Psychiatrists Must Address Image Problem, Expert Says

Psychiatry is often mischaracterized in the media and other outlets as biologically reductive, routinely corrupt, medically insubstantial, and clinically ineffective, and psychiatrists need to step up and speak out against such negative portrayals, said Daniel B. Morehead, M.D., today in the session “Time for Psychiatrists to Stop Waffling About Psychiatry: Advocacy in the 21st Century.”

Morehead, the director of training in general psychiatry residency and a clinical assistant professor of psychiatry at Tufts Medical Center in Boston, shared examples of articles and books that are deeply critical of psychiatry. He noted how these articles and books have contributed to stigma, delays in seeking care, and treatment nonadherence among patients, and bolstered the denial and restriction of care by public and private funders.

“The biggest and most pervasive myth about psychiatry is that our treatments are ineffective,” Morehead told Psychiatric News in an interview before the session. “Another common toxic assumption is that psychiatric illnesses are simply made-up cultural creations. This notion, still taken seriously by our intelligentsia, has just become silly when we look at the devastating effects of all the major mental illnesses.”

Morehead said that psychiatrists must take the lead in changing how their profession is viewed by addressing inaccuracies and mischaracterizations of psychiatry that appear in the media, because psychiatrists know firsthand the work that they do. Yet many psychiatrists do not speak out, which has repercussions on the nation’s mental health, Morehead added.

“Every psychiatrist I know is very confident that we are doing vital medical work. I don’t know a single psychiatrist who is in an existential crisis about what they do,” Morehead said. “On the other hand, few of us bother to respond to the fact that psychiatry is commonly portrayed in the media as illegitimate, ineffective, and corrupt. The public gets so many mixed and confusing messages that [people] neither demand nor seek adequate mental health care.”

In his presentation, Morehead emphasized several key talking points for psychiatrists to use when speaking to patients and the public about psychiatry:

• Mental illnesses are common—more than 46% of people in this country will experience mental illness at some point in their life, and 26.2% have had a mental illness in the past year.


• Mental illnesses are real, there is biological evidence that can be seen on brain scans, and there is societal evidence in that suicide is the 10th most common cause of death in the United States.


• Mental illnesses are nobody’s fault in that theories such as the “schizophrenogenic mother” have been disproven.


• Mental illnesses are treatable in that psychiatric medications have, on average, the same level of effectiveness as other medical treatments, including treatments for high blood pressure, stroke, heart disease, high cholesterol, migraines, asthma, and other chronic conditions.

Morehead told Psychiatric News that psychiatrists should be objective but not neutral when advocating for their profession on behalf of the public good.

“Once we can see from the science that mental health is serious business, we need to show some spirit, passion, and commitment about the scandalous underfunding, undertreatment, and incarceration of people with psychiatric illness,” he said.

Morehead shared two key ways that psychiatrists can empathize with the sensitivities of patients and families regarding psychiatrists and psychiatric illness.

“The most important thing psychiatrists can do is to remember that we too are family members and persons with mental illness. ‘They’ are actually ‘us,’” he said. “The second most important thing to remember is that countless families and patients have felt misunderstood, humiliated, or wounded by mental health treatment in the past. As psychiatrists, we need to go out of our way to apologize for this and convey full respect.” ■