The future of academic psychiatry in Europe

Academic psychiatry is going through a difficult period in Europe. Models of mental healthcare have changed dramatically in the last few decades and academic centres are often conforming reluctantly to this change or even trying to withstand it rather than being proactive and leading the process. Furthermore, only a minority of big or well organised university psychiatric departments are currently able to compete successfully with other academic centres for the meagre funds available for research, and at the same time to respond effectively to the persistent demand to be as 'productive' as non-academic hospitals or mental health services in terms of numbers of patients seen and treated in ordinary clinical practice. In several European countries, psychiatry has become less attractive to medical students and junior doctors than it was in the past, and recruitment of smart young researchers in academic departments has become increasingly difficult. In addition, the current confusion about the identity of psychiatry is generating uncertainty and controversies about the content of psychiatric education and training, which in some countries is being regarded as obsolete. Finally, the need to interact with an increasingly broad range of counterparts - including other mental health professionals, administrators at a variety of levels, families and their organisations, magistrates and journalists - has caught some academics unprepared. These new challenges in clinical practice, teaching and research need to be approached in a thoughtful and comprehensive way. The role and aims of academic psychiatry need to be redefined so that it can resume the initiative and lead further developments in the field rather than being overwhelmed by them.