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Crystal Ball Gazing

Crystal Ball Gazing

Editor in Chief

I’ve written before about the importance of self-reflection in our clinical practices and in teaching our residents and students to enhance their own skill and to help foster it in their patients. As hectic as the world is today, and with our increasingly busy schedules (as if they weren’t already), we often have little opportunity to consider the future of our profession. So, I’m pleased to suggest you spend a bit of time reading The Lancet Psychiatry Commission on the Future of Psychiatry. The target future selected was a decade from now —far enough that changes would likely be apparent, but not so far into the future that the conclusions would be almost completely speculative.

Many of us have been aware that The Lancet has been since the early 1800s one of the most prestigious medical journals in the world. But some may not be as aware that several years ago The Lancet established a number of specialty journals including The Lancet Psychiatry. I was honored to be asked to serve as a member of the Lancet Psychiatry Commission. (This was a volunteer academic effort, a collaboration of The Lancet and the World Psychiatric Association, so I receive no benefit from suggesting you read the report.) After a year of work, the final report will have been released by the time you are reading this in early October, timed to coincide with World Mental Health Day.

The report has 6 sections: (1) The Patient and Treatment, (2) Psychiatry and the Health Care System, (3) Psychiatry and Society, (4) The Future of Mental Health Law, (5) Digital Psychiatry Enhancing the Future of Mental Health, and (6) Training the Psychiatrist of the Future. Let me briefly highlight some of the critical issues highlighted in the report. Since most of our readers live in the US, many of the issues of concern will be well known though unsolved.

In the The Patient and Treatment section, one of the key issues addresses the tremendous global disparities in treatment resources, including psychiatrists, other clinical personnel, and treatment facilities. We are aware in the US that although we have among the most extensive treatment availability of any country, substantial segments of our population have limited access to quality care. These groups include those living in urban cores and rural areas; members of many minority groups, including recent immigrants; the elderly; children; and those with significant medical comorbidity.


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