Great piece. Child psychiatry could greatly benefit from a home hospitalization model. The path out of a pediatric mental health crisis involves the whole family. Also, neurodevelopmentally disabled patients often can’t access hospitals and the environments are not designed with their needs in mind
This is especially relevant in child psychiatry, where the best way to center the patient’s wellbeing may be even murkier given their constrained autonomy. I agree with @awaisaftab.bsky.social ‘s recommendation- careful formulation, and most importantly, honesty. (2/2)
A fantastic piece that names one of the core sources of professional distress for the psychiatrist: the person-environment mismatch and the desire to help in situations where fundamental solutions are impossible but mental health interventions may still have utility (1/2)
I had not heard that Lisa passed. I’m deeply saddened by her loss. Her voice changed how I approach my work. Thanks for sharing these words, Awais.
Though I think I’m a little late to the party, I had to share this book. Some of the best writing I’ve read in years. Come for the analysis of AI agency, stay for what it reveals about human consciousness and spirituality.
I always recommend social time with friends and especially extracurricular activities that involve peers. As a policy intervention, investing in after school programs could be game-changing for the unprecedented issues faced by our modern youth.
While screen time has understandably come under concern in recent years, I think it is the things kids are *not doing* when they’re in front of the screens that makes the biggest difference. Opportunity for social play is not only good for kids, it is required, just like learning.
In my practice, I ask:
- How often do you spend time with friends in-person outside of school?
- What activities do you do with other people that are just for fun?
I am often shocked by how little time kids are spending with this vital part of healthy development.
The series has been excellent. The concepts have been a helpful supplement to my training and should really be core to all psychiatry education.
Here at AACAP 2025. Excited to present with some incredible colleagues on the evidence we’re building in the treatment of pediatric catatonia in ASD.
Thought-provoking as always. My main question mirrors the post-script.
Is there anything we can do with nosology or language in ASD that would *guarantee* benefit for autistic people and maintain an honest recognition of the complex truths scientists know (and don’t) about the autism spectrum?
“Boredom proneness overlaps with inattention and impulsivity but does not capture hyperactivity, working memory deficits, or problems with planning and organization.”
Excellent article. An example of this distinction: the higher risk of car accidents is probably not due to boredom proneness alone.
An interesting look at integrating several emerging heuristic models in psychiatry. With some discussion of what it would really take to create a paradigm shift.
This is excellent work. Exactly the type of research that can help us resolve the tense debates around the diagnosis, epidemiology, and nosology of catatonia. Spoiler: presentations change fast, even within 24 hours!
The RFK Jr + MAHA alliance may very well ensure that the psychiatric harm movement is eventually remembered not for saving lives from medical overreach, but for wrecking public health in America. The irony of this outcome will not be lost on observers and future commentators.
Recent articles about the use of AI
in psychotherapy make me feel the way an older generation of psychiatrists must have felt watching the interpersonal aspects of their practice being discarded with applause from the business world and media.
Very well deserved
This post made me think of the many times I’ve heard a patient describe their past treatment with misleading metaphorical language, oftentimes inherited from a physician. It’s humbling to remember that our metaphors are carried outside our offices and may shape self understanding for a lifetime.
Robert F. Kennedy calls autism an epidemic and treats it like a crisis. But the Trump administration has cut autism-related research by 26 percent since he took office.
www.reuters.com/business/hea...
Thanks to @autismsciencefd.bsky.social for giving me some time to talk about how catatonia is diagnosed in autism. Some really excellent questions at the end. Enjoyed being with you all!
The MAHA vision is of a type of utopia, where those able to utilize lifestyle practices such as organic food to improve health can live a full life. For disabled people and those lives improved by psychiatric medications & public assistance, however… it’s not clear there is a plan for them.
4. And what are those motives? Based upon everything we’ve seen so far, it appears to be the promotion of libertarian ideology that sees suffering and disability as individual responsibilities. To replace medical care and social support with “beneficial lifestyle changes”
Piece by Jesse Meadows
3. We are now seeing what appear to be efforts by the government to address longstanding issues (insufficient evidence and awareness regarding the risks of medications). Still, it is clear there are ulterior motives.
Piece by @awaisaftab.bsky.social
2. Public trust has eroded in medical professions (including and maybe especially psychiatry) for both legitimate reasons (poor communication about certainty, risks, and harms) and because of leaders using rhetoric meant to undermine that trust.
Piece by @awaisaftab.bsky.social
1. There’s a myth that we used to be healthier in the past, and that we can get back there by shunning the medical establishment. It’s a myth that’s existed for a long time and has more to do with an idea of moral purity than it does with health.
Piece by @drrobertchapman.bsky.social
I’ve been searching for “the point” behind the MAHA movement and RFK’s policies. All the doctors I know feel like it’s headed for disaster. So why does it have so much steam? Some recent pieces have made it clearer to me: (1/6)
If psychiatrists want an effective collective response to the administration’s approach to psychiatric medications, it’s going to take clear-eyed communication like this.
Many major autism advocacy organizations representing a huge variety of viewpoints (sometimes starkly opposing one another) released this joint statement.
Their points:
1. Vaccines do not cause autism
2. Autistic individuals deserve respect and support
3. Evidence-based policy is essential
This is the language of eugenics. Autistic lives are inherently valuable.
