The crisis in psychiatry: A public health perspective

Abstract

The role and responsibilities of psychiatry and psychiatrists have changed significantly in recent decades as a consequence of changes in society. The target of psychiatrists has moved from the treatment of specific mental disorders to the management of a wide range of psychological conditions. Following these changes, a public health approach has been claimed as necessary for psychiatric practice and research, given the current ongoing crisis in mental health. If we want to promote a public health approach, the following actions should be responsibly taken by modern mental health professionals: (1) the identification of causes of mental disorders, (2) the refinement of diagnoses, (3) the social inclusion of patients, (4) the involvement of users and carers in mental health research and practice, and (5) the improvement of psychiatric treatments and services. This crisis should represent a stimulus for all psychiatrists and a reconceptualization of psychiatry as public health is not in question.

A weak scientific basis for gaming disorder: Let us err on the side of caution

“…We agree with Kuss, Griffiths, and Pontes (2017) on the importance of including multiple stakeholders in the process of formalizing a potential disorder, including not just academics, but gamers, industry executives, therapists, and others. We suggest that the WHO solicit input and feedback from a wider variety of stakeholders, including individuals who currently seek help or who have sought help for gaming-related problems and their family members/carers, as recommended for the development of mental disorder classifications in general (Pingani et al, 2014;Stein & Phillips, 2013). Children in particular should be included in this process as one of the primary stakeholder groups playing games regularly.…”

Psychometric validation of the Italian version of the Reported and Intended Behaviour Scale (RIBS)

“…Stigma influences a range of life domains, including employment, romantic relationships, housing/accommodation, civil participation and education (Evans-Lacko et al 2012a;Carrà & Clerici, 2013;Lasalvia et al 2013;Grifiths et al 2014;Rüsch et al 2014). Although several attempts have been carried out worldwide to fight stigma against people with mental disorders (Sartorius & Schulze, 2005), the levels of discrimination and prejudice towards people with mental illness are still very high (Pingani et al 2014). For example, as a consequence of discrimination, people with psychiatric disorders have poor social networks, are socially excluded, have reduced job opportunities and experience difficulties in accessing appropriate mental health care (Yamaguchi et al 2011;Gerlinger et al 2013;Volpe et al 2014;Del Vecchio et al 2015); thus, stigma represents one of the most significant obstacles to mental health care.…”

Does initial use of benzodiazepines delay an adequate pharmacological treatment? A multicentre analysis in patients with psychotic and affective disorders

“…According to the literature, stigma affects not only psychotic disorders, but all mental illnesses, including depression and anxiety (Jorm & Reavley, 2013), and has an impact on DUI and psychiatric referral. Furthermore, the high levels of stigma towards psychiatric disorders (Fiorillo et al, 2011;Magliano et al, 2003) and the limited availability of specific services for early intervention in many countries (Cocchi et al, 2013;Pingani et al, 2014;Pollice et al, 2012) may represent an important barrier to the psychiatric care of patients in the early phases of the disorder.…”