Psychiatrists as Healers, Teachers, Leaders, and Influencers

In this issue, Dr. Vasilis (“Bill”) Pozios, a young APA member with whom I had the pleasure to speak after a recent meeting, joined me in writing this column. We chatted at length about my sincerity when I spoke at APA’s 2018 Annual Meeting about moving into a future psychiatry that incorporates psychiatrists as leaders with the new understanding of neuroscience; “enviro-psycho-social” aspects of health, mental health, and well-being; and technology. During our conversation, he observed that we must do more than lead—we must also be mental health “influencers.”

So, what is an “influencer?” In social media parlance, an influencer is someone who has the ability to impact trends, ultimately driving the behaviors of followers. For psychiatrists, we can be cultural influencers by more effectively interacting with the public to shape perceptions of mental health and psychiatry, with the goals of reducing stigma and improving access to care. Psychiatrists are teachers as well as healers, and perhaps we can learn to embrace our “responsibility to participate in activities contributing to the improvement of the community and the betterment of public health,” as delineated by APA’s Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry. In fact, Section 5 tells us that psychiatrists “shall make relevant information available to patients, colleagues, and the public.”

Now, this does not mean that psychiatrists should quit their practices and start “doing it for the ‘gram’ ” or misrepresent ourselves as a panacea for all to increase our “followers.” (Many APA members, however, do have effective Instagram and other social media accounts through which they provide information and education to the public, and APA’s Communications Division can provide assistance to members who are ready to take the plunge and create personal accounts.) A more effective way to influence perceptions may be to interact with other professions and industries that drive popular culture, such as the entertainment industry.

Our relationship with media requires that we become aware of social trends so that we can carry out the mission of our organization and serve as “influencers” within the field. We must be aware of society’s growing sensitivity to power dynamics and movements to dismantle them, as exemplified by the #MeToo movement. Psychiatry and our “relationship-based” treatments may leave us more susceptible to criticism in this regard than other medical specialties, and we need to be mindful of this as we move forward, especially as society shifts away from normative identification to nonnormative descriptors such as “neuro-atypical.” The public’s relative apprehension of psychiatry compared with other specialties has historically been driven by a lack of knowledge about what we do—a misperception of our pharmacological treatments as being “mind altering” and concerns about involuntary treatment and the abuse of institutionalized patients, among other reasons.  We know better than most that language is important, and psychiatry needs to play an active role in shaping the language that influences the diagnosis and treatment of mental illness.

What are the challenges we face to becoming influencers? First, most of us probably don’t think of ourselves in that way, and if we do, we are probably not sure of how to do it. Some may think it is outside the scope of our professional identity. And maybe we don’t think we can make a change. Whatever the reason, my young colleague offers these recommendations in response:

• Each of us seasoned folks, especially those in leadership, must commit to working with a young colleague, trainee, or medical student to teach and encourage his or her interest in becoming a psychiatrist leader.

• We have to recognize the significant influence of popular culture on beliefs, attitudes, and habits and the opportunity we have to reduce the stigma associated with mental illness using current media and communication strategies. We must become comfortable with technology and innovation as part of the psychiatry of the future.

It can be frustrating to think that we can’t change some of the factors that challenge our ability to provide good service and achieve positive treatment outcomes, but we have to take the risk and not let that frustration keep us from trying. Bill and I believe that APA can be a support in these areas and hope you will join us in working on these issues. In a future column, Dr. Pozios will offer more suggestions on how we can move forward in this area. As your president, I stand ready to invest the time and energy into supporting psychiatrists who choose to become “influencers.” ■