Is the mental health system crumbling? One psychiatrist wonders who will take up the mantles of the innovative and socially conscious physicians who came before.
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I have enjoyed reading the informative articles in Psychiatric TimesTM. I followed in my father’s footsteps into psychiatry, veering only by adding a fellowship in child and adolescent psychiatry at the University of Illinois in Chicago.
Throughout my professional career as a bilingual, bicultural psychiatrist, I have held many diverse roles. I have worked as an outpatient community psychiatrist. As an assistant professor at Rosalind Franklin University of Medicine and Science, I taught residents, fellows, and medical students, while giving pro bono lectures in the community on mental health. During Annelle B. Primm, MD, MPH’s term as director of the American Psychiatric Association’s Office of Minority and National Affairs, I participated in the film Real Psychiatrists, Doctors in Action, which was used to recruit medical students into psychiatry. (It won the Golden Eagle Award). For the city of Chicago’s Division of Behavioral Health, I held the position of medical director for the city’s then-vibrant mental health clinics.
I think if my father, Emilio Espindola, MD, were alive today he would be shocked at the many changes in the medical industry in general, let alone in mental health!
I truly am concerned about how the mental health system provides treatment for our patients—and most especially those who are black, brown, and native, First Nation peoples.
When Carl Bell, MD, died, he was a national leader; veteran of the US Navy; a researcher with the National Institute of Mental Health; the author of more than 400 books, chapters, and scientific publications; and professor emeritus of psychiatry at the University of Illinois. Bell spent his career (ended with his untimely death August 2, 2019 at the age of 71 years old, 11 years beyond my own father’s untimely death) addressing issues of childhood exposure to violence. He worked on violence prevention programs, reunification of families, and HIV prevention among other pressing issues that continue to plague this nation. I met Bell as a medical student in an elective.
I chose to work with and learn from this amazing, brilliant black psychiatrist when he was president and CEO of the Community Mental Health Council, Inc. It was truly an unforgettable experience, and one that left an impact on my career as a psychiatrist.
I ask my colleagues, where are the brilliant, unstoppable psychiatrists of this nation? Will they allow the mental health system to slowly crumble? Are there any Dr Bells left in this nation to ring the bell, so to speak? Will they bring us to a just, fair, equitable, culturally appropriate mental health system, that will absolutely not allow for an 8-month waiting period for an individual suffering from severe mental health to be evaluated, let alone treated with appropriate integrative and functional psychiatry, that searches for the root cause of this illness? James Greenblatt, MD, has boldly initiated the integrative and functional psychiatry branch that appears to target this issue, but so much more remains to be done.
In what direction is the mental health system moving? What—if any—standard of quality, cultural relevance, fairness, and equity can be given to our nation’s current mental health system?
I remain hopeful that the dedicated psychiatrists of this nation, who have chosen to live by the Hippocratic Oath to do no harm, will stand in unity for a better, more inclusive, equitable, and effective mental health system. We need a mental health system that will truly meet the needs of America’s most vulnerable individuals, children, and their families. Those who suffer from mental illness at times suffer from the very system that is charged to bring them recovery. As stakeholders in this system, we must do something about it.
Dr Martinez is a board-certified child, adolescent, and adult psychiatrist.