No Other Land … Another “Edystorial” for Social Psychiatry in 2025

“We have no other land. It is our land. That is why we suffer for it.” We are social psychiatry. This is our land. We have no other land. We have been living here for ages. We have been helping ourselves and others, raising our cattle, ploughing our farmland, and making our humble livelihood. We have been focusing on community, on cohesion, on peaceful co-existence. Although our official nomenclature is not very old – barely more than a century perhaps[1] – yet our lineage goes back far, far deeper, into the early eras of human existence, when humans realized that living together and making stories together and forming nexuses was the only way to survive and prosper – materially, physically, and yes, mentally.[2] Despite this, there is a clear and persistent trend of decreasing public interest in social psychiatry,[3] acknowledged with concern.[4,5] The confident challenge thrown by the famous psychiatrist Samuel Guze in 1989 still stands: “Biological psychiatry – is there any other kind?”[6] And the tone changes to a calm assertion in 2023: “Psychiatry is biological.”[7] We are social psychiatry. This is our land. We have no other land. Hence, in this dystopian editorial (neologistically hybridized earlier as an “edystorial”[8]), penned as an opening statement of this special issue of World Social Psychiatry published to commemorate the 60th anniversary of its parent association, instead of creating an echo chamber of self-laudatory mutual back patting, we intend to give ourselves a reality check. Or, better, a reality shake, challenging ourselves to face the reality and, hopefully, to change it for the better. In doing so, we draw upon images and analogies from what is happening around us, and how they are impacting (or not impacting) us. After all, social psychiatry, like all socially oriented disciplines, cannot be blind to the harsh realities within us and surrounding us in today’s world. PUTTING OURSELVES IN CONTEXT Our official journey started in 1964; actually, the International Journal of Social Psychiatry started even another decade earlier, in 1954. We have changed names: from the initial International Congress of Social Psychiatry in 1964 under the dynamic leadership of its founder, Joshua Bierer, to a short stint as the International Association of Social Psychiatry, till our formal and final title as the World Association of Social Psychiatry (WASP) in 1974 at its 6th Congress.[9] Throughout this meandering journey till date, however, we have stood by our visionary principles. We are social psychiatry. This is our land. We have no other land. We have recently completed our 60th anniversary, and our Journal, which was launched in October 2019 at the 23rd World Congress of Social Psychiatry in Bucharest, Romania (as an interesting serendipitous coincidence, Joshua Bierer, the founder of WASP, himself came from Romania!), also completed its 6th year of regular publication [Figure 1]. The very first editorial talked about “mens sana in societate sana” – healthy mind in a healthy society.[10] In a series of editorials following this, the editors highlighted several aspects of the interaction between the mind and the society (a shorthand for the entire exposome with people, places, patterns, and perspectives) and their reflection in health and illness. For example, in the very second editorial, we highlighted the role of social psychiatry in a disturbed world: “We live in an increasingly difficult time, marked by growing intolerance, anger, frustration, addictions, aggression, hateful extremism, violence, terrorism, climate change and other environmental threats, migration, globalization, different ways of usandthem, stigmatization, social and economic inequities, marginalization, isolation, alienation, exclusion.the list is long and winding. And all these feed into our psyche, tormenting, disturbing, and violating the equilibrium, with mental health consequences.”[11]Figure 1: Release of the inaugural issue of World Social Psychiatry at the 23rd World Congress on Social Psychiatry, Bucharest, Romania, October 25–28, 2019. Standing (from left): Senator Gabriel Emanuel Botnariu, Prof. Rachid Bennegadi, Prof. Roy Abraham Kallivayalil, Prof. Norman Sartorius, and Prof. Debasish BasuWith the passing years, it was becoming progressively clearer to us that social psychiatry needs to be awake, alert, and responsive to the composite milieu which can influence mental health. Please note that the word “milieu” can be deceptively simple: it can hide under its cloak a diverse multitude of micro-, meso-, and macro-level factors, including factors as diverse as tribalism, pandemics, and wars. And we reflected these in our editorials. Thus, an editorial spoke of the emerging “pandemic” of loneliness, the word pandemic used in a symbolic sense.[12] But the real pandemic, which shook the world – the COVID-19 pandemic of 2020 and 2021 – left its indelible impression on social psychiatry; this was reflected upon, drawing a parallel with “The Plague” by Albert Camus.[13] Coming to wars and man-made conflicts, an editorial talked of the phenomenon of xenophobic intolerance in the context of the Russian invasion of Ukraine, which was strongly condemned and framed in the broader perspective of “social autoimmune disorders.”[14] This conflict, started unilaterally by Russia in February 2022, has been continuing since then despite resistance and some retaliation by Ukraine, with tremendous and tragic loss mounting on both sides, including an expected fallout on mental health. Indeed, the WASP issued a timely “Position Statement on War in Ukraine,” wherein it condemned the invasion of Ukraine, expressed its concern at the adverse mental health effects of the war, and extended its “full psychosocial support to all the persons and families who have faced losses in form of deaths, serious injuries, homelessness and unemployment, and the vulnerable population like children and women and the persons with pre-existing mental illness.”[15] Most importantly, the Position Statement began with the generic, all-time, and all-occasion statement: “Wars are a curse on civilized society, and don’t benefit anyone, winning or the losing country. All wars are associated with loss of life, establishments, misery, and mental health consequences both in short term as well long term.”[15] This statement assumes a prophetic importance in the context of the ongoing conflict between the Israeli and the Palestinian populations living in the occupied Palestinian territories, with a long chequered history but recently sharply accentuated by the horrific massacre and abduction of Israeli people by the terrorist group Hamas on October 7, 2023, which was then almost immediately reacted to by Israel, in an ongoing and escalating act of “collective punishment” resulting in killing of Palestinians residing in Gaza at least 50 times (yes, 50 times; most probably more) the number of Israelis killed, and including a huge number of children and noncombatant civilians. More than killing, though, the total destruction and suffering imposed on these people is unimaginable and multidimensional, leading to the impending erasure not only of a population but also of history, geography, economy, science, arts, religion, education, institutions, livelihood, healthcare, human dignity, and the culture of an entire population. The latest ongoing tragedy – unfolding in front of the world – involves an imposed man-made starvation engineered by severely restricting humanitarian aid, creating difficulty in accessing the aid, with around 800 persons or more having been killed while trying to access the aid. More than 100 children have died of starvation, and hunger and malnourishment are everywhere. And all these are preventable and actionable. The situation has been characterized as “plausible genocide,” “war crime,” and “crime against humanity” by international institutions including the United Nations and many of its organs, International Court of Justice, International Criminal Court, Amnesty International, Human Rights Watch, Israel-based human rights associations, and even by many Holocaust/genocide scholars and even holocaust survivors and successors of Holocaust victims. There are hundreds of documents, interviews, eyewitness accounts, and testimonies by doctors and other healthcare professionals with recent working experience in Gaza, and thousands of visual evidences which are, to say the least, heart-wrenching. As Nick Maynard, who is a consultant surgeon at Oxford university hospital in the U.K., who has been travelling regularly to Gaza for 15 years and is a volunteer with Medical Aid for Palestinians at Nasser hospital in Gaza, titled his recent write-up in The Guardian (July 22, 2025): “we’re witnessing the deliberate starvation of Gaza’s children – why is the world letting it happen?” At the end of this most poignant description of what he saw, experienced, and inferred, he hits the bull’s eye: “we want to be clear – what is being done to Palestinians in Gaza is barbaric and entirely preventable. We cannot believe we have come to a point where the world is watching as the people of Gaza are forced to endure starvation and gunfire, all while food and medical aid sits across the border just miles away from them….” and the unforgettable closing sentence: “History will judge not just those who committed these crimes, but those who stood by and watched…. From inside Nasser hospital, we are telling you: this is deliberate. This is preventable. And this must stop now.”[16] Social psychiatry cannot be, and must not be, oblivious of such geopolitical events and their effects on the mental health of those who are experiencing, co-experiencing, or witnessing – or even perpetrating – such mass-scale and man-made human suffering – a domain that has been named as “geo-psychiatry.”[17] Our next editorial was on this, which was published in December 2023.[18] Of course, things have worsened far, far now, and the human suffering forced upon thousands of innocent civilians, including women and small children, is unmeasurable, unimaginable, and unconscionable. Our latest editorial focused on the power determinants of mental health, including political and other power equations, especially in the context of an authoritarian regime, for which we imagined a dystopic sequel to the Orwellian classic 1984.[8] We are social psychiatry. This is our land. We have no other land. But…. WHERE IS OUR LAND? This longish account notwithstanding, we, social psychiatry, have taken a beating. This can be evidenced by at least four parallel but interconnected strands of happenings, which can only be enumerated here – it will take another full-length article to deliberate and expand upon these. First, as mentioned in the article by Alibudbud,[3] interest in social psychiatry, as assessed by the proxy measure of Google Search trend analysis, has witnessed a marked decline, from 2004 to 2021. Second, funding in social psychiatry (both research and service components) is much less compared to biological psychiatry globally, and the downward trend has been steadily continuing. Third, institutions, research bodies, and academic departments dedicated to social psychiatry have decreased, shut down, or repurposed globally, with only a few exceptions in the UK and a few European countries. Fourth, even among the subdivisions of psychiatry, social psychiatry is often a Cinderella. We, social psychiatry, have been gradually, slowly but surely losing our land to biological psychiatry, more correctly, to the aggressive juggernaut of biological reductionism. More worryingly though, other forces have been complicit in this aggression, particularly the “big pharma” and other “big bio” institutions, such as for-profit gene-profiling and biomarker-testing agencies, with their multimillion-dollar industries but with dubious claims. The world is more and more being led to believe that there is a drug for all maladies of mankind, from addiction to alienation, from insomnia to injustice, from paranoia to poverty, from depression to discrimination, and from gender dysphoria to genocide. Even when there is talk of the biopsychosocial model, it can quickly descend into optics and lip service.[19] Focus on biological determinants can potentially gag the focus on socioecological determinants of health and illness. Sadly, even such primarily psychosocial concepts as loneliness and resilience, just to take two examples, can become “biologized,” thus reducing them to biological-based “traits” that are largely immutable properties or characteristics residing within an individual. Thus, for example, there are claims of putative “genes” and other molecular biomarkers for resilience that make an individual more or less resilient (or the “resilient phenotype”).[20] Other than the conceptual and methodological quagmire of such kinds of studies, already there are profit-making advertising efforts to “define a profile of your genetic capacity for resilience, identifying the gene variants supporting areas of strength and the gene variants presenting potential hurdles” by a package of tests called “DNALife Resilience.”[21] Similarly, a recent study identified plasma proteomic signatures of social isolation and loneliness.[22] Again, irrespective of the conceptual and methodological issues involved, it is concerning to see that already the findings are being reported as having found the “loneliness proteins,”[23] hinting that, in future, tampering with these proteins by biological means will make you less lonely. Topics such as loneliness and social disconnection are now attracting top slots in hardcore biological psychiatry journals.[24] This can be hailed as biopsychosocial integration or partnership, but without an equal partnership and with an implicit biomedical hegemony (“all psychosocial phenomena are eventually explicable by biological mechanisms”) becomes biomedical reductionism. More than that, it is an example of biomedical colonialism and annexationism. And this is happening with the active support of the big pharma and other vested interests, who are providing the arms and ammunition to carry out the colonial annexationist agenda. There are many ways in which we, social psychiatry, are losing our land, our people, our rich tradition and culture, and are made essentially unliveable by the biomedical reductionist forces and their overt or covert enablers. Four major ways this ongoing obliteration of social psychiatry are briefly touched upon in the following paragraphs, using metaphors from what is going on around us. We, social psychiatry, have been brutalized; we have suffered from the weaponization of nonweapon entities; we have witnessed the normalization of our suffering; and finally, our suffering and slow demise have been denied, silenced, and have been invisibilized. BRUTALIZATION We have been caged, flogged, maimed, abused, tortured, starved, deprived, violated, gagged, chased like cattle, displaced repeatedly and mercilessly from our land, forced to live in and to of and without made to and forced to for food and of life, of our and then from accessing medical under the killed and killed slowly while being of all human dignity, like We have been We have been around us with to what is happening to us. We are social psychiatry. We have no other land. It is our land. That is why we suffer for has been against us as to us. and leading even to and starvation, including and including and even humanitarian aid have been Our has been at by such we, social psychiatry, have to then we have to such of to a phenomenon that when people or become to a from the and no it We now live in a world. is is is is – at the we or or even and, at the support and finally, even is denied, or or or at the other All of the of normalization of We have We have all kinds of to going normalization of – and what are the for the destruction of and other medical and land, places, of including of is the for the killing of repeatedly and displaced persons living in is the for killing by you the killing of of the the agencies, the food the and the medical people And the list goes all Indeed, we are becoming more in the normalization of We are now to and even genocide. Indeed, normalization of We are becoming used to our ourselves into that this not to us. We at imposed starvation and real and on our We at children or being killed in many different We at vulnerable people being We at people being while for some aid for – – We as people are to the – to by starvation or to be killed by a while trying to from We We We the We, social psychiatry, have – or been – to in the to our The final on us is by making us found himself into a huge and series of events and but eventually he was shut in a his and essentially away from the of the world. was invisibilized. The has with us. We are being made progressively We are social psychiatry. We have no other land. It is our land. That is why we suffer for And we are for and far, this has made you and even or then it has at least the initial this of the 60th anniversary of WASP, us come out of the us come out of That is the of this dystopian The we become other forces will to the social of psychiatry and the other we to be in this in to being mental health or at least come when psychiatry will to its social and will become only psychiatry, which will be when there will be no for or even that time, however, we will still to on to social psychiatry it is of its We to be about the famous we to carry social psychiatry a in our in a of ourselves to be entirely to and in crimes, and against we still want to some from under the a by the who was a Palestinian and and almost this just a few he was killed with his in we must you must live to to things to a of and some it with a long that a in Gaza while in the his who left in a and no not even to his not even to the you and for a an is there back we must it it be a finally, we us back years, to a Holocaust us of the reality of his in and to the on our and to our who live In your who come food and the of this is a in the no for of a or this is a and strength to and a like a in the the that this has we them on your and going your and them to your your you And they their away from us not be in us the to to our next can be We are social psychiatry. This is our land. We have no other land. That is why we are to suffer for this special issue of the Journal – not only for our despite persistent efforts by aggressive forces and their with on their to us by marginalization, and but also to make us to suffer for our we and strongly believe in That be in with the of the World Congress of Social Psychiatry as for the making social psychiatry This is a of all the places, and in this are the of the or used in a or symbolic to living or or events is this editorial the of the and not of the Journal or the