‘Every day is Mental Health Awareness Day’: Messages from Your Psychiatry Colleagues

Addressing mental health is more important than ever with America’s mental health crisis. The COVID-19 pandemic exacerbated mental health issues, and according to a JAMA Health Forum, 38% more people have been in mental health care since the onset of the pandemic.¹

As May draws to a close, it is time to recognize Mental Health Awareness Month and acknowledge this vital aspect of healthcare. The first week of May saw a flurry of psychiatry news during the American Psychiatry Association (APA) 2024 Annual Meeting in New York. Esteemed opinion leaders presented on a wide array of topics, with a particular emphasis on addiction.

At APA 2024, HCPLive asked 12 various experts what they would tell their colleagues for Mental Health Awareness Month. The advice fell into several subcategories—addiction, psychedelic-assisted therapy, compulsive-obsessive disorders, and ADHD. Many people directed their message to their colleagues on the broader aspects of mental health.

Featured in the article include Ryan McLaughlin, PhD, from Washington State University, Paul Appelbaum, MD, from Columbia University, Maria Oquendo, MD, PhD, from Penn Medicine, Jonathan Alpert, MD, PhD, from Montefiore Medical Center and the chair of the APA council on research, Nitin Gogtay, MD, from APA, Daniel Karlin, MD, from MindMed, Lenard A. Adler, MD, from NYU Langone Health, Brian Barnett, MD, from Neurological Institute at Cleveland Clinic, Manish Jha, MD, from UT Southwestern Medical Center, Katharine Phillips, MD, from Weill Cornell Medical College, Robert Weinrieb, MD, MD, FACLP, from University of Pennsylvania, and Franklin King, MD, from Massachusetts General Hospital.

HCPLive Psychiatry: What would you like to say to your colleagues for mental health awareness month?

Ryan McLaughlin: Cannabis use is growing, and the [most cited] reason for using cannabis is to alleviate stress. In today’s climate, we’re inundated with stress, and there might be an increased drive for people to cope with stress using cannabis. I would urge people to look for alternative strategies that might be healthier.

We know that cannabis can help with stress coping, but we know that the endocannabinoid system our bodies and brains produce makes [us] take advantage of that. Instead of applying exogenous drugs, we can look for ways to help our mental health status by naturally augmenting the endocannabinoid system, [with] things like exercise, social interactions, going out, and getting out of your general routine. A lot of these things, especially exercise, have been shown to increase endocannabinoids in the brain.

Paul Appelbaum: We're at a significant point where there has been substantial destigmatization of mental disorders. Encouraging people to be open about their conditions and their treatment is likely to play a strong and important role in destigmatizing mental disorders and is something we should all be encouraged to do.

Maria Oquendo: Every day is Mental Health Awareness Day. The pandemic has brought us many negative things, but a positive thing is that there is broad awareness amongst the public, and in the house of medicine, of the importance of mental health. The reality is there is no health without mental health.

Jonathan Alpert: We are all human beings and none of us are immune to physical conditions. None of us are immune from mental health conditions. The distinction between mental and physical health is artificial; we are talking about health for ourselves, our families, and our communities.

Nitin Gogtay: Mental health is medical health. Just as medical health should be a birthright, mental health should be a birthright [as well].

Daniel Karlin: I work in a specialized segment of the field… [but still] practice outpatient psychotherapy. Keep learning, keep moving forward, keep fighting the fights where fights are needed to be like mental health parity, making sure people have as much access to psychiatric care as they do in physical healthcare. It's easy to write off psychiatry and psychiatric distress, but in the end, the experience of all illnesses is through the brain.

Reid Robinson: This is an important time in psychiatry, where we’re exploring these new options and have some challenges ahead, [such as] regulatory and policy challenges. There’s the safety and efficacy that needs to be worked out, but we need to band together and use our collective wisdom to roll these [treatments] out in a good way. There's an opportunity to get some important treatment options [for] patients who desperately need it. I would encourage a careful and collaborative path forward so that we can expand equitable access to these important medicines.

Lenard A. Adler: If individuals are concerned they might have adult ADHD, bring them in the office, give them an evaluation. Missing a diagnosis can have serious consequences.

Brian Barnett: I am grateful for my colleagues in this field. We do work that is very important and often underappreciated by our society and our healthcare system. People I work with have sacrificed a lot to do this work, and I hope others [appreciate them] too.

Manish Jha: Depression and other mental health disorders are often chronic. We should not wait for specialists; [primary care practices can manage, screen, diagnose, and treat these conditions. Do not give up after trying a few treatments].

I would encourage clinicians to get together and ask for more research, and as researchers, ask for more participation from clinicians so that we all come together and try to work together to find better treatments and better ways to use currently available treatments.

Katharine Phillips: [OCD, body dysmorphic disorder, excoriation disorder, and trichotillomania] are more common than most people think, and they’re usually underrecognized. It’s important to screen for these disorders in clinical practice [and] ask patients about them. We have good treatments, the SSRIs being our first-line treatments for body dysmorphic disorder and OCD. Most patients do get better with the right treatment.

Robert Weinrieb: What we want to tell people in the community is if patients are drinking, and they have end-stage liver disease, it does not rule them out for transplant evaluation. These psychotherapy programs [give] them a chance to get back on track and hopefully get a transplant if they need it to survive and do well in the future.

It's more about not being afraid to refer them to us because they think that everybody has to have six months of sobriety—that was sort of an old-school perspective that was many years ago. It turns out that six months of pre-transplant sobriety does not predict post-transplant survival or sobriety very well.

Franklin King: I get a lot of questions about psychedelics from patients, [which] presents a challenge. All classic psychedelics and MDMA remain Schedule I drugs, so they’re illegal outside of research settings in the US. Patients can certainly get a hold of these things if they need to. There’s tension between intensifying interest in seeking out these things and not any safe above ground to do that. [I recommend reading the APA's statements from 2022 and 2023 on this topic].

References

1. ^{Insel, T. America’s Mental Health Crisis. The Pew Charitable Trusts. December 8, 2023. https://www.pewtrusts.org/en/trend/archive/fall-2023/americas-mental-health-crisis. Accessed May 31, 2024.}