Dr. Plakun is a leader in psychiatry and psychoanalysis. He serves as Medical Director/CEO of the Austen Riggs Center, a renowned psychiatric hospital and residential treatment center in Stockbridge, MA. Dr. Plakun was plaintiffs’ expert on adult mental disorders in Wit v. United Behavioral Health/Optum. The landmark verdict in this federal class action against the nation's largest behavioral health insurer established pursuit of recovery rather than mere crisis stabilization as the generally accepted goal of treatment for mental disorders. He currently serves on the APA Board of Trustees as the Area 1 Trustee, representing New England and Eastern Canada, and is a former member of the APA Assembly. As the founder and former leader of the APA Psychotherapy Caucus (a 700-member “big tent” organization inclusive of all schools of therapy), and as chair of the former Committee on Psychotherapy by Psychiatrists, he stands for the importance of patient access to psychotherapy and psychosocial treatment and of psychotherapy as part of the identity and skill set of psychiatrists.
A MESSAGE FROM DR. PLAKUN
Like many of us as individuals and in our work roles, the APA is at a time of self-reflection in addressing structural racism. I look forward to working within the APA to tackle this enormous problem and move toward a course correction in 2 domains:
Identifying and addressing structural racism in the APA.
Addressing health disparities by increasing our focus on access to care and on the full implementation of the mental health parity law.
Accomplishing the first requires opening ourselves up to sometimes uncomfortable conversations and learning about the unpalatable but real history of racism in the APA. I support the APA issuing a formal apology for this part of our history as one step in a larger process of moving forward as an organization.
Accomplishing the second includes ongoing work to move the APA to embrace the 8 elements of effective treatment identified in Judge Joseph C. Spero’s decision in Wit v. United Behavioral Health/Optum. In his 106-page verdict, Judge Spero identified the generally accepted standards of effective care offered by the plaintiffs. Here they are as summarized in Paul Appelbaum and Joe Parks’ 2019 Psychiatric Services article:
Effective treatment requires treatment of the individual’s underlying condition and is not limited to the alleviation of the individual’s current symptoms.
Effective treatment requires treatment of co-occurring behavioral health disorders and/or medical conditions in a coordinated manner that considers the interactions of the disorders and conditions and their implications for determining the appropriate level of care.
Patients should receive treatment for mental health and substance use disorders at the least intensive and restrictive level of care that is safe and effective.
When there is ambiguity as to the appropriate level of care, the practitioner should err on the side of caution by placing the patient in a higher level of care.
Effective treatment of mental health and substance use disorders includes services needed to maintain functioning or prevent deterioration.
The appropriate duration of treatment for behavioral health disorders is based on the individual needs of the patient; there is no specific limit on the duration of such treatment.
The unique needs of children and adolescents must be taken into account when making level of care decisions involving their treatment for mental health or substance use disorders.
The determination of the appropriate level of care for patients with mental health and/or substance use disorders should be made on the basis of a multidimensional assessment that takes into account a wide variety of information about the patient.
In addition to embracing these 8 elements of effective care, the APA has an affirmative obligation to assert its authority over generally accepted standards of treatment, thereby ending the prolonged period of abdication of this authority to insurance companies that the Wit verdict reveals prioritized financial interests over the fiduciary obligation to meet patients’ needs.
These steps offer real hope of extending the impact of the Wit verdict beyond UBH and other ERISA plans to ACA, Medicaid, and Medicare plans, thus reducing shameful health disparities and implementing true mental health parity.
Wit v. UBH: What it Means to You
Psychotherapy After the COVID-19 Pandemic: What Can We Expect?
Can We Tame The Wild West of Managed Care Through Top-Down and Bottom-Up Action?
IN HIS OWN WORDS
Eric Plakun, MD, is the Medical Director/CEO of the Austen Riggs Center. A board-certified psychiatrist, psychoanalyst, researcher, and forensic psychiatrist, Dr. Plakun is the editor of New Perspectives on Narcissism (American Psychiatric Press, 1990) and Treatment Resistance and Patient Authority: The Austen Riggs Reader (Norton Professional Books, 2011), and author of over a hundred articles and book chapters on psychotherapy and on the diagnosis, treatment, longitudinal course and outcome of patients with borderline personality disorder and treatment-resistant disorders.
Dr. Plakun is a Distinguished Life Fellow of the American Psychiatric Association and serves on the APA Board of Trustees as the Area 1 Trustee, representing New England and Eastern Canada. He is a former member of the APA Assembly, where he served as chair of the Assembly Committee of Representatives of Subspecialties and Sections and on the Assembly Executive Committee. In the APA he is past chair of the Committee on Psychotherapy by Psychiatrists and the founding leader of the APA Psychotherapy Caucus. Dr. Plakun is a member of the Group for the Advancement of Psychiatry Psychotherapy Committee and a Fellow of the American College of Psychiatrists. He is a Psychoanalytic Fellow and former Trustee of the American Academy of Psychodynamic Psychiatry and Psychoanalysis, and was named an Honorary Member of the American Psychoanalytic Association in 2017 for "championing psychoanalysis and psychodynamic therapy within American psychiatry and paving the way toward a return to a more individualized treatment model."
Dr. Plakun is a member of the editorial board of Psychodynamic Psychiatry and contributing editor to the Journal of Psychiatric Practice. He has appeared on CBS' 60 Minutes as an expert in forensic psychiatry and served as one of two plaintiffs' experts in the landmark Wit v. United Behavioral Health federal class-action lawsuit. He has been quoted in the New York Times, Forbes, and the Toronto Globe and Mail. In 2003, Dr. Plakun was named by the Massachusetts Psychiatric Society as the "Outstanding Psychiatrist in Clinical Psychiatry." Dr. Plakun also served for more than a decade with the American Board of Psychiatry and Neurology as a member of the written test committee and as an oral examiner.
Dr. Plakun graduated from Hofstra University and received an MD from the Columbia College of Physicians & Surgeons. After an internship in medicine at Dartmouth, Dr. Plakun worked as a rural primary care practitioner in Vermont before completing a psychiatry residency at Dartmouth and a Fellowship in Psychoanalytic Studies at Riggs.
Plaintiffs’ expert on adult mental disorders in Wit v. United Behavioral Health, the landmark federal class action whose verdict established pursuit of recovery rather than mere crisis stabilization as the generally accepted goal of treatment for mental disorders.
Former clinical faculty, Harvard Medical School
Distinguished Life Fellow, American Psychiatric Association
Founder and past leader, APA Psychotherapy Caucus; past chair, APA Committee on Psychotherapy by Psychiatrists and the APA Bylaws Committee
Member, APA Assembly Executive Committee; chair, Assembly Committee of Representatives of Subspecialties and Sections; past chair, Assembly Task Force on Psychotherapy by Psychiatrists; and past member, Task Force on Maintenance of Certification
Fellow, American Academy of Psychodynamic Psychiatry and Psychoanalysis; Academy representative to APA Assembly; and past Trustee of the Academy
Fellow, American College of Psychiatrists; and past chair, Ethics Committee
Member, Board of Regents of the American College of Psychoanalysts
Member, Group for the Advancement of Psychiatry Psychotherapy Committee
American Board of Psychiatry and Neurology, former member of written test committee and oral examiner
Honorary member, American Psychoanalytic Association
Honored by American Psychoanalytic Association for “championing psychoanalysis and psychodynamic psychotherapy within American psychiatry and paving the way toward a return to a more individualized treatment model.”
"Outstanding commitment to medical student career development in psychiatry"
from Psychiatry Student Interest Group Network (PsychSIGN)
Named "Outstanding Psychiatrist in Clinical Psychiatry"
by the Massachusetts Psychiatric Society
"A 'Trans-Dyadic' Perspective on the Goldwater Rule" (subscription required)
"Psychotherapy, Parity, and Ethical Utilization Management" (open access)
“The Mental Health Crisis in America: Recognizing Problems; Working Toward Solutions (subscription required)
“Psychotherapy in the Post-COVID-19 Era" (subscription required)
“Psychodynamic Psychiatry, the Biopsychosocial Model, and the Difficult Patient” (subscription required)
Advocating for a biopsychosocial perspective that values psychosocial etiologies and treatments along with those that are biomedical
Recognition of the roles early adversity and personality disorder comorbidity play in the phenomenon of treatment resistance
Advancing the role of the APA in addressing access to care and health disparities
“Both/and” NIMH research funding that explores brain mechanisms underlying mental disorders, but that also funds studies of treatment interventions that lead to improved care in the near term
Dr. Plakun appeared on the CBS show 60 Minutes, where he was interviewed by Mike Wallace as a forensic psychiatrist, and has conducted a periodic call-in radio show on issues in psychiatry for WAMC Northeast Public Radio in Albany, NY
(Vox Pop, Medical Monday). He has been quoted in the New York Times, Forbes, Toronto Globe and Mail, and other publications.