From toilet to tap: Getting
people to drink recycled water
Carol J. Nemeroff,
this problem in a
As the world’s
of Recycled Water:
Getting the Cognitive
Psychologists are working to convince
people that sewage treatment really
can create potable water.
Sewage Out After the
Physical Sewage Is Gone” at the 2011 Annual APA Convention.
Nemeroff, an expert in so-called magical thinking and contagion
research, talked about the challenge of moving people beyond
the image they have of “toilet to tap.” She described a technology
called tertiary recycling, a three-level system that starts with
sewage and ends with “really excellent, good quality water.”
It’s great stuff, she said, but people don’t want to drink it. A
tertiary recycling system is in place in Los Angeles, for example,
but the water is used primarily for irrigation. “Currently, nobody
drinks it,” she said.
The problem is what’s been termed the magical law of
contagion, she said, which essentially says once something has
come in contact with something disgusting, it’s always in contact
in people’s minds.
She described a five-city survey she conducted to gain better
understanding of the level of purification that would move
people toward drinking recycled water. When respondents were
asked whether they were willing to drink recycled water (it was
defined in the question), 38 percent said they were willing, 49
percent were uncertain and 13 percent said no.
“We need to break the perceived connection between water
and its history of sewage,” she said.
What’s ahead for
To keep practice moving forward, psychologists need to
continue the fight for proper implementation of parity
for mental health and substance use disorder treatment,
appropriate reimbursement for psychological services,
leadership roles for psychologists in evolving systems
of care under health-care reform, and prescriptive
authority for appropriately trained psychologists, said
panelists at an APA 2011 Annual Convention session.
Over the past 30 years, the profession has made
significant strides, such as securing a place for
psychological services in health-insurance reimbursement,
said Sanford Portnoy, PhD, chair of APA’s Committee for
the Advancement of Professional Practice (CAPP). But
now as the Patient Protection and Affordable Care Act gets
implemented, he said, psychologists must work to ensure
that they’re properly compensated for their services and
that they determine evidence-based treatment guidelines
for practice — and not insurers.
“We ran into a situation a few years ago where
the insurance companies began to develop their own
treatment guidelines — for example, Blue Cross Blue
Shield in Massachusetts — and slashed reimbursement
rates,” said Portnoy. “It was at that point that CAPP and
some other groups at APA decided that we needed to
take that back.”
An association-wide effort to develop evidence-based
clinical treatment guidelines is under way.
APA has also forestalled cuts to Medicare
psychotherapy reimbursement rates and is working to
ensure that psychological testing data is given the same
privacy protection as psychotherapy notes in the Health
Information Technology for Economic and Clinical
Health Act, said Katherine C. Nordal, PhD, APA’s
executive director for professional practice.
But more challenges are coming, she said. “With the
Deficit Reduction Act that just passed, we are headed
for some rough-and-tumble times, which could include
additional cuts in fees paid to all Medicare providers,”
Psychologists can help fight these and other
legislative threats through the APA Practice
Organization’s Legislative Action Center, http://capwiz.
—B. MURRAY LAW