Upstanding Against the Adverse Mental Health Repercussions of Confrontational Street Protests
Key Takeaways
- Street protests, whether violent or nonviolent, can lead to adverse mental health outcomes, including increased posttraumatic disorders and depression in affected communities.
- Psychiatrists have an ethical responsibility to address the mental health repercussions of protests and provide support and warnings to the public and patients.
Psychiatrists explore the mental health impacts of protests, emphasizing the need for community support and ethical responsibility in turbulent times.
PSYCHIATRIC VIEWS ON THE DAILY NEWS
Tell me: If you turn on the news from a little bit of distance away, can you tell whether the current street protests encountering violence is coming from Iran or Minneapolis? I could not recently, as another shooting from a federal agent happened last night.
In the New York Times article yesterday, Sam Sifton started with the confrontation in Minneapolis.1 After Renee Good was killed, the protests by the citizens increased and, in turn, ICE was sent in more officers. One citizen replied: “It feels like a military occupation.”
A colleague has reported hearing that patients are being dismissive of “Good’s killing and incidents like this.” Are you hearing this from your patients? Such dismissal might be ironic or worse since psychiatric patients are often the first to be at risk in rising autocratic power, as in Nazi Germany. Perhaps dismissal of danger is denial of the risk for them and, really, for any of us.
And we in psychiatry, what is our ethical responsibility here? One of our ethical principles, as stated in Section 7 of The Principles of Medical Ethics (2013 APA Edition) is:
“A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.”
The research studies on protests and mental health repercussions are pretty clear in the concerns. A systemic review presented compelling evidence that although there can be some positive catharsis and social cohesion when peace is relatively maintained, even nonviolent protests are often associated with adverse mental health outcomes, including a rising prevalence of posttraumatic disorders and increased depression in the surrounding community.2 Those with a history of mental health problems seem at higher risk and now, with sudden further federal cuts of mental healthcare resources on Tuesday, the risk escalates.
Though less studied, the perpetrators of violence representing the powers-to-be may also be at higher risk for traumatic repercussions. They also are likely to be at increased moral injuries involving guilt, that is, as long as they are not sociopathic.
Such protests and personal mental health outcomes may still feel worthwhile if desired results outweigh the risks, as they have sometimes done in history, but so far that is unclear in Minneapolis and other parts of our country.
To be an upstander in regard to such protests, whether in the United States, Iran, or elsewhere, we in psychiatry need to be vigilant about the adverse sequelae and be ready to provide warnings and increased services to the public and especially to our patients. Moreover, we also have the opportunity to contribute our own presence at protests or even conduct our own, as some of us did at the last APA annual meeting, which I
Let us do honor to Benjamin Rush, known as the father of American psychiatry. As my colleague, Ravi Chandra, points out in his Substack posting yesterday, titled “Ken Burns’ “The American Revolution”: Lessons and Imperatives for Modern Psyche and Society,”4 what Rush said about American liberty still stands for human connection:
“…bear a testimony against a vice which degrades human nature and dissolves the universal tie of benevolence which should connect all the children of men together in one great family.”
There are already tools for positive connections out there developed by psychologists that can be used, including those of the organization Brazer Angels and their model group processes to reduce political polarizations, as well as the similar techniques of nonviolent communication.5 Let’s increase our upstanding and use them and others. Just talking among the likeminded can be reassuring but not necessarily effective in reducing the rising interpersonal conflicts.
Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He presented the third Rabbi Jeffrey B. Stiffman lecture at Congregation Shaare Emeth in St. Louis on Sunday, May 19, 2024. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.
References
1. Sifton S. Minneapolis’s limit. New York Times. January 14, 2026. Accessed January 15, 2026.
2. Ni MY, Kim Y, McDowell I, et al.
3. Moffic HS. Rally for mental health: boldly going where psychiatry has never gone before! Psychiatric Times. May 27, 2025.
4. Chandra R. Ken Burns’ “The American Revolution”: lessons and imperatives for modern psyche and society. Letters from a Psychiatrist: The Pacific Heart, Ravi Chandra. January 14, 2026. Accessed January 15, 2026.
5. Rosenberg M. Nonviolent Communication: A Language of Life. PuddleDancer Press; 2015.
Newsletter
Receive trusted psychiatric news, expert analysis, and clinical insights — subscribe today to support your practice and your patients.
