Research view
Title: | Psychiatry forecast: hopefully sunny |
Author: | Bhugra, Dinesh; Elkholy, Hussien |
Abstract: |
Medicine as well as psychiatry has been continuously developing for decades, although the pace of development may well be different in the two specialties. In many countries, the shift from asylums to a more community-based approach and now to home-based treatments has shown that the march of psychiatry has indeed been impressive, leading to changes in management strategies. Similarly, diagnostic modalities have gone through a series of changes. Psychiatry might be one of the most rapidly changing medical disciplines, as it adapts to ever-changing social, cultural, and environmental conditions, leading to newly emerging disorders or manifestations. Inevitably, there is a gap between those changes and evidence-based guidelines and real-life practice, which necessitates more attention to safety and quality of healthcare 1.
For this reason, the World Psychiatric Association with Lancet Psychiatry established a commission that recently published a report 2 on the future of psychiatry, addressing the challenges and opportunities for the best benefit of psychiatry in the 21st century. The commission covered topics ranging from treatment, mental health law to the training of future psychiatrists.
The first area considered in the commission is rightly concerned with patients and their treatment. Factors like urbanization and high rates of migration in many parts of the world have to be taken into account, with resulting diversity of cultures, languages, and traditions of patients, doctors, and policy makers and other stakeholders. Attention must be paid to improve diagnostic assessment especially with the lack of resources. This also highlights the role of digital communication and their effect on diagnosis and management of different psychiatric disorders.
In addition to the gap between guidelines and service 1, often services focus on the individual, which is right, but ignore proximal and distal factors, which include the mental health needs of populations. Emphasis on public health should be a crucial part of training. Pathways to care should be audited and adapted to different countries’ specific needs, with involvement of trained primary healthcare professionals to facilitate engagement of patients with more specialized services when needed 3.
Despite being a key medical specialty, the social factors in etiology and management of psychiatric disorders cannot be ignored, as it is the social aspect which influences not only development of mental health problems but also helps reach diagnosis. Thus, the role of psychiatry and psychiatrists is always changing over time according to societal needs.
Owing to a number of reasons, including a lack of resources, countries must place more emphasis on e-mental health and telemental health, which can help in both diagnosis and treatment 4. This also can help in digital phenotyping leading to a more personalized management of mental illnesses. Not only digital devices and sensors can help in diagnosis, but also technological advances play important roles in prevention and therapy. Thus, training psychiatrists of the future on the use of e-mental health and telemental health and also issues related to privacy and confidentiality is a must. Furthermore, quality improvement of mental healthcare can only be achieved by ensuring proper training as a start. Innovative techniques and revisiting teaching modalities to adapt the needs of the current generations will be reflected on the quality and accessibility of service as well as their acceptance and utilization.
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Journal: | Middle East Curr Psychiatry 25 (1):1. 2018 |