“[T]ransformative progress in care of our patients will rely not only on technical breakthroughs, but also on reinstating a scientific culture that values novelty, creativity, and active mindfulness of our patients,” writes Joshua L. Roffman, MD, MMSc, of Massachusetts General Hospital, Editor-in-Chief of HRP. His article inaugurates a series of brief essays under the title of ‘Disruptive Innovation’ – dedicated to generating new ideas and progress in psychiatry research, practice, and policy.
Some psychiatric researchers feel a “justifiable melancholy” over the lack of recent advances in prevention and treatment of major mental health disorders – especially compared to revolutionary advances made in other specialties, such as successful immunotherapy for metastatic cancers. Dr. Roffman writes, “While the reasons for this gap are multifactorial, some are iatrogenic, in that they actively discourage creative, collaborative, high-risk, high-reward research with a clear trajectory toward clinical impact.” At the same time, he sees strong opportunities for meaningful translational research in psychiatry, including “big data” approaches, new genetic research techniques, and major long-term research projects.
In his essay, Dr. Roffman identifies obstacles to clinical innovation in psychiatry research, and proposes a system of key scientific values that promote innovation. He highlights key areas where he believes new approaches are needed – including grant review processes that “tend to favor more comfortable ideas through groupthink, and to disproportionately reward senior scientists.”
“Indeed, it is often impossible to differentiate promising new ideas from those headed toward blind alleys without giving them some room to grow,” the HRP Editor adds. “Some of the best new ideas may come from junior and mid-career investigators, but their impact can be suppressed by the formulaic and deliberate ladder of career progression in our field.” He also addresses limitations of the current peer review process that tend to maintain the entrenched status quo while posing obstacles to innovation.
Dr. Roffman’s essay is freely available on the Harvard Review of Psychiatry website. The editors hope their new essay series will help to “catalyze transformation” of new research approaches and technology into improved outcomes for patients. Dr. Roffman concludes: “We envision ‘Disruptive Innovation’ as a forum for forward-thinking clinicians, investigators, policymakers, and thought leaders to challenge orthodoxy in thoughtful and well-reasoned ways, and propose new ideas, approaches, and methods to tackle intractable problems in psychiatry.”
About the Harvard Review of Psychiatry
The Harvard Review of Psychiatry is the authoritative source for scholarly reviews and perspectives on a diverse range of important topics in psychiatry. Founded by the Harvard Medical School Department of Psychiatry, the journal is peer reviewed and not industry sponsored. It is the property of Harvard University and is affiliated with all of the Departments of Psychiatry at the Harvard teaching hospitals. Articles encompass major issues in contemporary psychiatry, including neuroscience, epidemiology, psychopharmacology, psychotherapy, history of psychiatry, and ethics.
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