A Psychiatric Rights Proposal
Key Takeaways
- Resource allocation should restore psychiatry to parity with other medical specialties, reversing administrative constraints that limit access and treatment capacity.
- System-level redesign is required to mitigate physician burnout and halt escalating moral injury among clinicians delivering mental health care.
A psychiatrist links today’s civil rights tensions to urgent psychiatric rights—funding, burnout relief, social care, and free speech for clinicians and patients.
PSYCHIATRIC VIEWS ON THE DAILY NEWS
Given my age approaching 80 and political leanings, the Civil Rights Era of the 1960s seemed very important to me, with triggers—both traumatic and celebratory—to that era showing up now as part of our current political conflicts. The Civil Rights Act of 1964 and Voting Rights Act of 1965 outlawed public discrimination based on race, sex, religion, or national origin. Those, like me, of the beginning of the boomer generation, went through that period as young adults and may thereby have a special perspective on how much current political conflicts resemble those of the 1960s and what we can learn from the comparison. One of the rallying cries of the 60s was to not trust anyone over the age of 30!
As can be recalled or noted, there was nothing too much formal as far as mental health and psychiatric rights. Surely, though, there were positive mental health repercussions involving righting some of the wrongs of our country’s history of discrimination, the social psychopathologies as I call them. There was also an appropriate pullback on the unnecessary and overly long commitment of psychiatric patients, although some would argue that the pendulum swung too far in the requirement for proof of dangerous.
Yet, by now, over these last 60 years or so, these psychiatric advances have been subject to stops and starts at best. Mental health disorders have been increasing, as well as the less severe and newer mental disturbances like loneliness, burnout, moral injuries, and cultish thinking. Yes, our ability to heal has increased, but resources to do so reduced by administrative fiat of the current federal administration.
My last column was on establishing rights for older adults. Now, over 60 years later, it may also be the right time for psychiatric rights—for both patients and clinicians.
These might include:
- Adequate resources. Once again, there is a need to increase psychiatric resources at least equivalent to the rest of medicine.
- Burnout prevention. We must improve the systems of care at least enough to significantly reduce the continuing epidemic of physician burnout and also stop the increase in moral injuries.
- Concentrate on the social. We should be sure the social in our bio-psycho-social model becomes more equivalent in focus.
- Declaration of freedom of speech. We need to allow psychiatrists to publicly engage on social concerns as psychiatrists using our expertise.
- Elders and evolutionary neurobiology. As my colleague Rama Rao Gogineni wisely conveyed to me, there seems to be an evolutionary preference for youth due to reproductive potential and physical vitality. Now we can add technical expertise, necessitating more conscious recognition of the potential wisdom of older psychiatrists, given our longer life spans.
To these initial ABCs, including a D and E above of psychiatric rights, what psychiatric rights might you add?
Dr Moffic is an award-winning psychiatrist who specializes in the social, cultural, ethical, spiritual, and religious aspects of psychiatry, and since 2012 is in retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekdays column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He has been an advocate and activist for mental health issues related to climate instability, physical burnout, and xenophobia, among other social justice causes, serving on many related local and national community and professional Boards. He serves on the Editorial Board of Psychiatric Times.
