May 21, 2025

Too many mental health challenges and not enough psychiatrists (with Jacob Appel)

1 hour 18 minutes

Read the full transcript here.

How big is the current mental health crisis? What's causing it? What do we know about the age distribution of people suffering from mental health issues right now? Is the crisis just that more people are suffering from anxiety and depression, or is there an increase in other disorders as well? Why are psychiatrists seemingly very picky about which insurance policies they'll accept? What percent of hospital psychiatric patients are repeat visitors? What would an ideal mental health system look like? How effective are addiction detox programs? Why might suicide prevention programs backfire? Which disorders are associated with the highest risks of suicide? If a person attempts suicide but is saved, how likely are they to attempt it again? When is it better to see a psychologist than a psychiatrist and vice versa? What are some of the most exciting and most worrying parts of genetic medicine? How should we decide which diseases to study and which treatments to develop? What's an "invisible" victim? Is there any solution to the problem of invisible victimhood? How effective was the Affordable Care Act (AKA "Obamacare")? Are we collectively spending too much money on end-of-life care? How can medicine better incorporate preventive care? What is body integrity disorder? Why do we have such a hard time combating our biases relating to physical beauty? Should polygamy be morally and/or legally permissible? Should medical aid in dying (AKA "assisted suicide") be morally and/or legally permissible? Are doctors too willing to resuscitate dying patients?

Jacob M. Appel is currently Professor of Psychiatry and Medical Education at the Icahn School of Medicine at Mount Sinai in New York City, where he is Director of Ethics Education in Psychiatry, Associate Director of the Academy for Medicine and the Humanities, and Medical Director of the Mental Health Clinic at the East Harlem Health Outreach Program. Jacob is the author of five literary novels, ten short story collections, an essay collection, a cozy mystery, a thriller, two volumes of poems and a compendium of dilemmas in medical ethics. He is Vice President and Treasurer of the National Book Critics Circle, co-chair of the Group for the Advancement of Psychiatry’s Committee on Psychiatry & Law, and a Councilor of the New York County Psychiatric Society and of the American Academy of Psychiatry & Law. Learn more about him at his website, jacobmappel.com.

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