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Truthful communication of mental science: pledge to our patients and profession

Published online by Cambridge University Press:  24 April 2025

Gin S. Malhi*
Affiliation:
Academic Department of Psychiatry, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia CADE Clinic and Mood-T, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, Australia Department of Psychiatry, University of Oxford, Oxford, UK Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, Oxford, UK
Joan Marsh
Affiliation:
The Lancet Psychiatry, London, UK
Dost Ongur
Affiliation:
McLean Hospital, Belmont, USA Department of Psychiatry, Harvard Medical School, Boston, USA
Fiammetta Cosci
Affiliation:
Department of Health Sciences, University of Florence, Florence, Italy
John H. Krystal
Affiliation:
Departments of Psychiatry, Neuroscience, and Psychology, Yale University, New Haven, USA
Karen L. Cropsey
Affiliation:
Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, USA
Gregers Wegener
Affiliation:
Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark Department of Affective Disorders, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
Susan Redline
Affiliation:
Departments of Medicine and Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA Departments of Medicine and Neurology, Harvard School of Public Health, Boston, USA
Carmine M. Pariante
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
Ida Hageman
Affiliation:
Mental Health Services, Copenhagen University Hospital, Copenhagen, Denmark Institute of Biomedicine, Copenhagen University, Copenhagen, Denmark
Cameron Carter
Affiliation:
Department of Psychiatry and Human Behavior, School of Medicine, University of California at Irvine, Irvine, USA
Winfried Rief
Affiliation:
Division of Clinical Psychology, University of Marburg, Marburg, Germany
Robin Emsley
Affiliation:
Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University Tygerberg Campus, Cape Town, South Africa
Lynn E. DeLisi
Affiliation:
Department of Psychiatry, Cambridge Health Alliance and Harvard Medical School, Cambridge, USA
Andrea Cipriani
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK NIHR Oxford Health Clinical Research Facility, Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
Benedicto Crespo-Facorro
Affiliation:
Hospital Universitario Virgen del Rocio, Department of Psychiatry, University of Seville, Seville, Spain Centro de Investigacion en Red Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Seville, Spain Institute of Biomedicine of Seville (IBiS-CSIC), Seville, Spain
Steve Kisely
Affiliation:
Princess Alexandra Hospital, Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Brisbane, Australia Metro, South Addiction and Mental Health Service, Woolloongabba, Australia Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Halifax, Canada
Lakshmi N. Yatham
Affiliation:
Department of Psychiatry and Institute of Mental Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
Jeffrey C. L. Looi
Affiliation:
Social Psychiatry and Epidemiology Research Unit, School of Medicine and Psychology, The Australian National University, Canberra, Australia
Roger Mulder
Affiliation:
Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
Rajiv Tandon
Affiliation:
Department of Psychiatry, Homer Stryker Western Michigan University College of Medicine, Kalamazoo, USA
Paola Dazzan
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
*
Correspondence: Gin S. Malhi. Email: [email protected]
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Summary

Recent changes in US government priorities have serious negative implications for science that will compromise the integrity of mental health research, which focuses on vulnerable populations. Therefore, as editors of mental science journals and custodians of the academic record, we confirm with conviction our collective commitment to communicating the truth.

Type
BJPsych Editorial
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists

Recent actions in the USA involving the withdrawal and redirection of scientific funding and the suspension of international scientific agreements, if sustained, are likely to have a profound impact on research. 1 These developments are particularly significant for research and clinical practice in psychiatry and mental health where much of our knowledge relies on having rich demographic and sociocultural information. Choosing to fund research based on government preferences and placing constraints on researchers, institutions, funding bodies and ultimately clinicians Reference Bibbins-Domingo, Bonow, Bressler, Brubaker, Christakis and Christiansen2 risks generating research findings that lack innovation and clinical meaning. At the same time, such selective research is likely to skew the truth, if not fail to capture it altogether – meaning that in practice, the advances and benefits to patients that have been enjoyed because of research will no longer be forthcoming. The distortion of scientific inquiry and clinical practice poses a grave risk to the advance of science and the care of all patients, but perhaps especially so to those who are disadvantaged. Reference Woolf3 This particularly includes those who have intellectual disabilities and neurodevelopmental problems, and face socioeconomic challenges, as well as those belonging to sociocultural and ethnic minority groups. Our focus here, however, as editors of academic journals is the impact of the changes taking place in the USA on the integrity of the scientific record that serves to inform the care and management of patients with psychiatric and mental health disorders. Our role is to ensure that research is accurate and that it reliably informs both clinical practice and further scientific inquiry. To achieve this in our field of psychiatry and mental health, the inclusion of various personal characteristics of patients, such as their gender or sex, age, ethnicity or socioeconomic status, is essential. Such knowledge has advanced our understanding of mental disorders and helped direct the provision of treatments and services. For example, clinical depression has been shown to be not only common, but twice as common in females as compared to males. Reference Di Benedetto, Landi, Mencacci and Cattaneo4 This gender bias occurs irrespective of a whole host of other factors, underscoring the need to direct detection and care accordingly. Similarly, gender and age differences with respect to suicide have been critical in informing prevention efforts and targeting treatment strategies to those most vulnerable. Reference Qu, Zhu and Chen5 Most, if not all, psychiatric disorders and mental health problems are more common in those who are economically disadvantaged, and having these illnesses has been shown to drive downward drift – compounding the effects of the illness and making service provision more difficult. Reference Lee, DelPozo-Banos, Lloyd, Jones, Walters and Owen6 Excluding basic demographic information that is clearly essential to understanding the nature of psychological illnesses and how best to treat them is illogical and unethical. Science is predicated on scientific method. Consideration of all known factors is critical to determining what matters. Clinical research in psychiatry is about discovering the true nature of illnesses and the distress that people experience. This necessitates capturing reality with as much fidelity as possible. To do this meaningfully all relevant demographic, socioeconomic, psychological and biological data must be considered without bias or prejudice. Only then can we understand the ontology of psychiatric disorders and the true nature of mental health conditions.

Research drives such understanding and is published through rigorous peer review. Journals and their editorial teams provide the necessary means of ensuring the science that is communicated is as accurate as possible; specifically, that research has been conducted ethically, with due consideration of biases and the inclusion of appropriate participants; that researchers have approached the scientific endeavour objectively – without undue influence based on personal beliefs and preferences. In the past decade, scientific enquiry in psychiatry and mental health has refocused on clinically meaningful outcomes – findings that matter to the people living with mental illness. This focus has been sharpened by inclusion of people with lived experience of mental illness in some, or all, stages of research to co-produce research studies and ensure that outputs resonate with those who are most affected. Reference Davis, Pinfold, Catchpole, Lovelock, Senthi and Kenny7

Within this context, we as journal editors, wish to reaffirm our commitments and reassure the communities we inform, that we will continue to strive for the highest scientific standards. To this end, we reassert that we will continue to:

  1. (a) communicate research that has been conducted ethically and report findings that are scientifically accurate and clinically meaningful;

  2. (b) publish science that reflects reality and advances knowledge based on inclusion of those who are disadvantaged;

  3. (c) uphold our high standards of scientific publishing and maintain the integrity of our research record.

Apart from serving those who are amongst the most vulnerable in society, psychiatry and mental health are themselves arguably the medical specialties most vulnerable to any interference in our research methodology, based on the inclusion of factors that reflect the richness of human experiences. Reference Bolis, Dumas and Schilbach8 It is therefore essential that we counter biases and disinformation and oppose changes to the promulgation of science that will ultimately compromise the health of our patients. In addition, our focus should remain on publishing science that has been properly conducted and objectively assessed so that clinicians and scientists are well informed and equipped with genuine knowledge that will enhance our understanding and ultimately improve the quality of life of patients.

Data availability

Data availability is not applicable as no new data were created or analysed.

Acknowledgements

The views in this article are solely those of the authors. Our thanks to Erica Bell for assistance with preparation of the manuscript for submission.

Author contributions

G.S.M. drafted the manuscript with assistance from P.D. and J.M. All authors read, edited and approved the manuscript. The views in this article are solely those of the authors.

Funding

Research for this article received no specific grant from any funding agency, commercial or not-for-profit sectors.

Declaration of interest

G.S.M. is the College Editor and the Editor-in-Chief of The British Journal of Psychiatry. He did not participate in the evaluation of this article. G.S.M. has received grant funding from the American Foundation for Suicide Prevention, the National Health Medical Research Council in Australia, Australian Rotary Health, NSW Health, Ramsay Research and Teaching Fund and the North Foundation in Sydney. He also presently holds an ignition grant from the University of Sydney and the National University of Taiwan. In addition, he has received an educational grant from Lundbeck and research grant funding for an investigator initiated study (IIS) from Jansen.

J.M. is the Editor-in-Chief of The Lancet Psychiatry. J.M. is also a member of the Editorial Board of European Science Editing and chair of the gender policy committee of the European Association of Science Editors.

D.O. is an editor at JAMA Psychiatry and has received honorarium from Rapport Therapeutics.

F.C. is the Editor-in-Chief of the Journal of Psychosomatic Research.

J.H.K. is an editor for Biological Psychiatry.

K.L.C. is the Editor-in-Chief of Drug and Alcohol Dependence and has received grant funding from the National Institutes of Health (NIH).

G.W. is the Editor-in-Chief of Acta Neuropsychiatrica and has received research grants from Horizon Europe, the Independent Research Fund, Denmark, the Lundbeck Foundation and the Novo Nordisk Foundation. He has received educational grants from the Novo Nordisk Foundation, the Lundbeck Foundation, speaker/advisory board fees from J&J, Inc., H. Lundbeck A/S, Eli Lilly A/S, Takeda-Shire AB and Medice GmbH. Neurotorium and research grant funding from H. Lundbeck A/S, Alkermes, Inc., and Arla Foods Ingredients P/S.

S.R. is the incoming Editor-in-Chief for Sleep Health and received grant funding from the NIH in the USA and consulting fees from Eli Lilly, Inc.

C.M.P is the Editor-in-Chief of Brain, Behavior and Immunity (BBI) and the associated journals, BBI Health and BBI Integrative. C.M.P. has received speaker’s fees from Varde Partners and research funding from Compass Pathways.

I.H. is the Editor-in-Chief of Acta Psychiatrica Scandinavica.

C.C. is the Editor-in-Chief of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.

W.R. is the Editor-in-Chief of Clinical Psychology in Europe. W.R. receives funding for research (e.g. as spokesperson of the LOEWE Excellence Center DYNAMIC, funded by the Hessian Ministry of Science and Arts LOEWE1/16/519/03/09.001(0009)/98, and from the German Research Foundation DFG, e.g. CRC 289 ‘Treatment Expectation’, Project-ID: 422744262). He also received speaker’s fees from Boehringer Ingelheim in 2022.

R.E. is the Editor-in-Chief of Schizophrenia and has received honoraria from Janssen, Lundbeck and Otsuka.

L.E.D. is the Editor-in-Chief of Psychiatry Research.

A.C. is the Editor-in-Chief of BMJ Mental Health. A.C. has received research, educational and consultancy fees from INCiPiT (Italian Network for Paediatric Trials), the CARIPLO Foundation, Lundbeck and Angelini Pharma, and is supported by the National Institute for Health Research (NIHR) Oxford Cognitive Health Clinical Research Facility, by a NIHR Research Professorship (grant RP-2017-08-ST2-006), by the NIHR Oxford and Thames Valley Applied Research Collaboration, by the NIHR Oxford Health Biomedical Research Centre (grant NIHR203316) and by the Wellcome Trust (GALENOS Project). The views expressed are those of the authors and not necessarily those of the UK National Health Service, the NIHR or the UK Department of Health and Social Care.

B.C.-F. is the Editor-in-Chief of the Spanish Journal of Psychiatry and Mental Health. B.C.F. has received grant funding from the European Commission under Horizon Health Europe, Fundacion Progreso y Salud, the Ministry of Health, Comunidad Autonoma de Andalucía and the National Institute of Health Carlos III, Ministry of Health, Spain. In addition, he has received a research grant funding from Lundbeck and educational grants from Johnson & Johnson, Rovi and Otsuka-Lundbeck.

S.K. is the Editor-in-Chief of the Australian and New Zealand Journal of Psychiatry. S.K. is also a member of the international editorial board of BJPsych, BJPsych Open and BJPsych International. However, S.K. did not take part in the review or decision-making process of this submission to BJPsych. As a researcher he has received grant funding from the National Health Medical Research Council in Australia and the Australian Research Council.

L.N.Y. is the Editor-in-Chief of the Canadian Journal of Psychiatry. L.N.Y. has received grant funding from Abbvie and Sumitomo Pharma and has been a member of the advisory board/a consultant or a speaker for Abbvie, Alkermes, Intracelular Therapies, LivaNova, Merck, Neurotorium, Newron, Xenon and Sumitomo in the last 3 years.

J.C.L.L. is the Editor-in-Chief of Australasian Psychiatry and a consultant on a US NIH grant with fees disbursed to the Australian National University.

R.M. is the Co-Editor-in-Chief of Personality and Mental Health and has received grants from the Health Research Council of New Zealand.

R.T. is the Editor-in-Chief of the Asian Journal of Psychiatry.

P.D. is the Editor-in-Chief of Schizophrenia Research and has received speaker’s fees from Lundbeck.

G.S.M. has received grant funding from the American Foundation for Suicide Prevention, the National Health Medical Research Council in Australia, Australian Rotary Health, NSW Health, Ramsay Research and Teaching Fund and the North Foundation in Sydney. He also presently holds an ignition grant from the University of Sydney and the National University of Taiwan. In addition, he has received an educational grant from Lundbeck and research grant funding for an investigator initiated study (IIS) from Jansen.

Transparency declaration

The authors guarantee that this manuscript is an honest, accurate and transparent account.

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