Carlat asks: Is psychiatry's leadership getting real?

An ongoing topic here -- raised in depth here, and most recently here -- is how psychiatry is going to right itself from being knocked off-course and off-kilter by its overcozyness with pharma and a corresponding picture of mental disorder.

Psychiatrist Danny Carlat -- one of many dismayed by psychiatry's directtion over the last few years -- sees signs in a recent commentary in the American Journal of Psychiatry, signed by 26 highly prominent psychiatrists, that the discipline is starting to get it.

The key point of the commentary is stated in its title, "Conflict of Interest: An Issue for Every Psychiatrist": After touching on some of the recent scandals and problems of the sort Carlat and Philip Dawdy (who also weighs in on this commentary) track so well, the AJP authors note that such problems harm all practitioners and all patients and state that "we now need to protect our patients from conflicts of interest in the selection of their treatment."

This and the rest of the language in the commentary is fairly mild, and the group doesn't exactly call any guilty brethren onto the carpet. But as Carlat notes,

when they reference "congressional hearings and articles in the New York Times or Boston Globe" it's pretty obvious who they are talking about. Look, this is a guild, folks, and you don't smear members of your own guild (unless you are as reckless as I am!). I think it is remarkable that these 26 authors were able to agree on a document that is pretty critical of industry's coziness with psychiatry--especially since many of them are direct beneficiaries of industry's largesse.... That that leaders in the field could have written this AJP commentary shows that the patient is looking much healthier.

I think he's pretty close to on-target here.

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