Free Speech in Psychiatry is Essential, to Meet Bias, Distress, and Upheaval, and to Promote Nonviolence, Justice, and Belonging

Free speech is a fundamental right in American democracy, laid out in the First Amendment of the U.S. Constitution. It is essential in protecting and promoting democracy, examining bias and power, and thus helping to produce better mental health and social well-being. Freedom of speech is essential to psychiatric care, as well as communication, understanding, and growth in organizational psychiatry. Channels of free speech range from in-person communication to various forms of telecommunication, including social media and email listservs, each posing their unique challenges to cognitive, intellectual, emotional, and relational capacity. There have been significant challenges to communication on distressing subjects, with some fearing disagreement could tear organizations apart. Others have felt silenced and marginalized when attempting to raise awareness of issues such as the humanitarian effects of the post-10/7 war in Gaza. However, some recipients of these communications have reported feeling less informed than “assaulted.” By highlighting the pro-social possibilities of free speech, individuals and organizations can move through fears and distress, as well as professional biases towards silence, avoidance, neutrality, and “abstinence,” which all work to serve a status quo of unresolved conflict and disconnection. Relational cultural theory has it that suffering is a crisis in connection, and the opposite of suffering is belonging. Free speech can thus be a tool to decrease disconnection and suffering by promoting belonging through cultural and organizational growth.