Incorporating Broad Societal Impacts in Training Key to Future Psychiatric Relevance

Today psychiatry is but one of numerous disciplines that consider themselves to be providers of mental health care. Psychiatry is the only mental health discipline, however, with the unique ability to integrate the psychological aspects of behavior, the biologic contributions, and the social elements (the latter refer to the unique life experiences of an individual). The public, however, perceives medication management as the apparent foundation of psychiatrists’ clinical work. Many patients who would benefit from psychotherapy by psychiatrists are referred to or must be seen by other mental health practitioners because of insurance limitations.

While medication management is obviously an important tool for psychiatrists to use, the COVID-19 pandemic, the murder of George Floyd, and other national tragedies have renewed our attention on the societal impact on behavior in addition to the biopsychosocial approach to developing psychiatric treatment. Understanding the societal determinants of mental health and identifying their impact on patients must be taught as a critical element in psychiatric education and in psychiatric practice.

In the years ahead, we must continue to ensure that all psychiatrists possess skills in several therapeutic modalities, grounded in the biopsychosocial approach with the addition of integrating societal forces and the ongoing developments in our understanding of the brain’s functioning and its impact on behavior. While psychiatrists must know how to use basic therapeutic modalities, they may not be expert in performing all; however, they must know how each works and provide or refer patients for the treatment that will be most effective for them. ■

Sidney Weissman, M.D., is a former APA trustee and past president of the American Association of Directors of Psychiatric Residency Training.