Dr. Nasrallah responds
Thank you for your comments on my editorial. I sense that you are quite frustrated with the current status of psychiatry, and are longing for improvements.
I do share some of your concerns about: 1) society turning a blind eye to the mentally ill (and I have written about that from the angle of tragically high suicide rate1); 2) the hatred and contempt embedded within stigma of serious mental disorders; 3) the deplorable criminalization and trans-institutionalization of our patients from state hospitals to jails and prisons; 4) the shortage of acute psychiatric beds in many communities because the wards were converted to highly lucrative, procedure-oriented programs; 5) the dysfunctional public mental health system; and 6) the need for new and novel treatments.
However, despite those challenges, I remain optimistic that the future of psychiatry is bright because I keep abreast of the stunning neuroscience advances every day that will be translated into psychiatric treatments in the future. I envision a time when these brain research breakthroughs will lead to important clinical applications, such as a better diagnostic system using biomarkers (precision psychiatry), not just a cluster of clinical symptoms, and to brave new therapeutic interventions with superior efficacy and better safety. I would not be surprised if psychiatry and neurology will again merge after decades of separation, and that will certainly erase much of the stigma of disorders of the mind, which is the virtual brain.
Please hang in there, and do not let your patients perceive a sense of resignation and pessimism about psychiatry. Both our patients and psychiatrists need to be uplifted by hope for a better future.