All Psychiatrists Are Social Psychiatrists!

Article

Social psychiatry is embedded in the practice at large.

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Most psychiatrist readers and those of other disciplines would probably wonder about the veracity of the title. How can we all be social psychiatrists?

The first argument for such inclusivity may be our own well-known bio-psycho-social model, meaning that the 3 perspectives are important to a varying extent in everything in psychiatry.

The second argument is that we are all social beings, meaning we are born interacting with others and almost invariably do so until we die.

Yet, there has always been very small numbers of psychiatrists who are members of social psychiatry organizations in the United States and around the world. Once upon a time, when I was President at the turn of the millennium, the very existence of the American Association for Social Psychiatry (AASP) was threatened among a population of 30,000 psychiatrists.

What is the reason for this dichotomy? The importance of the social is obvious in both psychiatry and society, yet social psychiatry seems to exist on the outskirts of general psychiatry. Perhaps it is because social psychiatry has not yet seemed relevant to everyday clinical work, the bread and butter of all psychiatry.

Now, biological aspects of psychiatry seem of obvious importance to clinical psychiatry, especially in terms of medication usage, to the extent that our model has said to become bio-bio-bio. Nevertheless, the psychological aspects, embedded in the various psychotherapies, has been making a comeback of interest.

But the social? Most professionals in psychiatry recognize the importance of some social concerns, including racism, burnout, cults, climate change, gun violence, political divisiveness, and availability of resources, among others. Those can be apparent as social determinants of mental illness and assessed as part of an evaluation process of a society and of individual patients.

However, translating these social challenges into treatment is less apparent and appreciated, perhaps other than in family and group treatment rather than with individuals. Even so, the essence of a positive therapeutic alliance, so necessary for any progress in treatment, is a social aspect of the clinician and patient relationship, just like good parenting is so crucial for the development of a child.

Really, the small units of social psychiatry in terms of therapeutic dyads all the way up to large international conflicts, as is now apparent in Ukraine, are part of the continuum of the social and a general systems perspective of psychiatry.

Some have realized that the various aspects of social psychiatry need to be appreciated by all psychiatrists because we are all social psychiatrists—just like most all are biological psychiatrists and psychological psychiatrists. We can potentially help address both the large social challenges and social psychopathologies as well as basic clinical care.

To do so, we just had a fledging meeting of a new think tank of psychiatrists from various countries whose careers have had a social psychiatric focus. It is tentatively called the Social Psychiatry Research Interest Group (SPRIG). The acronym SPRIG evokes the sprig of the kind of green growth which we are now having in the spring of the northern hemisphere. We are looking to spring forward to being of use to the public, patients, and professionals in mental health care.

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times. SPRIG is a new think tank of psychiatrists from various countries whose careers have had a social psychiatric focus. It includes Dilip Jeste, H. Steven Moffic, Rama Rao Gogineni, Ken Thompson, Sam Okpaku, James Griffith, Gabriel Ivbijaro, Vincenzo Di Nicola.

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