There’s a popular narrative that drug companies have stolen the soul of psychiatry. That they’ve reduced everything to chemical imbalances. The people who talk about this usually go on to argue that the true causes of mental illness are capitalism and racism. Have doctors forgotten that the real solution isn’t a pill, but structural change that challenges the systems of exploitation and domination that create suffering in the first place?

No. Nobody has forgotten that. Because the third thing you notice at the American Psychiatric Association meeting is that everyone is very, very woke.

Here are some of the most relevant presentations listed in my Guidebook:

Saturday, May 18

• Climate Psychiatry 101: What Every Psychiatrist Should Know
• Women’s Health In The US: Disruption And Exclusion In The Time Of Trump
• Gender Bias In Academic Psychiatry In The Era Of the #MeToo Movement
• Revitalizing Psychiatry – And Our World – With A Social Lens
• Hip-Hop: Cultural Touchstone, Social Commentary, Therapeutic Expression, And Poetic Intervention
• Lost Boys Of Sudan: Immigration As An Escape Route For Survival
• Treating Muslim Patients After The Travel Ban: Best Practices In Using The APA Muslim Mental Health Toolkit
• Making The Invisible Visible: Using Art To Explore Bias And Hierarchy In Medicine
• Navigating Racism: Addressing The Pervasive Role Of Racial Bias In Mental Health

Sunday, May 20

• Addressing Microaggressions Toward Sexual And Gender Minorities: Caring For LGBTQ+ Patients And Providers
• Latino Undocumented Children And Families: Crisis At The Border And Beyond
• Racism And Psychiatry: Growing A Diverse Psychiatric Workforce And Developing Structurally Competent Psychiatric Providers
• Sex, Drugs, And Culturally Responsive Treatment: Addressing Substance Use Disorders In The Context Of Sexual And Gender Diversity
• Grabbing The Third Rail: Race And Racism In Clinical Documentation
• Racism And The War On Terror: Implications For Mental Health Providers In The United States
• The Multiple Faces Of Deportation: Being A Solution To The Challenges Faced By Asylum Seekers, Mixed Status Families, And Dreamers
• What Should The APA Do About Climate Change?
• Intersectionality 2.0: How The Film Moonlight Can Teach Us About Inclusion And Therapeutic Alliance In Minority LGBTQ Populations
• Transgender Care: How Psychiatrists Can Decrease Barriers And Provide Gender-Affirming Care
• Gun Violence Is A Serious Public Health Problem Among America’s Adolescents And Emerging Adults: What Should Psychiatrists Know And Do About It?
• Working Clinically With Eco-Anxiety In The Age Of Climate Change: What Do We Know And What Can We Do?
• Are There Structural Determinants Of African-American Child Mental Health? Child Welfare – A System Psychiatrists Should Scrutinize

Monday, May 21

• Community Activism Narratives In Organized Medicine: Homosexuality, Mental Health, Social Justice, and the American Psychiatric Association
• Disrupting The Status Quo: Addressing Racism In Medical Education And Residency Training
• Ecological Grief, Eco-Anxiety, And Transformational Resilience: A Public health Perspective On Addressing Mental Health Impacts Of Climate Change
• Immigration Status As A Social Determinant Of Mental Health: What Can Psychiatrists Do To Support Patients And Communities? A Call To Action
• Psychiatry In The City Of Quartz: Notes On The Clinical Ethnography Of Severe Mental Illness And Social Inequality
• Racism And Psychiatry: Understanding Context And Developing Policies For Undoing Structural Racism
• Trauma Inflicted To Immigrant Children And Parents Through Policy Of Forced Family Separation
• Deportation And Detention: Addressing The Psychosocial Impact On Migrant Children And Families
• How Private Insurance Fails Those With Mental Illness: The Case For Single-Payer Health Care
• Imams In Mental Health: Caring For Themselves While Caring For Others
• Misogynist Ideology And Involuntary Celibacy: Prescription For Violence?
• Advocacy: A Hallmark Of Psychiatrists Serving Minorities
• Inequity By Structural Design: Psychiatrists’ Responsibility To Be Informed Advocates For Systemic Education And Criminal Justice Reform
• Treating Black Children And Families: What Are We Overlooking?
• Blindspotting: An Exploration Of Implicit Bias, Race-Based Trauma, And Empathy
• But I’m Not Racist: Racism, Implicit Bias, And The Practice Of Psychiatry
• No Blacks, Fats, or Femmes: Stereotyping In The Gay Community And Issues Of Racism, Body Image, And Masculinity
• Silence Is Not Always Golden: Interrupting Offensive Remarks And Microaggressions
• Black Minds Matter: The Impact Of #BlackLivesMatter On Psychiatry

… you get the idea, please don’t make me keep writing these.

Were there really more than twice as many sessions on global warming as on obsessive compulsive disorder? Three times as many on immigration as on ADHD? As best I can count, yes. I don’t want to exaggerate this. There was still a lot of really meaty scientific discussion if you sought it out. But overall the balance was pretty striking.

I’m reminded of the idea of woke capital, the weird alliance between very rich businesses and progressive signaling. If you want to model the APA, you could do worse than a giant firehose that takes in pharmaceutical company money at one end, and shoots lectures about social justice out the other.

Scott Alexander, “The APA Meeting: A Photo-Essay”, Slate Star Codex, 2019-05-22.