatry residents and practicing psychiatrists. The content may need to be simplified for undergraduate medical curriculum inclusion. More details in “Climate and Health Curriculum Development: Mental Health Impacts and Responses.”HeatThe impact of high temperatures on violence, suicide, and depression.The relationship between neurotransmitters and heat regulation and how psychotropic medications increase heat stroke risk.Safety measures during heat waves.Policy measures that can be enacted to promote resilience to mounting temperatures.Air pollutionThe psychiatric impacts of ozone and particulate air pollution on children’s developmental cognitive health, on dementia, and on depression and suicide.The relationship between clean air policies and improved population health.Habitat change and neurobiologyClimate impacts on infectious disease vectors, waterborne disease, and the nutritional value/availability of food.Connection of nutritional changes to common mental disorders.How waterborne toxins result from changes or diversions of water supply.Habitat change and psychological effectsClimate impacts on loss of culture and livelihood due to geophysical changes and forced migration.The psychic demands and emotional impacts of habitat change.The role of mental health professionals in facilitating the emotional process of adaptation and focusing on the psychological processes that support social cohesion.Existential and general psychologyHow climate change affects people emotionally.How to address existential distress, resistance to change, cognitive biases, denialism, and the overwhelming complexity of climate solutions.Eco-anxietyDescription of eco-anxiety and psychiatric models for understanding it, emphasizing that eco-anxiety is often nonpathological and different from clinical anxiety disorders.Ecological griefThe impacts on indigenous communities, women’s reproductive decisions, farmers/ranchers, and others whose lives depend upon the land.Our larger collective grief and sense of human failure.The work of planetary mourning and how our love of what we lose can stimulate positive action.Behavioral change for climate changeChange theory and the neurobiology of habits.Habits of thought that deter climate responsiveness at individual and societal levels.Re-imagining, telling new stories, being creative, being authentic, and showing moral courage to facilitate sustained change in the face of the climate crisis.Communicating about climate changeEffective strategies for educating/motivating health professionals.The best approaches for clinical encounters, public presentations, and policy discussions.Group approaches to climate distressCommunity groups for processing climate distress.Methods for living sustainably through conscious community.Community approaches to climate resilienceWhat communities can and should do to prepare for the health and mental health impacts of climate change.Engagement with environmental justice and just transition initiatives.Transformational resilience–derived public health interventions at the community level to promote psychosocial resilience and social cohesion.Climate disastersThe psychological impacts of acute and repeated weather and climate disasters.Understanding how “we are all in or between disasters” to support sustained humanitarian and emotional disaster responses. ■David Pollack, M.D., is professor emeritus for public policy in the Department of Psychiatry and Division of Management at Oregon Health and Science University. He is also a member of the Climate Psychiatry Alliance.Elizabeth Haase, M.D., is medical director of behavioral health at the Carson Tahoe Regional Medical Center and chair of APA’s Committee on Climate Change and Mental Health. ISSUES NewArchived

Accountability Committee Tracks APA’s Progress on Structural Racism

Accountability Committee Tracks APA’s Progress on Structural Racism

Use of Emotion Recognition Tools in Psychiatry Said to Be Premature

Back to table of contents Previous article ViewpointsFull AccessUse of Emotion Recognition Tools in Psychiatry Said to Be PrematureJacob Lee, M.D.Jacob LeeSearch for more papers by this author, M.D.Published Online:28 Jan 2022https://doi.org/10.1176/appi.pn.2022.2.36AbstractThe extended COVID-19 pandemic has brought about untold changes across nearly every facet of life in the United States. As society looks to transition from the crisis phase toward a so-called “new normal,” many industries are making greater use of tools that enable productivity at a distance. In many cases, artificial intelligence (AI) has provided the foundation upon which these tools are developed. Emotion recognition tools (ERTs) are one example. These AI-powered technologies are alleged to be able to evaluate facial micro-expressions based on camera data, from which an emotional state is reported. Is your co-worker happy? Is this second grader angry? The potential benefits of these technologies are obvious, but the many pitfalls may not be.As this new field explodes onto the scene and is poised to reach a value of $20 billion to $60 billion by mid-decade, the stakes for an industry rightfully already under ethical scrutiny have been heightened. The central questions for these technologies regard how accurately software can identify facial expressions, and whether facial expressions are a reliable indicator of underlying emotion. The technology companies confidently assert that these questions are answered and have introduced their new technologies into diverse and ethically complex settings including private and national security, criminal justice, and health care. Already, software programs such as Woebot have introduced mental health–specific ERT applications to monitor depression, anxiety, and substance use. This program received FDA Breakthrough Device designation to monitor women for postpartum depression. While Woebot was designed and validated by Stanford-trained computer scientists and psychologists, many other programs have not been developed with such scientific rigor.Built upon models by Paul Ekman, Ph.D., to categorize facial movements into emotional taxonomies, current ERT technologies largely tout the ability to recognize “the six universal human emotions”: anger, disgust, fear, happiness, sadness, and surprise. Technologies such as the Enablex or Emotient software also claim to detect attention and arousal. Psychiatrists utilize facial expressions as part of a complex, multifactorial formulation of a patient, whereas these software programs rely primarily on graphical information captured by a webcam. For the same reasons Ekman’s ideas have been subject to increasing scrutiny by contemporary psychologists and psychiatrists, technologies built upon these models often fail to consider cultural differences and cultural factors.A landmark 2019 review in the journal Psychological Science in the Public Interest by Lisa Feldman Barrett, Ph.D., et al. found weak correlation between facial expressions and emotions. In short, while people do smile when happy, there are substantial differences across cultures, situations, and even individuals. Many female-presenting individuals are socialized to smile politely, which might not confer happiness or agreement. As these technologies are largely being developed by a small, homogenous group of programmers, particular caution is needed.Anticipating the dangers of this understudied technology, legislators within the European Union have already drafted an omnibus proposal to regulate AI in this and similar applications. The American think tank Brookings Institution called for a total ban of ERTs in law enforcement, citing civil liberty concerns.Just as medications and therapies are subject to intensive study prior to use on humans, psychiatrists should lobby for greater study of emotion analysis technologies prior to their further deployment. Child psychiatrists, in particular, should object to the use of these understudied technologies to analyze minors in ways that might have lasting negative consequences. Until these software programs are validated, we should approach their analyses with caution and skepticism. ■“Emotional Expressions Reconsidered: Challenges to Inferring Emotion From Human Facial Movements” is posted here.Jacob Lee, M.D., is a PGY-4 child/adolescent psychiatry fellow at the University of Hawaii and a member of the APA Committee on Climate Change and Mental Health. ISSUES NewArchived

Audio-Only Telehealth Now Approved Permanently for Mental Health/Substance Use Services

Audio-Only Telehealth Now Approved Permanently for Mental Health/Substance Use Services

APA Committee Overseeing Implementation of APA’s Anti-Racism Plan

Back to table of contents Previous article Next article APA & MeetingsFull AccessAPA Committee Overseeing Implementation of APA’s Anti-Racism PlanSearch for more papers by this authorPublished Online:7 Dec 2021https://doi.org/10.1176/appi.pn.2022.1.24Last June, the APA Board of Trustees transitioned the work of its Presidential Task Force to Address Structural Racism Throughout Psychiatry (TFSR) to the Structural Racism Accountability Committee (SRAC). The SRAC was created by the Board to oversee the implementation of the task force’s recommendations, evaluate their success, make additional recommendations for improvements, and accomplish the other objectives that were noted in the final task force report. The task force focused specifically on anti-Black racism, and in the coming year, the SRAC will expand the recommendations to include other minority/underrepresented groups (M/UR).The SRAC is co-chaired by Mary Hasbah Roessel, M.D., and Felix Torres, M.D., M.B.A.; its members are Elie G. Aoun, M.D., M.R.O., Ken Certa, M.D., Jeffrey Geller, M.D., M.P.H., Glenn A. Martin, M.D., Urooj Yazdani, M.D., and Melinda L. Young, M.D. Former APA President Altha J. Stewart, M.D., serves as committee consultant.To achieve its objectives, the SRAC has consulted and will continue to consult with APA members who have positions, expertise, and influence that align with each Board-approved action item. Also, the SRAC is working with APA’s district branches, the Assembly, the Joint Reference Committee, and councils and committees to implement the task force recommendations and to ensure that APA as an organization is a champion of anti-racism and provides a welcoming and inclusive environment for all its members.The SRAC presented progress reports to the APA Board at its October and December 2021 meetings; reports will be filed for the March and May 2022 Board meetings. In addition, Psychiatric News will periodically publish articles on the SRAC’s activities and progress.For information on the task force’s recommendations, the work of the SRAC, and APA’s initiatives on diversity, equity, and inclusiveness, visit psychiatry.org/SRAC. ■ ISSUES NewArchived

Award for Distinguished Contributions to the International Advancement of Psychology: Kathleen M. Pike.

APA's Committee on International Relations in Psychology (CIRP) is pleased to present the 2021 APA Award for Distinguished Contributions to the International Advancement of Psychology to Dr. Kathleen M. Pike. Over a nearly 40-year career, Dr. Pike has worked with scholars and research centers around the world. Having conducted valuable and high-quality scholarship around the world, she delivered the keynote address, about the global burden of mental health, at the 2014 G-20 Summit in Brisbane, Australia. In her current role as Director of the Columbia-WHO Center for Global Mental Health, she continues to work tirelessly for the advancement of psychological science as a pathway to improve the lives of people everywhere. This is evident in her development of an evidence-based online toolkit for supporting mental health during the COVID-19 pandemic, her establishment of the Global Mental Health Scholars Program, and her founding of the Global Mental Health Small Grants Program. She has taught over a thousand students from more than 60 countries, laying the groundwork for future generations to continue this important work. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Psychiatrists Can Help Support ‘New Normal’ at Schools

Psychiatrists Can Help Support ‘New Normal’ at Schools

Supreme Court Strikes Down Third Challenge to Affordable Care Act

Supreme Court Strikes Down Third Challenge to Affordable Care Act

APA’s Outgoing President Recalls Year of Accomplishments Despite Unsettled Times

APA’s Outgoing President Recalls Year of Accomplishments Despite Unsettled Times

Building a ‘Culture of Wellness’: Lessons for the Pandemic and Beyond

Building a ‘Culture of Wellness’: Lessons for the Pandemic and Beyond

Pandemic Takes Toll on Those Who Grieve

Pandemic Takes Toll on Those Who Grieve

Collaborative Care Rises to the Pandemic Challenge

Collaborative Care Rises to the Pandemic Challenge

Psychiatry’s Climate Reckoning: Time Is Now

Psychiatry’s Climate Reckoning: Time Is Now