Citation

Kalin NH. Am. J. Psychiatry 2021; 178(3): 207-209.

Copyright

(Copyright © 2021, American Psychiatric Association)

DOI

10.1176/appi.ajp.2020.21010043

PMID

unavailable

Abstract

As practitioners, we are well aware of the need for new and better treatments for our patients, but we must not overlook others in the population who would benefit from existing treatments and yet, for various reasons, are neglected. New treatment development must be based on the understanding of underlying pathophysiology, which directly depends on new empirical insights into genetic, molecular, cellular, and neurocircuit alterations as they relate to individuals' symptoms and phenotypic presentations. Ultimately, rigorous clinical trials must be performed in diverse populations to translate more basic discoveries to patients and to determine the efficacy and potential risks of new treatments. At a societal level, the key issues are related to increasing access to psychiatric treatment for populations who are underresourced and to decreasing barriers to mental health care for Black, Indigenous, and people of color (BIPOC) individuals. To make headway, focus needs to be on the effects of structural racism as they play out in relation to mental health care for BIPOC individuals. This issue of the Journal presents articles that address new treatment development, that aim to improve the applicability of current treatments, and that provide recommendations for developing a more diverse psychiatric workforce as part of an effort to overcome barriers to psychiatric care for BIPOC communities.

In relation to new treatment development, articles in this issue explore the use of a progesterone receptor modulator strategy for treating premenstrual dysphoric disorder (PMDD) and the use of a neurosteroid progesterone metabolite for treating postpartum and major depression. Other work focuses on understanding and improving the applicability of current treatments, including the use of electroconvulsive therapy (ECT) for the treatment of mania, the use of antipsychotics for reducing violent behavior in patients with schizophrenia, the general use of contraceptives in female psychiatric patients, and the use of virtual modalities to enable "long distance" psychotherapy treatment. From a health care delivery perspective, we include two pieces that emphasize the imperative of creating greater diversity in the psychiatric workforce and in academic psychiatry departments. This foundational component addresses barriers to treatment for underserved populations and is a necessary step in enhancing mental health care for BIPOC individuals...

Language: en

Keywords

Outcomes; Racism; Psychotherapy; Depressive Disorders; Violence/Aggression; Diversity; Premenstrual Dysphoric Disorder; Sociopolitical Issues