I also appreciate this piece and find it very on-point. I think what the Trump administration is effectively doing is acutely honing in on every crack and inconsistency (there are some legitimate problems in medicine or psychiatry, Harvard does have a huge endowment and tax-free status) and splitting them wide open to cast aspersion on the entire premise. He's phenomenally good at this.
I do think psychiatry and mental health began, after a long delay, to take a political stand with support of trans rights, and I think the rights of trans youth became a lighting rod for this administration.
I appreciate that you find yourself not knowing what to do. I've been wondering how I as a psychiatrist have any impact, other than signing letters through the APA. Trump has shown a capacity to destroy the credibility of people like judges, and heads of universities, who are ordinarily regarded with respect; he can easily destroy whatever credibility we have as a profession. But we also can't in good conscience not act.
Sorry- I meant that I think our embrace of a more liberal gender ideology, generally, and in particular applied to youth, has been viewed as political. And in a way it is, because at times it puts kids at odds with parents. Trump is exploiting this tension point.
I do feel inclined to push back when you say “Congress couldn’t even save the expanded child credit that had cut child poverty in half. So what can physicians do in a situation like that? We simply do not possess the political authority to offer anything beyond policy guidance”
There are examples of physicians and other health professionals engaging through advocacy and direct activism, like Doctors for XR/Health for XR, and Physicians for Social Responsibility. Some medical schools and residency programs even train doctors to engage in advocacy and organizing. And we have plenty of physicians who have stepped up and run for elected office.
As somebody who has worked in both health and climate spaces I think it can be helpful for health professionals to work in coalition with all sorts of interest groups to tackle issues like housing and income inequality that can exacerbate mental health issues.
Thanks John! Yes, I don’t mean to suggest that this excludes “advocacy” in the sense you are mentioning. I’m all for it. My only concern is that when it comes to issues where public opinion is fiercely divided along partisan lines (gun violence, various issues around COVID, health insurance, social welfare, etc), a) does physician activism result in medical community being seen as a partisan actor, and b) does it actually lead to meaningful political action that has bipartisan support.
PS I tried to find examples of psychiatrists in public office and couldn’t come up with a single example, but I’m really curious if there are any of them out there!
I really appreciate this piece. It resonates (kind of) by extension, while also being personal. More than that, it’s very important. I’m so glad I subscribed, here. Thank you.
So disheartening yet invigorating. I appreciate the honesty in this piece. I will save it for the references to share with students I come across. There is a message here that needs an audience to build momentum.
This is such an elegant synthesis of the many thoughts that arise when we think about the current climate. American psychiatry, put on the defensive, and tasked with setting the record straight on “the science” yet has too often lacked the pluralism and nuance to do so. The deprioritizing of structural determinants in establishment psychiatry for so long, and when finally emphasized, there is little power to do much about it.
I appreciate your perspective on the limitations of Reinhart’s calls too. Things just seem so bleak when all that organized medicine aspires to be is a trade guild for physicians professional interests, not a real vehicle for social change. I do feel like for me there *was* activist tendencies before I’ve gradually been succumbing to cynicism. Still reflecting on where I go from here
This morning, as I was doom scrolling Reddit, I found myself thinking “ I wonder what psychiatry thinks about all of this craziness?” A few minutes later, this post appeared in my Substack feed. Thanks for writing this. I intend to read a few of the pieces you cited.
I also appreciate this piece and find it very on-point. I think what the Trump administration is effectively doing is acutely honing in on every crack and inconsistency (there are some legitimate problems in medicine or psychiatry, Harvard does have a huge endowment and tax-free status) and splitting them wide open to cast aspersion on the entire premise. He's phenomenally good at this.
I do think psychiatry and mental health began, after a long delay, to take a political stand with support of trans rights, and I think the rights of trans youth became a lighting rod for this administration.
I appreciate that you find yourself not knowing what to do. I've been wondering how I as a psychiatrist have any impact, other than signing letters through the APA. Trump has shown a capacity to destroy the credibility of people like judges, and heads of universities, who are ordinarily regarded with respect; he can easily destroy whatever credibility we have as a profession. But we also can't in good conscience not act.
Sorry- I meant that I think our embrace of a more liberal gender ideology, generally, and in particular applied to youth, has been viewed as political. And in a way it is, because at times it puts kids at odds with parents. Trump is exploiting this tension point.
Really appreciate this!
I do feel inclined to push back when you say “Congress couldn’t even save the expanded child credit that had cut child poverty in half. So what can physicians do in a situation like that? We simply do not possess the political authority to offer anything beyond policy guidance”
There are examples of physicians and other health professionals engaging through advocacy and direct activism, like Doctors for XR/Health for XR, and Physicians for Social Responsibility. Some medical schools and residency programs even train doctors to engage in advocacy and organizing. And we have plenty of physicians who have stepped up and run for elected office.
As somebody who has worked in both health and climate spaces I think it can be helpful for health professionals to work in coalition with all sorts of interest groups to tackle issues like housing and income inequality that can exacerbate mental health issues.
Thanks John! Yes, I don’t mean to suggest that this excludes “advocacy” in the sense you are mentioning. I’m all for it. My only concern is that when it comes to issues where public opinion is fiercely divided along partisan lines (gun violence, various issues around COVID, health insurance, social welfare, etc), a) does physician activism result in medical community being seen as a partisan actor, and b) does it actually lead to meaningful political action that has bipartisan support.
PS I tried to find examples of psychiatrists in public office and couldn’t come up with a single example, but I’m really curious if there are any of them out there!
I really appreciate this piece. It resonates (kind of) by extension, while also being personal. More than that, it’s very important. I’m so glad I subscribed, here. Thank you.
So disheartening yet invigorating. I appreciate the honesty in this piece. I will save it for the references to share with students I come across. There is a message here that needs an audience to build momentum.
This is such an elegant synthesis of the many thoughts that arise when we think about the current climate. American psychiatry, put on the defensive, and tasked with setting the record straight on “the science” yet has too often lacked the pluralism and nuance to do so. The deprioritizing of structural determinants in establishment psychiatry for so long, and when finally emphasized, there is little power to do much about it.
I appreciate your perspective on the limitations of Reinhart’s calls too. Things just seem so bleak when all that organized medicine aspires to be is a trade guild for physicians professional interests, not a real vehicle for social change. I do feel like for me there *was* activist tendencies before I’ve gradually been succumbing to cynicism. Still reflecting on where I go from here
This morning, as I was doom scrolling Reddit, I found myself thinking “ I wonder what psychiatry thinks about all of this craziness?” A few minutes later, this post appeared in my Substack feed. Thanks for writing this. I intend to read a few of the pieces you cited.