We Are Psychiatrists

Jeffrey Geller’s “From the President” columns have been outstanding throughout his presidency, and his sharing of his vast knowledge about the history of racism in psychiatry offered an important and in-depth education to us all. I was impressed as well with his piece in the January issue titled “Is the Term ‘Psychiatric’ Becoming Extinct?”. I have never liked the term “behavioral health” as it suggests that psychiatric illnesses, including addiction, are manifestations of “people behaving badly,” be they adults or kids.

As a student of psychology and philosophy in college, I entered medical school knowing my path was to become a psychiatrist. In medical school I became more fascinated by psychiatric-general medical interfaces, and consultation-liaison (C-L) work has been a focus of my career. My first rotation in C-L psychiatry was an elective as a medical school senior under a wonderful mentor, Al McFarlane, M.D. With perhaps an overappreciation (over 40 years ago) of how social determinants affect disease onset, manifestations, and progression, and in an early implementation of physician-led multidisciplinary teams in general medical settings, he established a C-L service at McMaster University Hospital. The first person to see the patient at the hospital was a psychiatric social worker, and every case was staffed with Dr. McFarlane to determine whether physician involvement was indicated. He called the service the “Psycho-Social Service,” not the Psychiatric Consultation Service. I felt awkward with the term “Psycho-Social Service” even then; I wanted to enter the room as a trainee in psychiatry.

I support Dr. Geller’s message and encourage all of us to be mindful of the words we use and to use the words “psychiatric” and “psychiatry” whenever these words apply. After all, we are members of the American Psychiatric Association. ■

MICHAEL MILLER, M.D.

Madison, Wis.