Psychologists treat mental health and alcohol and substance abuse disorders.

• Did You Know? Mental disorders are common in the United States. An estimated 22.1% of Americans ages 18 and older — about 1 in 5 adults — suffer from a diagnosable mental disorder in a given year.

Training and Licensure. Psychologists receive a median of seven years of education and training beyond their undergraduate degree, including practica and internship training in hospitals and in other health care settings. Psychologists are licensed in all 50 states and the District of Columbia. Licensure is generally uniform, authorizing a psychologist to independently diagnose and treat mental and nervous disorders upon completion of both a doctoral degree in psychology (Ph.D., Psy.D. or Ed.D.) and a minimum of two years of supervised direct clinical service.

• Did You Know? The President's New Freedom Commission on Mental Health recommends that the nation must address mental health with the same urgency as physical health.

Psychotherapy. Psychologists provide psychotherapy, a treatment that in many cases is equally, if not more, effective than drug therapy. Cognitive and interpersonal psychotherapies, for example, are effective treatments for depression. Psychotherapy, as an alternative to drug therapy, is particularly valuable to elderly patients to avoid ovennedication or side effects of various drugs and drug interactions. Psychotheiapy is effective alone or in combination with medication to address a wide range of mental disorders, including anxiety disorders (such as panic, obsessive-compulsive, and post-traumatic stress disorders), depression, substance or alcohol abuse, and many other disorders that can devastate an individual's personal, family, social and work life.

Diagnostic Services. Psychologists also diagnose health problems with state-of-the-art diagnostic testing tools. Physicians and other health care professionals turn to psychologists for their diagnostic capabilities and services, including for example, detecting functional impairment and assessing the prognosis for improvement or deterioration in functioning. Psychologists apply these results and develop rehabilitative services and treatment.

Diversity. Psychologists are trained to and provide services to an increasingly diversified national population. By 2025, racial and ethnic minorities will comprise nearly 40% of Americans. These individuals experience access-to-care and socio-cultural issues that must be addressed to ensure quality care. People living in rural and frontier areas also commonly have access-to-care challenges, and psychologists in these areas tailor care and make use of innovative technologies to provide treatment, Women, children and adolescents, the elderly, persons of diverse sexual orientation and the disabled have special needs and require interventions that address their unique needs. Psychologists continue to work to solve issues related to diversity in mental health treatment.

In addition to mental health, psychologists provide primary, preventive and disease management services for patients dealing with both mental and physical disorders. The mind and body are linked, and mental disorders frequently co-exist with physical disorders. Psychologists, often working with physicians and other health care professionals, care for patients to prevent illness and to participate in chronic disease management.

• Did You Know? 24% of patients who present themselves to primary care physicians suffer from a well-defined mental disorder. The majority of these patients (69%) usually present to physicians with physical symptoms and there is ample evidence that many of these cases remain undetected.
• Did You Know? Of individuals who die by suicide, approximately 90% had a mental disorder, and 40% of these individuals had visited their primary care doctor within the month before their suicide.

Preventive Care. The President's New Freedom Commission on Mental Health recommends screening for mental disorders in primary health care, across the life span, and connection to treatment and support systems. Psychologists' screening services are key to meeting this need, and psychologists help patients develop coping strategies and healthy behaviors, which are effective in reducing the factors associated with the development of illness. For instance, psychotherapy and/or behavioral interventions help individuals to change habits to reduce risks for cardiovascular disease, cancer and HIV.

Primary Care. Recognizing that mental health is key .to overall physical health, the President's New Freedom Commission on Mental Health cited primary care as an area where patients need to receive more effective mental health assessment and treatment. The Commission recommended widespread implementation of collaborative care models in primary care health care settings, highlighting for example a collaborative care model for treating late-life depression. Psychologists in primary care settings work together with physicians and other health care professionals and serve a crucial function in assessment, treatment planning, and provision of psychological services for patients with a wide variety of health complaints. Psychologists also commonly provide behavioral interventions to ensure patient compliance with treatment regimens for physical health problems.

Chronic Disease Management. Psychologists commonly work in primary, acute and long-term care settings to provide services to patients with chronic conditions, such as diabetes and conditions stemming from obesity. These services include an array of individual, group, and family psychological interventions that are effective for depression, anxiety, pain and adjustment issues surrounding chronic illness. Psychologists help patients with life-threatening illnesses, such as coronary artery disease and cancer to manage pain, cope with medical interventions and the side effects of interventions, and by providing support to address family needs and the tangible and intangible aspects of illness.

Diabetes. As the President's New Freedom Commission on Mental Health cites, people with both diabetes and depression have an increased likelihood of experiencing diabetes complications compared to those without depression. Psychologists deliver a number of interventions to help patients address diabetes. For example, psychologists help diabetic individuals maintain diet and insulin treatments through psychotherapy.

Obesity is now recognized as a major national health concern due to its prevalence in adults and children, and its impact on mortality, diabetes, cancer, cardiac and other health conditions. In fact, the annual U.S. direct costs (such as treatment) and indirect costs (such as lost wages) associated with obesity and overweight are estimated at $122.9 billion, which is comparable to the costs of cigarette smoking. Psychologists are helping to fight obesity through behavioral interventions and counseling programs.

• Did You Know? In a groundbreaking study conducted jointly by researchers at the Duke University Medical Center andAPA, patients who were taught to manage their stress in addition to usual medical care had fewer adverse cardiac events and cost less to treat over a sustained period of time.

Cardiac Care. Psychosocial factors contribute significantly to coronary artery disease. Psychologists have expertise to help people reduce the risk of heart disease and the incidence of heart attacks. Psychologists also help patients recover from heart attacks. Incorporating psychological interventions, such as stress management, into the overall treatment of cardiovascular disease has been shown to have significant economic and health benefits.

• Did You Know? Researchers estimate that as many as 50 to 7 5% of cancer deaths in the United States are caused by human behaviors such as smoking, physical inactivity and poor dietary choices.

Cancer. Psychologists are also often part of the team of health care professionals who treat cancer patients, working directly with the patient and his or her family and the entire medical team to personalize decisions, deal with symptoms, manage treatment side-effects, improve communications and provide support and enhance recovery and well-being.

Psychologists provide services not only in health care facilities but also in many other settings.

Outpatient Care. Psychologists typically deliver psychotherapy and other services as solo or group practitioners. For many patients and payers of care, outpatient psychology treatment is effective, cost-efficient, and less restrictive and more accessible than inpatient care. Psychologists are trained to treat the most serious mental disorders, but they also help people in all aspects of daily life, such as parenting, caring for elderly parents, other family issues, or sexual issues.

Inpatient and Other Settings. Psychologists are important providers of inpatient care in general hospitals, psychiatric hospitals, VA and military hospitals, and in clinic settings such as community mental health centers, outpatient clinics, nursing homes, and rehabilitation facilities. Psychologists also teach and provide services in universities and colleges, medical schools, and university counseling or guidance centers.

• Did You Know? One in 12 high school students is threatened or injured with a weapon each year. An individual between the ages of 12 and 24 faces the highest risk of being a victim of violence.

Elementary and Secondary Schools. Psychologists in elementary and secondary schools fulfill multiple roles. They deliver prevention, intervention and crisis services to students. They provide psychological educational assessment and evaluation. Psychologists consult with teachers and school administrators about student issues, classroom management and school-wide programs. Administrators and teachers also turn to them for their diagnostic and treatment capabilities, and for help in resolving students' family issues. Since the September 11, 2001 terrorist attacks, psychologists have increased efforts to help children and adolescents cope with and develop their resilience skills.

• Did You Know? 4 of the 10 leading causes of disability in the United States are mental disorders.

Workplace. Psychologists help employers to make the workplace more psychologically healthy and productive. They help employees deal with stress and other workplace issues through employee assistance programs and initiatives. APA encourages psychologically healthy workplaces by honoring best practices as a part of the Psychologically Healthy Workplace Award Program.

• Did You Know? About 16% of all inmates in state and federal jails suffer from a mental disorder and an astounding 80% of all children entering the juvenile justice system have a mental disorder.

Criminal Justice System. Psychologists provide forensic evaluations and testimony, and they work in correctional and juvenile justice facilities, providing mental health services to criminal offenders with mental disorders. Psychologists are at the forefront of developing innovative initiatives, such as jail diversion, mental health courts, and community re-entry programs to prevent mentally ill offenders from recycling back into the criminal and juvenile justice systems. The President's New Freedom Commission on Mental Health recommended the widespread adoption of these programs to avoid the criminalization and extended incarceration of non-violent adult and juvenile offenders with mental disorders.

Psychologists aid people in a crisis or disaster, and psychologists have responded to terrorist attacks by helping Americans build their resilience to the threat of terrorism.

Disaster Response. In association with the American Red Cross, APA's Disaster Response Network of more than 2,000 volunteer psychologists, trained in disaster response, assist relief workers, victims, and victims' families in the wake ofmanmade or natural disasters. These psychologists help disaster victims cope with extremely stressful, often tragic circumstances in many ways, including providing emotional support and helping people marshal their own successful skills of resilience.

Terrorism. Since the September 11, 2001 terrorist attacks, psychologists are helping people build their resilience in response to a continuing threat of terrorism and the ongoing stresses of war. Psychologists active in outreach are conducting forums and bringing resources to communities to enable people to strengthen their resilience. To this end, APA has developed pamphlets and on-line material for psychologists and the public.

Government Relations Office - February 2005