Psychiatry: Where to Now?
- Posted by Editor JPR
- Posted in Editorials & Commentary
Vol 3 #1, January 2018
Alan Eppel MB, FRCPC
Welcome to Volume 3 of the Journal of Psychiatry Reform!
As we enter the third year of publication it is useful to review our core purpose, values and activities.
To promote the humane and effective practice of psychiatry by the publication of unbiased and critically appraised psychiatric information.
- biopsychosocial orientation
- social justice
- To publish articles, reviews and abstracts.
- To disseminate psychiatric information by means of social media and electronic communications.
- To advocate for improvements to psychiatric services and practice.
- To improve the experience and engagement of patients within psychiatry
- To promote the mental health of patients
The Journal arose out of concerns about the quality and nature of psychiatric practice and services. In the past decade there has been increasing concern about overt and covert influence by the pharmaceutical and other commercial interests on psychiatric research, nosology and practice. The public confidence in the credibility and independence of the profession has been threatened.
The Journal is unique in being completely open access without any costs or fees to authors. Published articles are linked to a Twitter account to disseminate to relevant individuals and groups.The Journal has taken the position that it will not will not publish any articles that reflect bias or conflicts of interest. Abstracts will only be published from journals with high ethical standards and written by authors who do not have financial ties with industry.
Despite many advances in the field of psychiatry there has been some disillusionment with the current state of psychiatric practice in many jurisdictions.While there exist many good psychopharmacological and psychotherapeutic treatment approaches, effectiveness and recovery rates are far below desired levels.
There have been no real breakthroughs in new medications over the past couple of decades. While it is true that many new agents have been developed and marketed very few have any advantages over older medications. In fact in some cases the side effect profiles are worse. In particular side effects related to some of the newer antipsychotic medications can result in greater morbidity and mortality.
Accessibility to timely psychiatric care remains problematic even in countries with well-developed publicly funded healthcare systems such as an Australia, Canada, Western Europe and Taiwan.
Even in Canada with universal healthcare, access to psychiatrists is variable depending on geographic region. Access to care in rural and northern regions remains problematic. Tele-psychiatry has been posited as one method to overcome these inequities in access but it is not clear that this provides the same quality and continuity of care.
All too often psychiatric services continue to be provided in diagnostic silos and there is a lack of comprehensive approaches. Overly specialized services can lead to barriers to access.
Access to care should be centralized and services organized based on patient needs for specific treatment modalities and not diagnostic groups.
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