May 15-17, 2026 | San Francisco, California
By John P. D. Shemo, MD, DLFAPA
PSV Representative to the APA Assembly
The Assembly meeting, as usual for the spring meeting, was held prior to the annual scientific meeting in the hosting city. During the Assembly meeting the Assembly members, including the representatives of the district branches in the United States, Canada, and Puerto Rico as well as representatives of various subspecialty groups, and the resident/fellow and early career representatives are given reports by components of APA governance and leadership and also deliberate on an array of APA Position Statements and Action Papers.
Position Statements are usually concise outlines of the position of the APA on issues relevant to psychiatric practice, our patients, or society in general. They are formulated by various committees and components of the APA and often are the response of the APA to an issue addressed by an Action Paper. They are reviewed in the Assembly generally both by the seven area councils, which are mostly geographic, but also by one of the five reference committees. The Assembly cannot apply any revisions to the Position Statements. They must only pass or reject as written, but if rejected, the concerns leading to the rejection are known to the authoring component and a member of the Assembly does sit on each component. The authoring component can, therefore, make revisions to address the concerns and resubmit the amended Position Statement at the next assembly meeting.
Action Papers arise from the Assembly. They must have at least one Assembly co-author who presents it to the Assembly for consideration, but the Action Papers can have non-Assembly APA members as co-authors. The Action Papers are reviewed at a variety of levels. They are often first reviewed by the board of the district branch of the author. Each Action Paper is then assigned to one of the five reference committees which consist of Assembly members from each of the seven areas as well as representatives from the various subspecialty groups and from the resident/fellow and early career caucuses. The reference committee generally do work on their assigned action papers virtually before the Assembly Meeting and reference committee meetings are held on the first day of the Assembly Meeting when any Assembly member can attend and comment. In this process, concerns about or improvements to the paper can be addressed and revisions made. The final revision of the Action Paper by the reference committee is then put on a consent calendar. At the ensuing full Assembly Meeting, each reference committee will present its consent calendar recommendations. Any single member of the Assembly at that point, including the original author of the paper if they disagree with the revision or the decision of the reference committee to not recommend the paper for approval, can move that the paper be removed from the consent calendar and be debated on the floor of the full Assembly. Once any papers are thus pulled from the consent calendar the Assembly votes to approve, as amended by the reference committee, all papers still remaining on the consent calendar.
When the “pulled” papers are presented on the floor of the Assembly, any Assembly member has the opportunity to speak for or against the paper and/or propose revisions. Each revision can be debated and accepted or rejected by vote of the full Assembly. After this process, the then standing or revised paper is, by voice vote, usually, either passed or defeated. If the voice vote is not clear and decisive, the Assembly will vote again using a device by which the vote is based on the number of APA members each Assembly member represents, which, in turn, is determined by the number of APA members in their district branch. Members representing a group such as a subspecialty or in a governance position have one vote each as all APA members have district branch representatives. I appreciate that this explanation is a bit lengthy but I do think that, for new members, a periodic review of how the Assembly functions is appropriate.
In this Assembly Meeting, we did address a total of 30 Position Statements and Action Papers. Position Statements must be reviewed and potentially revised every five years to ensure that they are still relevant and current.
A brief sample of the issues addressed at this Assembly included:
- Passed – Revised Position Statement on Substance Use Disorders.
- Passed – Revised Position Statement on Tobacco Treatment and Recovery.
- Passed – Revised Position Statement on Nicotine, Vaping Products, Electronic Cigarettes, and Alternative Inhaled Delivery Systems.
- Passed – Position Statement on Kratom and Derivative Products.
- Passed – Position Statement on Medicare Psychiatric Hospitalization Limit.
- Passed – Position Statement on Integrated Care.
- Passed – Revised Position Statement on Pharmacy Benefit Management.
- Passed – Revised Position Statement on Cultural Psychiatry as a Critical Area of Study Relevant to the Assessment and Care of all Patients.
- Passed – Position Statement on Plastics.
- Failed – Revised Position Statement on Pharmaceutical Marketing to Justice Entities Regarding Medication Treatment for Psychiatric Disorders Including Substance Abuse Disorders.
- Passed – Revised Position Statement on HIV Risk Reduction.
- Passed – Position Statement on The Use of Artificial Intelligence for Mental Health Services and Treatment.
- Passed – Position Statement on Access to Antipsychotics for the Treatment of Behavioral and Psychological Symptoms of Dementia.
- Passed- Report of the DSM Steering Committee: Proposed Changes for the Severity-Specifiers for Eating Disorders.
- Passed – Action Paper – Creating an APA Position Statement on Gambling Harm Mitigation. Passed – Action Paper – The Ethical Use of Artificial Intelligence and Legal Implications for Psychiatrists.
- Passed -Action Paper – Strengthening the Role of Psychiatry in the Behavioral and Clinical Management of Obesity.
- Failed – Action Paper – Creating Clear and Operational Definition of Parity for Mental Health Treatment.
- Passed – Action Paper – Supporting Countertransference Education for Non-Psychiatric Physicians.
- Passed – Action Paper – Develop an APA Position Statement on Age-Triggered Physician Assessment.
- Failed – Action Paper – Member Dues Discount for Psychiatrists Serving in Leadership Positions.
- Passed – Action Paper – Title Misappropriation and Transparency – The Erosion of Informed Consent.
Details of the individual Position Statements and Action Papers reviewed and their outcome is available on the APA website.
A few points of interest:
- APA’s investment policy prohibits direct investment in pharmaceuticals, managed healthcare, tobacco, and fossil fuels. Nonetheless, APA investments increased in market value in 2025 by 15 percent – outperforming the composite industry benchmark of 14.6 percent.
- Future DSM Strategic Committee – Volunteer experts and committee members have already contributed more than 1,700 hours to the effort. In January, APA released publications outlining a new conceptual framework for the next DSM, emphasizing contextual factors, biological markers, refined diagnostic categories, and transdiagnostic features.
- APA joined patients and families in filing a federal class action complaint against Emblem Health, alleging the insurer maintained a deceptive “ghost network” of mental health providers, directories containing inaccurate, duplicated, or unavailable clinicians that obstructed members ability to access in-network psychiatric care.
- Voter turnout for the 2026 APA leadership election was 12.85 percent with 3,734 of 29,061 eligible voting members participating. Those who vote are concentrated in very predictable areas. This is not compatible with the organization functioning as a participatory democracy.
I have long advocated one of two solutions to this dismally low voter turnout. One would be to have leadership voting done by the Assembly, as every member in every district branch has representation in the Assembly. This is the method used at the AMA. An alternative would be to have the election ballot attached to and sent out with the yearly dues payment notice. Virtually all APA members get the dues notice, since the request for contributions to both the APA Foundation and the PAC is attached as part of this notice. Obviously, a member must pay their dues to remain a member, so they must respond to this notice.
Those who have been in the APA/PSV very long will be aware that, in the past, I did for four years in a row, submit an Action Paper at the Assembly proposing this option. It was passed four times by the Assembly, but never acted on by the board. It is relevant that the board members are elected in the context of this very small and geographically limited voter turnout. PLEASE vote in APA elections.
Adam, Sherin, and I, as always, remain available to bring member concerns and suggestions to the attention of the Assembly.
