We in Psychiatry Are Social Determinants of Mental Health

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

It seems to me that most of the time we forget that we are a major social determinant of mental health, besides always looking outward to social determinants. Yes, we are first trying to help treat mental disorders and enhance mental health, doing with the latter when we can.

After all, we not only want better mental health for our patients, but know that their improvement ripples out to the rest of loved ones and society. I had an early lesson about that when I was in medical school at Yale and challenged a prominent psychoanalyst, sort of demanding: “How could you spend so much time seeing so few patients when the need out there is so great?” He answered that his patients were often leaders in one way or another, and therefore influenced so many others. That shut me up, even if I myself still went on to focus on the poor and underserved in community and social psychiatry.

We also have the chance to influence broader society outside of direct patient care. That includes using our expertise to help with various social challenges such as racism, anti-Semitism, sexism, ageism, Islamophobia, burnout, loneliness, war, and cults.

Then there is the current presidential race. Although there is the so-called ethical Goldwater Rule that prohibits using our knowledge to discuss public figures, there are other ways to participate, including pointing out the need for adequate funding for resources as well as the stated policies of each party.

Because there is a stigma still in regard to psychiatrists and mental health, we often will not be asked to participate in these societal concerns. That mean we must reach out to local organizations to educate that we can do more to potentially help than just patient care. I believe we will then be more welcomed, especially if we do such societal endeavors gratis.

I have found that the same way of forming therapeutic alliances with patients can work for societal alliances. That includes respect, humbleness, curiosity, and empathy. We can be positive determinants for mental health.

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.