Psychologists Promote Health and Well-Being Throughout Our Nation

Psychologists treat mental health and alcohol and substance use disorders.

Did You Know? Mental disorders are common in the United States. An estimated 22.1 percent 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, the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands. 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 (PhD, PsyD or EdD) and a minimum of two years of supervised direct clinical service.

Did You Know? President George W. Bush’s New Freedom Commission on Mental Health recommended 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 overmedication or side effects of various drugs and drug interactions. Psychotherapy 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 percent of Americans. These individuals experience access-to-care and socio-cultural issues that must be addressed to ensure quality care. For example, the suicide rate among young African American men has nearly doubled since 1980. People 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. The mind-body connection was a motivation for Congress to pass the Wellstone/Domenici Mental Health Parity & Addiction Equity Act of 2008 and the parity and integration aspects of the Patient Protection & Affordable Care Act.

Preventive Care

The president's New Freedom Commission on Mental Health recommended screening for mental disorders in primary health care, across the life span and in 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

Mental health services are key primary care services, especially in rural and underserved areas. 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. Physicians, particularly in rural and underserved areas are carrying the burden.

• Research shows that 24 percent of patients who present themselves to primary care physicians suffer from a well-defined mental disorder and 69 percent of these patients present to physicians with physical symptoms and many of their mental health needs remain undetected.
• Of individuals who die by suicide, approximately 90 percent had a mental disorder, and 40 percent of these individuals had visited their primary care doctor within the month before their suicide.

Primary care physicians increasingly rely on the vital and unique mental and behavioral health services that psychologists provide to patients in primary care. No other provider is so highly trained to work with primary care physicians in addressing these needs of patients.

The Veterans Health Administration has undertaken a national initiative that Congress may consider as a model. The VA integrates primary care and mental health services by having both mental health and primary care providers physically present in the primary care setting with shared responsibility for evaluation, treatment, planning and monitoring of outcomes.

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 cited, 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

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. 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 and APA, 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 75 percent of cancer deaths in the United States are caused by human behaviors such as smoking, physical inactivity and poor dietary choices.

Cancer

Psychologists serve on multidisciplinary teams that treat cancer patients, working directly with patients and their families to personalize decisions, manage symptoms and treatment side-effects, improve communications, provide support and enhance recovery

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 Sept. 11, 2001 terrorist attacks, psychologists have increased efforts to help children and adolescents cope with and develop their resilience skills.

Did You Know? Four 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 percent of all inmates in state and federal jails suffer from a mental disorder and an astounding 80 percent 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 and natural disasters by helping Americans build their resilience in times of adversity.

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 of disasters. Following hurricanes Katrina and Rita, for example, these psychologists helped 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 Sept. 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 conduct forums and bring 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.

APA Practice Organization, February 2011