What It Takes to Be a Global Leader in Psychiatry

When I said those words at APA’s 2018 Annual Meeting in May, I was describing my goal of expanding APA’s global reach by increasing our collaborative efforts with colleagues around the world and our involvement in contemporary social issues.

Less than 24 hours after taking office as the 145th president of the Association, I appeared with other national mental health leaders, government officials, and state first ladies at the 2018 National Children’s Mental Health Awareness Day celebration in Washington, DC. This year’s theme was “Partnering for Health and Hope Following Trauma” (Psychiatric News, June 15), and millions around the country viewed the live-streamed program, with simultaneous events held in many localities.

We could not know at the time that this topic would resonate with the entire nation (and the world) by the end of the month when we all found out about the federal policy of separatig immigrant children from their parents at the U.S. southern border. On May 30 APA issued a statement strongly encouraging the Trump Administration to stop separating immigrant families when they entered the United States seeking asylum (see page 1). News outlets were reporting these events nonstop in the 24-hour news cycle, and footage of sobbing children and frantic parents seemed on a continuous loop.

Ours was one of the first statements on the issue, and members immediately weighed in, some thanking us for our support of these vulnerable people, others asking that we do more. The president of the American Academy of Pediatrics visited one location and reported on the reactions of the children she saw there, behaviors that suggested they were experiencing a level of psychological trauma that we psychiatrists recognize as extremely harmful to a child’s positive growth and development.

Finally on June 20, President Trump signed an Executive Order to end the policy, but many of us feared that irreparable damage had been done already to the reported 2,500 or so children already in the custody of the departments of Homeland Security and Health and Human Services without their families.

By then I had traveled to Kobe, Japan, for the annual meeting of the Japanese Society of Psychiatry and Neurology (JSPN). I had been asked to speak on strategies to increase women’s participation in psychiatry’s leadership. More interesting, however, was the fact that on both the English- and Japanese-speaking news channels, the lead story every morning was about the U.S. government’s separation of families at the border. The JSPN members had many questions about how and why this was happening, and the visiting Americans had no good answers.

The next stop was the Royal College of Psychiatry, which was meeting in Birmingham, England (and unlike the one in Alabama, that’s roll the “r” and drop the “h” in Birmingham). And although the topic was selected months beforehand, the plenary address that I delivered was about childhood trauma and adverse childhood experiences globally, something that could have been taken straight out of the current U.S. news headlines. Again, there were many questions about how and why this was happening in America, and for which there was no good answer.

I offer this lecture-based travelogue as a reminder of these areas of focus from my Opening Session speech. I want to let you know why I think it is so important that we work more closely with our colleagues around the world on issues many have been dealing with for some time—trauma and immigrant populations generally and the special issues facing children in these situations. The participants at the two meetings I’ve described came from all over the world, and most had stories about the challenges they are facing in these areas.

“We cannot be a leading voice for mental health in isolation.” My recent meetings with our global colleagues have shown me just how true this statement is. APA has an opportunity to lead the way as a big voice for psychiatry around the globe, but it means that we must pay attention to what’s going on here at home as well as events elsewhere. As our international membership grows, we need to communicate more about our shared interests and needs. Only then will we be the leading global psychiatric organization. ■