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November 10, 2019 by Sandra Steingard, MD | Community Mental Health Journal

Inaugural Editorial

I begin my tenure as Editor-in-chief of the Community Mental Health Journal with humility and gratitude. I have deep respect and admiration for my predecessor, Jacqueline Feldman, who led the journal with an intellectual rigor and generous attitude that helped to expand the scope of the journal. I am also grateful that our dedicated associate editors, Curtis Adams and Margie Balfour, have agreed to continue their work with CMHJ. At the same time, editorial transition offers an opportunity to reflect on a journal’s aims and identify areas for growth. This inaugural editorial offers an opportunity to introduce myself and share ideas on what lies ahead.

I am a psychiatrist who has worked in public sector psychiatry for over 30 years. My primary clinical interest has been in treating individuals who experience psychosis. As Chief Medical Officer of Howard Center, a large agency that has grown along with the expansion of community programs, I am familiar with services provided to a broad range of individuals as well as the pressures and challenges entailed in efforts to provide good care. I also serve on the board of the American Association of Community Psychiatrists (AACP) and am a Clinical Associate Professor of psychiatry at the University of Vermont Larner College of Medicine.

In recent years, my scholarly efforts have been directed toward a critical evaluation of psychiatry. I edited a book published by Springer Nature titled, Critical Psychiatry: Controversies and Clinical Implications and I serve on two other boards whose purviews reflect these interests: the Foundation for Excellence in Mental Health Care and Mad In America Continuing Education. I also blog on the website, madinamerica.com; these blogs along with the book offer an explicit articulation of my perspectives and interests.

Critical analysis has led me to an interest in the notion of epistemic authority—the question of who are the recognized holders of knowledge in a given field of endeavor. Traditionally in medicine, articles published in peer-reviewed journals confer on such texts and their authors significant authority, both within and outside of the discipline. I understand, accept, and respect the traditions of academic research. But I also have come to believe that such conventions reflect and reinforce embedded power structures that sometimes ignore important voices. Among my hopes going forward is to find ways to uphold intellectual rigor while also exploring means of incorporating perspectives that have historically been neglected in psychiatric discourse. People who have been diagnosed with psychiatric disorders have made and will continue to make valuable contributions to the field. Other branches of social science have contributed not only to our conceptual understandings of mental conditions but also to our effectiveness as individuals and communities responding to those in distress. These are perspectives that will enhance the journal.

While the community mental health movement has made great strides since its inception, most would agree there remains room for improvement. My hope is to have CMHJ serve as a place for critical reflection. While I am not advocating an abandonment of the core focus of CMHJ, I suggest that systematic, penetrating evaluations of many aspects of practice would serve us well. My initial focus is on developing ways to achieve these goals. I have gathered a group of diverse stakeholders to assist me in this process and I am eager to hear from others. We are currently exploring ways to publish that would complement the original papers and brief reports that comprise the bulk of each issue of CMHJ. We hope to include reports of emerging and novel practices as well as to offer space for commentary and debate. This is in a preliminary phase. I look forward to sharing this process with you in the coming months and I am always happy to hear from you.

With respect and appreciation,

Sandra Steingard.

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