AAPL Pivots to Thrive Post-COVID
================================

* Liza H. Gold

*   American Academy of Psychiatry and the Law
*   online learning
*   membership
*   post-COVID

Over the past months, as I have received gentle reminders that I had a September 1 due date to submit the manuscript of this address, I struggled with finding a topic. To give a traditional address this year just did not feel right, and I could not work up the enthusiasm for doing so. But thinking further, I considered the theme of this year’s meeting: Forensic Psychiatry and AAPL Post-COVID. In the bleak days of mid-2020 when I selected this theme, it was and even today, still is, aspirational.

Throughout history, the chaos that epidemics bring has caused social and institutional structures to fray and at times to collapse. Whole cultures have been completely eradicated by infectious disease. Individually and collectively, anxiety and fear test rational thinking and logic, and we become more vulnerable to denial, distortion, false hope, and fatalism. Institutions and norms are tested; some rise to the challenge, others are permanently damaged or lost.

At times over the past months, it was not just the pandemic that caused many of us to feel pessimistic. For example, like many of you, I suspect, I never anticipated that once we had a vaccine, our country would still be struggling to cope with COVID. But, as 2021 draws to a close, despite the widespread availability in the United States of multiple free vaccines, our summer hopes of being closer to looking at the pandemic in the rearview mirror have tragically not been realized. About 2,000 people are still dying every day from this viral infection, despite the efficacy of the vaccines.

And I realized I did actually have some important things I wanted to talk about, not to the members of AAPL, really, but with the members of AAPL. There can be no doubt that the COVID pandemic has been a turning point in all our lives. In the wake of grief, sorrow, and loss, the pandemic has created new and overwhelming vulnerabilities and fears. Many AAPL members have been ill or have family members and colleagues who have been ill, or have lost loved ones, or a combination of the above. My heart goes out to all who have suffered in these ways. For our friends and colleagues who have endured illness and loss, the world will never be the same.

But let’s be honest. The world is never going to be the same for any of us, even if we have not been personally touched by illness or grief and even when our lives are no longer limited by COVID restrictions. Though the full toll of the pandemic has yet to be reckoned, people are already referring to “before” and “after” COVID as a demarcation in time, similar to the before and after of 9/11. Many things that we took for granted in the “before” time are no longer routine, accessible, or easily accomplished.

In addition, the existential threat the COVID pandemic has posed has also revealed the depth and breadth of unaddressed and unresolved societal, institutional, and economic problems that preexisted the pandemic. Income inequality, racism, homelessness, and other perennial but complex problems were exacerbated by the turmoil of the pandemic. Therefore, I am sure it is not surprising to hear me say that COVID also created an existential crisis for AAPL, both because of pandemic restrictions, but also because of exacerbation of preexisting but unaddressed needs and challenges.

So, I have good news and bad news. The good news is that, with the hard work of many people under difficult circumstances, AAPL has not only held its own, but we have positioned ourselves to be able to come out of the pandemic as a stronger organization than we were before. The bad news is that AAPL is not out of the woods and our existence post-COVID, although certainly less precarious, is still not assured.

Our first dilemma was created on March 15, 2020, when I was still President-Elect, when the American Psychiatric Association canceled its April 2020 Annual Meeting in Philadelphia. Some of the usual AAPL organizational business we had to address at the APA semiannual meeting could be postponed, but some business, such as selecting a new slate of officers, could not be indefinitely delayed without affecting the integrity of AAPL’s governance. Jackie Coleman and the AAPL staff, with their usual resourcefulness and commitment, were able to help us get the essential organizational business accomplished. I am sure I was not the only person who didn’t know how a zoom meeting with more than one other person worked. Just figuring out how to participate felt like moving mountains to me, so I can only imagine how it felt to those responsible for making it happen.

I became increasingly concerned that the canceled APA meeting was just the beginning of AAPL’s problems. By late spring it became clear to me that the AAPL 2020 Annual Meeting in Chicago, and probably the 2021 Annual Meeting in Vancouver, Canada, were not going to take place as planned. As you know, AAPL has traditionally been organized around two meetings a year, the Semiannual Meeting at the APA Annual Meeting in the spring and the AAPL Annual Meeting in October. These large, complex events require planning and contractual commitments multiple years in advance. Nearly all our organizational activities took place at these two in-person events. The Annual Meeting is the educational and social highlight of AAPL’s year. Unexpectedly, two years of meetings, and who knew how many more, were gone.

I was also aware that AAPL’s membership had been decreasing. In October 2016, we had 2,074 members; in October 2019, just before the pandemic, we had 1,890, a loss of almost 10 percent. In October 2020, AAPL had 1,728 members, a loss of just over 17 percent from the 2016 high. We tend to forget, but we are a really small professional organization. The loss of members was not a trend likely to be reversed if we could not hold our annual meeting.

Moreover, the meeting cancelations and loss of membership had profound financial implications for us. Our financial reserves are healthy enough for an organization of our size, but our operating budget depends on maintaining membership and on attendance at the annual meeting. As per the report of Stuart Anfang, our treasurer, our annual budget has been gradually but increasingly in the red, despite increases in annual dues and meeting fees. Over fiscal years 2016–2019, there was a total 4-year cumulative loss of almost $60,000, despite robust rates of attendance at the annual meetings.

Without the in-person annual meetings, a huge portion of AAPL’s income (about $100,000 per year) also disappeared. Much of our operational infrastructure, such as committee meetings, business meetings, and governing Council meetings, became nonoperative. And despite years of discussion regarding the need for online education, AAPL had no online educational technology or programming, minimal online visibility, a website with longstanding and unresolved problems, and no interactive or dynamic online educational or organizational activity or capability.

It is not clear why anyone should join or continue to pay annual dues to an organization that cannot offer its members either the important and valued annual meeting professional fellowship or educational opportunities. It is also not clear why folks should pay dues to an organization whose mission is education but, in a crisis, could not deliver, even though in recent years, online education has become standard in many professional and academic settings.

I’d say that losing most of our income, decreases in membership, having limited access to technological resources, and an essentially nonoperative organizational infrastructure pretty much constitute an organizational existential crisis. And frankly, AAPL as an organization was overwhelmed. Nothing was business as usual, experience did not suggest a path forward, and everyone was reeling from the impact of COVID on our own lives. Allow me to say that this was not what I hoped to be dealing with during my presidential year.

I have heard so many members say that AAPL has been their professional home that it has become something of a cliché, but clichés become clichés because they are true. Certainly, AAPL has been my professional home. My affiliation to AAPL came through Bob Simon. It is not possible for me to think of Bob without thinking of how much AAPL meant to him.

Bob was also a realist. As he once observed, “Forensic psychiatry is not a team sport.” Outside AAPL, as Bob acknowledged, many of us are each other’s professional competition. Nevertheless, AAPL is one of the few places where forensic psychiatrists can find an affirmative and practical commitment to ethical forensic practice, postgraduate forensic education, and professional comradery and fellowship. I know that the friendships and professional relationships I have developed during my years at AAPL have had a profound influence on my life.

So short term, the first major challenge was whether we could go forward with our 2020 Annual Meeting by going virtual. This obviously was not *terra incognita* for many members in other parts of their professional lives, but like many other larger professional organizations with more resources, AAPL had to figure this out from square one and we had only months to do something that usually takes years of advance planning and do it completely differently than we had before.

The 2020 Annual Meeting Program Chairs, Ryan Wagoner and Trent Holmberg, with Education Committee Co-Chair Anne Hanson’s guidance, and with the incredible efforts of Jackie Coleman and her staff in the AAPL office (but really working from home like many of us were), were able to pull off what looked to me like a near miracle. They identified a company that could provide a streaming platform for the annual meeting. Then, despite having no template for putting together a three to four-day virtual meeting across multiple time zones, Drs. Wagoner and Holmberg and AAPL’s executive office staff organized a successful and glitch free event. AAPL owes all of them a tremendous debt for not only demonstrating that AAPL could go virtual in such a big way, but also for giving us hope that if we could build Virtual AAPL, our members would come!

As I began my presidential year at the end of the 2020 Annual Meeting, I was reassured: Even if the 2021 Annual Meeting were virtual, as I suspected it would be, AAPL now had the experience and technology to make it happen with the standard of excellence we have all come to expect but, to some degree, have taken for granted. In addition, the path forward was now clearer, if not less difficult.

Nevertheless, I felt that one online Annual Meeting in October 2020 and then another in October 2021 (and maybe even beyond) was not going to be enough of a long-term plan for AAPL to weather the pandemic and thrive postpandemic. The Annual Meeting is valued not only for its educational content and opportunities, but for its social aspects as well. No matter how successful an online meeting can be from an educational perspective, not being able to get together as a group was a loss felt by many. Also, a multiday virtual professional meeting that is not broken up by in-person social interactions, such as coffee breaks, dinners, or smaller group meetings, whether of committees or of self-defined groups, can quickly become tedious. Even in October 2020, it was clear that zoom fatigue was already a thing.

AAPL needed to find a way to stay relevant to our members throughout the year just to keep treading water and survive the pandemic, not even considering our postpandemic position. And AAPL had nothing else in place for committee meetings, projects, planning, and education (the core of AAPL’s mission). These concerns could not be ignored, especially as no one had any idea how long the pandemic would last.

As I struggled to pick up my end of this burden, I was grappling with my own professional losses. For almost three decades, I practiced from my own office. For many women, the struggle to balance (really juggle) multiple responsibilities and to set and enforce boundaries between the personal and professional is a work in progress over a lifetime. A physical space dedicated to professional activities is very powerful, both practically as a means to this end and as a physical representation of professional identity. Mine had purple leather couches, which for me symbolized this balance: a psychiatrist’s office needs seating, of course, but the purple leather was an expression of my own personal esthetic and, I have always felt, a necessary touch of whimsy.

In January 2020, before the pandemic, I had committed to working 20 hours a week as an outpatient psychiatrist at a community mental health center, with a start date of May 1. My plan was to work half-time from my office continuing my clinical and forensic practice and half-time in community mental health. Although the world changed between January and May, I began the position as planned. But instead of working on site with a team, or even in my own office, I was now working from home.

By October, I had already realized that the challenges of trying to work remotely with a chronically and seriously ill outpatient population with whom I had no prepandemic relationship were so stressful and problematic that the position might not be sustainable for me long term. And on October 1, 2020, I closed my office, a difficult (but it seemed to me a prudent) decision.

But there was no private space at home in which to set up shop and certainly no room for 30 years of files, books, papers, etc. My professional life went into storage. I felt a deep sense of loss, of my work privacy, my boundaries, and of my professional identity. What’s more, by October it was also clear that I really was not working from home; I was living at work, including “presidenting” from my living room. And I even felt bad about feeling bad, because I knew that so many people with more limited resources were struggling with so much more than I was.

As I thought about the uncertainty of AAPL’s future and my own professional future, I remembered a passage from The Lord of the Rings,1 written by J.R.R. Tolkien. Gandalf the wizard confronts Denethor, the Steward of the kingdom of Gondor, with the need for Denethor to take action against the Dark Lord Sauron, an evil enemy with overwhelming forces. Gandalf says to Denethor, “For my part, I shall not wholly fail of my task, though Gondor should perish, if anything passes through this night that can still grow fair or bear fruit and flower again in days to come. For I also am a steward. Did you not know?” (Ref. 1, p 30–31).

I am no wizard (nor am I a wizard’s pupil) but I could try to be a steward for AAPL. Obviously, I was not going to do this alone, but all of us were understandably not always functioning at our best. Nevertheless, we were going to have to think about doing things differently at AAPL, really differently, if AAPL was to both survive the pandemic as well as position ourselves for success and growth after the pandemic. Just reacting to events over which we had no control was not a plan that worked for me, and I didn’t think it would work for AAPL. We had to decide what we wanted AAPL to look like during COVID and after COVID. And we needed to steer AAPL through these times so that we came out of the pandemic stronger than we were going into it.

I need to state at this point that we were given a certain amount of breathing room by the American Board of Psychiatry and Neurology (ABPN). Tolkien also coined the term “eucatastrophe” to describe this kind of development, that is an unexpected turn of events which ensures that the protagonist in a story does not meet some terrible, impending, and very plausible and probable doom. The ABPN offered a $100,000 educational grant in 2020, and again in 2021, to all the psychiatry subspecialty professional organizations, including AAPL, and AAPL Council voted both times to accept the money. Some members are not happy about that, and I understand why. Yet, without the grant, we would have sustained another fiscal year of financial loss, our largest so far.

So, with this pressure mitigated, we were able to pursue several paths forward with short-term and longer-term goals in mind. In the short term, it was clear that to stay relevant during the pandemic, we needed to start providing online Continuing Medical Education (CME) opportunities. And we had to invent an online program and content from the ground up with minimal technology resources.

Step one was to develop criteria for meeting Accreditation Council for Continuing Medical Education (ACCME) requirements for CMEs. Jackie Coleman and I chose to modify formats with which AAPL members were already familiar: the Annual Meeting four-hour courses and two-hour panels. The virtual submission CME criteria required careful scrutiny, especially because we had an ACGME audit coming up in the latter half of 2021. (Hopefully, by the time this address is published, we will have heard that we passed the September 2021 audit.) We also developed a new non-CME format, a “town hall meeting” that we hoped would stimulate member interest and participation.

Step two depended entirely on Jackie and the AAPL office: figuring out how to make the technology resources we had work for user friendly and professional online live streaming educational events. The platform we used for the 2020 Annual Meeting could not be utilized effectively for smaller individual events. As usual, Jackie and the AAPL office made it happen, even though I am sure it was not straightforward or challenge free.

Step 3 was to solicit content. I believed that the academic depth and experience of AAPL members was a resource that would not be hard to tap, and I am happy to say that this has so far proven true. Nevertheless, the folks who stepped up when called upon to do the work involved in providing a contribution to AAPL’s Virtual Program for 2021 deserve credit as well as thanks:Charles Scott taught AAPL’s inaugural online course on Substance Use and the Law in January 2021.

> Phil Resnick and the forensic review course faculty provided a four-hour “update” course in February 2021. They also adapted and recently taught the full multi-day Forensic Review Course entirely online.

> Danielle Kushner organized a course on the Role of Psychiatry in Counter Terrorism cases, which was held online in July 2021.

> Anthony Tamburello organized a course on Correctional Psychiatry, given in December 2021.

> Ariana Nesbit-Bartsch put together a panel on Starting a Private Practice in Forensic Psychiatry, coordinated to coincide with the end of the academic year, when such questions might be most pressing to our earliest career members.

> Charles Dike, Chair of the Diversity Committee, provided a town hall meeting to discuss diversity and inclusion concerns in AAPL, and another, together with Barry Wall, to discuss LGBTQ matters.

> Susan Hatters Freeman and Renée Sorrentino designed a lecture series, “Ask the Experts,” that provides monthly lectures from some of AAPL’s most experienced members, with speakers scheduled well into 2022.

I am pleased to say that, despite the challenges of reinventing the wheel, attendee evaluations have been extremely positive. As an added bonus which we had not counted on, and despite the fact that we have no real advertising in place other than to send out email to our own members, Virtual AAPL was able to generate about $45,000 in revenue in 2021.

So, over the course of 2021, as you can imagine, we have been pedaling as hard as we can to provide online programming. Earlier this year, when juggling all the balls in motion became too overwhelming, I reached out to former AAPL President Charles Scott for help. Dr. Scott graciously agreed to be the first Virtual AAPL Program Director (VAAPL PD). In September 2021, Council officially created the VAAPL PD position. Dr. Scott will be serving in this position, a role integral to future VAAPL development, for two years.

The two questions (and some of the complaints) I have heard most often this year have been: “Is this program being recorded?” and “Why haven’t I received my CME certificate yet?” These questions seem like they would not require complicated answers, but they do. Although recording an online program is not a problem, everything else associated with such recordings is. Until now, AAPL has not had the capacity even to store podcasts, never mind multi-hour live stream programs. Data storage and on demand access technology requires technical expertise and costs money. Nothing of this sort was in place. Similarly, we have no organizational policies regarding what would or should be offered on demand, a payment structure, and all the other technology and human resource infrastructure needed to provide on demand content.

And this includes, by the way, CME certificates, which this past year all had to be done individually, by hand. Victims of our own success, the AAPL office had hundreds of CME certificates to fill out. AAPL did not have the technology with which we are all familiar: finish the program, fill out an evaluation, press the button for the CME certificate and *voila*. That is, *voila* if you have set up the technology and have onboarded the necessary data bases.

These seemingly “easy” questions touched on the most important immediate long-term need: AAPL clearly needed an online learning management system (LMS), and fast. So, I appointed the Virtual AAPL Task Force II, chaired by David Burrow, Chair of the Technology Committee, and Anne Hanson. (The first VAAPL task force had selected the platform used for the 2020 and 2021 Annual Meetings.) VAAPL II was tasked with developing a Request for Proposals for an online learning management system, soliciting proposals from technology companies, and making a recommendation for a company with which AAPL could contract and develop a virtual program that did not require repeatedly reinventing the wheel and, of course, automatically generated CME certificates.

Again, I am happy to say that after multiple meetings, much intense research, and multiple demonstrations with technology company representatives, again while members were facing their own COVID struggles, the VAAPL Task Force, along with myself,Susan Hatters-Friedman, Jeffrey Janofsky, our Medical Director, and of course, Jackie Coleman, completed its mission. In September 2021, Council voted unanimously to approve a three-year contract with an LMS tech provider, and AAPL will be “onboarding” and migrating our data bases after the Annual Meeting.

Appointing a VAAPL PD and getting an LMS in place are really only the beginning of developing “Virtual” AAPL. Developing a robust program of online offerings will require creating a solid infrastructure, modeled on the infrastructure that has been so successful with the AAPL Journal (JAAPL). As you may know, The Journal has an editor, a deputy editor, a board, and departments with their own editors. All of these folks are AAPL members; leadership positions come with stipends, and the AAPL Executive Office has a dedicated staff member who supports The Journal’s administrative needs. With this infrastructure, JAAPL, unlike AAPL, has been able to keep up with technological innovations that facilitate publication and dissemination of the journal: current and back issues of the journal are available online and on demand, and manuscript submissions as well as peer review are now managed online as well.

This brings us to Step 4. For VAAPL to take full advantage of the potential offered by an online LMS and by the creativity and expertise of AAPL members, it will need a similar infrastructure. Live stream programs will be VAAPL’s “current issue;” recorded programs, whether live streamed first or not, will be VAAPL’s library of back issues. The VAAPL Program, headed by Charles Scott, will be a working group of the Education Committee, but it will need to set up a peer review process, its own departments, solicit and develop content, propose an on-demand system of access, and have a strong working relationship with the AAPL office and the LMS team. Proposals for pricing, potential new sources of revenue, and advertising of programming will also need to be developed.

Step 5: The AAPL website serves as the virtual face of AAPL and needs to be given priority. The website editor position description has been revised and it should come as no surprise to anyone that Anne Hanson has graciously agreed to serve as website editor. AAPL cannot afford to go for years, as we have done, without a Website Editor, because we need an up to date, dynamic, and interactive website to elevate AAPL’s online presence, to function effectively as a gateway to membership, information, and online education, and for the success of Virtual AAPL. The website needs to be integrated with VAAPL and with AAPL’s databases, and include the most current information, an interactive calendar, a member directory, access to important resources, and means to facilitate member communication and the work of AAPL’s committees.

Step 6 is additional planning for the future. Under Stuart Anfang’s leadership, a strategic planning task force met this year to examine AAPL’s current and future challenges, including topics of diversity and inclusion. Their review was comprehensive and wide-ranging and resulted in the recommendation of many action items, the adoption of any one of which, in other years, would have been a major accomplishment. All these items were also passed unanimously by Council in September 2021. These included:the adoption of an updated mission statement;

> the tasking of Council to develop a Values and Goals Statement;

> implementing the collection of membership demographic data as part of annual membership renewal to facilitate evaluation of AAPL’s efforts to improve diversity and inclusion;

> formal consideration of the pros and cons of “de-linking” AAPL membership from APA membership; and

> adoption of a standard procedure for nominating committee deliberations.

In addition, a work group of the Women’s Committee, led by Corina Freitas and with the assistance of Barry Wall, developed and proposed a Code of Conduct for AAPL meetings and for interaction with AAPL staff. Council also voted to adopt this Code, pending legal review, which is now in process.

Most importantly, in the next several years there will be changes in AAPL leadership. Dr. Janofsky, AAPL’s third medical director, will not be seeking another term. Incoming President Susan Hatters Freedman has been tasked with appointing a search committee to identify a new medical director, who will take over from Dr. Janofsky in two years. Jackie Coleman, our institutional memory, has served as Executive Director since 1992. As Jackie starts thinking about her own future several years down the line, SS Management, our executive management company, will begin working with AAPL’s medical director and treasurer to identify someone who can continue to serve as Executive Director.

Post-COVID, AAPL is going to look different; it needs to look different. A VAAPL program means that AAPL’s educational and organizational activities will no longer be limited to a few days in October. We will be able to, and we should, reach out to new and wider audiences, and hopefully by doing so, grow our membership and create new sources of revenue. Some have expressed concerns that a year-round virtual educational program will “cannibalize” the annual meeting once we can meet again in person. But educational opportunities are not a zero-sum game. Every year, many excellent annual meeting submissions have been turned down only because of the limited time available.

Indeed, rather than detracting from our Annual Meeting, I believe that these changes can serve to make the Annual Meeting more attractive to our members. Now that CMEs can be provided year-round, we should rethink the goals of the Annual Meeting and expand the amount of time and quality of time scheduled for non-CME, member events promoting networking, mentorship, diversity and inclusion, and smaller group interests. Even if unintentional, the traditional scheduling, for example, of the Early Career Breakfast at 7 a.m. or Women of AAPL at 9 p.m. on a Friday night sends a message to members about how important AAPL thinks these meetings are. As we think about growing membership and increasing diversity and inclusion, AAPL should think about scheduling networking and mentorship meetings at more user-friendly times throughout the program, to demonstrate that AAPL places real value on our members, their diverse backgrounds, and their forensic interests.

In fact, there are so many potential win–win scenarios that it’s hard to give just a few examples, but I will try. Committee meetings and Council meetings can move to a combination of online and in-person meetings. One reason AAPL leadership was able to address so many concerns this year is that Council was not limited to two marathon five- to six-hour meetings. Council met formally four times this year, and informally (meaning attendance not required) twice. Cognizant of zoom fatigue, no meeting was scheduled for longer than three hours. There is no reason this should not continue post-COVID, with a combination of in-person meetings at the APA and the AAPL annual meetings, supplemented by online meetings.

Committee activities can also take place both in person and online. This is likely to increase committee participation. Those who are unable to travel to the APA or AAPL meetings will still be able to participate in and contribute to committee work. And I hope that there will be a lot more committee work, because, as discussed above, there will be more time for offerings since they can be online and year-round. Committees have long been frustrated by the requirement that they submit proposals for presentations for the annual meeting only to find that their proposals have not been accepted.

I encourage committee chairs to talk to their members about online panels, courses, town hall meetings, or any other type of online educational event you can think of. Since these will be provided year-round, there will be no limit for the number of submissions that can be accepted and less competition for time slots. All submissions will need to go through the peer review process, but the VAAPL “Board” should be able to work with submitters to help them address problems in their submission so that those can be addressed, just as The Journal does with submitted manuscripts in its peer review process. And I encourage committees to develop new traditions, such as offering a panel, for example, every year or so, perhaps with different members, on topics of perennial interest, such as the Early Career Committee’s panel earlier this year on Starting a Forensic Practice.

Courses are another subject for discussion and development. Traditionally, AAPL has provided several four-hour courses at each annual meeting. Many courses work just as well online as in person. Plus, online courses can be recorded and become part of a library that can be accessed on demand or become a member perk. AAPL should consider transitioning four-hour course offerings that would work well in an online format to an online platform post-COVID. This will create as many as six to eight more time slots at the Annual Meeting for panels, workshops, and other member events.

This could also attract more members, both to the annual meeting as well as to courses. In person, courses have been limited by seating capacities to no more than 50 to 100 people. This year’s online attendance at courses has exceeded that number. In addition, online courses can be advertised to affiliated forensic and clinical organizations, providing educational opportunities to nonforensic psychiatrists and to people who are unlikely to attend an in-person forensic psychiatry meeting, such as general psychiatry residents.

We must also reconsider members and audiences; traditionally, AAPL education has been geared toward forensic psychiatrists. Yet, as discussed, membership is decreasing. We cannot count on making up membership numbers through the limited pool of forensic fellows. As Octavio Choi reported in his recent JAAPL article calling for reform of forensic fellowship recruitment by use of a match,2 the number of forensic fellows, regardless of the number of fellowship programs, seems to be holding steady at about 60 to 70 fellows a year. If this is the only pool of potential new members for AAPL, we will continue to struggle with membership.

We should explore working relationships with organizations that routinely reach out to psychiatric residents and general clinical psychiatrists to expand our audience. For example, many psychiatric residencies in the United States and Canada do not have an affiliated forensic fellowship. These programs often lack a “deep bench” for forensic didactic training, and very few, if any, opportunities for forensic clinical training. AAPL should encourage and support the development of an online forensic training series for general psychiatric residents. This is another win-win, another way to fulfill our educational mission, possibly another source of revenue, a way to increase awareness of forensic psychiatry as a subspecialty career, and possibly increase both the number of forensic fellows and AAPL members. I am delighted to say one such proposal has already been submitted.

There are many practical concerns that will need to be addressed as we consider these kinds of changes. I strongly believe that the long-term benefits to AAPL of making some of these and other changes, in terms of membership, participation, and revenue, are likely to far outweigh any short-term inconveniences or financial losses that such transitions might entail.

Regardless, AAPL will need more of our members to step up. I encourage members to join committees or put together proposals to submit to the Education Committee, Virtual AAPL, or Council. I for one don’t know how to make optimal or creative use of online learning, and I am sure there are others in AAPL who feel the same. But I challenge any organization, large or small, to match our members’ academic and professional *bona fides*. And we need the “geeks” of AAPL, as well as experienced online education consumers and providers, to show us the way, as many of them have done since the pandemic descended upon us.

And of course, I want to remind everyone that money for the development of education and research, as Debra Pinals continues to report, is available from the AAPL Institute for Education and Research (AIER). Don’t be shy. Ask for funding for your proposal. AIER has funds that they would be delighted to give away.

In conclusion, first I want to say that I am in a much different and better place this October than last October. It turned out that the community mental health position was not sustainable; I lasted a year but resigned in May. And with the support and encouragement of the important people in my life I am now fully ensconced in a home office we were fortunate to be able to build this year as a second floor on our garage. I see my old office, including the purple couches! (Figure 1) But I also see new things, reminding me that I am in a new chapter of my life, things I would never have thought of integrating into my traditional office space and that are good for my soul, like a new turntable and my old vinyl record albums, and my collection of books by and about J.R.R. Tolkien.

![Figure 1.](http://jaapl.org/https://jaapl.org/content/jaapl/50/1/13/F1.medium.gif)

[Figure 1.](http://jaapl.org/content/50/1/13/F1)

Figure 1. 
New space, same purple couches.

Like my new home office, I know that AAPL post-COVID is going to look different. Change is never easy and, certainly, change precipitated by terrible events we cannot control is hardly how anyone would choose things to happen. We are all going to need time to grieve our losses, while bearing in mind that treating others as well as ourselves with compassion is harder but even more important in difficult times than in good times.

Nevertheless, AAPL must accept that we cannot prosper and thrive in a post-COVID world by trying to go back to the way we did things pre-COVID. But just as there is a lot of work that still needs to be done, there is a tremendous amount of opportunity to make contributions to AAPL and to forensic psychiatric education. Post-COVID AAPL can be more robust than pre-COVID if, as much as folks are able under the circumstances, we think about how AAPL and our members use AAPL’s strengths and resources to take advantage of these new opportunities. Let’s work together to shape post-COVID AAPL to be stronger, more secure, more diverse, and more welcoming than before 2020, and as focused on our supporting our members (our social resources and assets) as we are on our educational mission.

AAPL’s 2022 Annual Meeting is scheduled to take place in October in New Orleans. I am hopeful that we can all see each other then. It has been my honor to serve as AAPL’s President. Thank you.

## Footnotes

*   Disclosures of financial or other potential conflicts of interest: None.

*   © 2022 American Academy of Psychiatry and the Law

## References

1.  1.Tolkien JRR. The Lord of the Rings. London: George Allen & Unwin Ltd, 1955
    
    

2.  2.Choi O. The fellowship application process must be reformed. J Am Acad Psychiatry Law. 2021 Sep; 49(3):300–10
    
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