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Isaac Baldwin @ibaldwin.bsky.social · 12/08/2026

As this is just the start of trying to work through this ethical challenge, we welcome questions and comments. If you aren’t able to access the article, let me know in the comments and I can send it your way!

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Isaac Baldwin @ibaldwin.bsky.social · 12/08/2026

Excited to share our new article in the @annalsofim.bsky.social, a first step at answering a big question: “What do we do when the established supporter for a patient with an IDD disregards the patient’s perspective in a medical decision?”

r.mail.acpresources.org

Securing Patient-Centered Decision Making With Adults With Intellectual and Developmental Disabilities | Annals of Internal Medicine

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Isaac Baldwin @ibaldwin.bsky.social · 12/08/2026

As this is just the start of trying to work through this ethical challenge, we welcome questions and comments. If you aren’t able to access the article, let me know in the replies and I can send it your way!

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Isaac Baldwin @ibaldwin.bsky.social · 12/08/2026

Here we illustrate cases, provide ethical groundwork, and walk through practical steps clinicians can take.

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Isaac Baldwin @ibaldwin.bsky.social · 09/05/2026

A heartbreaking yet touching story of a woman who lives in her car in Denver. One of the best pieces of journalism I've read in years that asks the question-- "and who is my neighbor?"

denverite.com

She has lived in her car for a decade. Denver neighbors wanted her gone

In a city trying to end homelessness, Suzanne Elaine McKinney has refused everybody’s efforts to bring her inside.

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Isaac Baldwin @ibaldwin.bsky.social · 03/05/2026

Important work here! Psychiatrists in training know philosophical and conceptual issues affect their work but less than a third feel their training has been adequate in these areas.

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Isaac Baldwin @ibaldwin.bsky.social · 24/04/2026

Some needed focus on school tech- Overuse of tech might be limiting the social, emotional, and executive function development we didn’t even realize our schools were supporting in the past. Will be interesting to see if moves like this one (back home in central Kansas!) will catch on.

nytimes.com

Chromebook Remorse: Tech Backlash at Schools Extends Beyond Phones

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Isaac Baldwin @ibaldwin.bsky.social · 11/04/2026

Great piece. Child psychiatry could greatly benefit from a home hospitalization model. The path out of a pediatric mental health crisis involves the whole family. Also, neurodevelopmentally disabled patients often can’t access hospitals and the environments are not designed with their needs in mind

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Isaac Baldwin @ibaldwin.bsky.social · 13/03/2026

This is especially relevant in child psychiatry, where the best way to center the patient’s wellbeing may be even murkier given their constrained autonomy. I agree with @awaisaftab.bsky.social ‘s recommendation- careful formulation, and most importantly, honesty. (2/2)

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Isaac Baldwin @ibaldwin.bsky.social · 13/03/2026

A fantastic piece that names one of the core sources of professional distress for the psychiatrist: the person-environment mismatch and the desire to help in situations where fundamental solutions are impossible but mental health interventions may still have utility (1/2)

open.substack.com

What Do We Owe the Overburdened?

Doing justice to trait-demand mismatches

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Isaac Baldwin @ibaldwin.bsky.social · 29/12/2025

I had not heard that Lisa passed. I’m deeply saddened by her loss. Her voice changed how I approach my work. Thanks for sharing these words, Awais.

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Isaac Baldwin @ibaldwin.bsky.social · 09/11/2025

Though I think I’m a little late to the party, I had to share this book. Some of the best writing I’ve read in years. Come for the analysis of AI agency, stay for what it reveals about human consciousness and spirituality.

goodreads.com

God, Human, Animal, Machine: Technology, Metaphor, and …

A meditation on what it might mean to be human in an ag…

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Isaac Baldwin @ibaldwin.bsky.social · 31/10/2025

I always recommend social time with friends and especially extracurricular activities that involve peers. As a policy intervention, investing in after school programs could be game-changing for the unprecedented issues faced by our modern youth.

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Isaac Baldwin @ibaldwin.bsky.social · 31/10/2025

While screen time has understandably come under concern in recent years, I think it is the things kids are *not doing* when they’re in front of the screens that makes the biggest difference. Opportunity for social play is not only good for kids, it is required, just like learning.

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Isaac Baldwin @ibaldwin.bsky.social · 31/10/2025

In my practice, I ask: - How often do you spend time with friends in-person outside of school? - What activities do you do with other people that are just for fun? I am often shocked by how little time kids are spending with this vital part of healthy development.

www-cnbc-com.cdn.ampproject.org

'Kids are increasingly lonely,' child psychiatrist says: Here's how parents can help

In a recent study, Common Sense Media discovered that 26% of adolescent boys are lonely. The reasons vary.

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Isaac Baldwin @ibaldwin.bsky.social · 22/10/2025

The series has been excellent. The concepts have been a helpful supplement to my training and should really be core to all psychiatry education.

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Isaac Baldwin @ibaldwin.bsky.social · 20/10/2025

Here at AACAP 2025. Excited to present with some incredible colleagues on the evidence we’re building in the treatment of pediatric catatonia in ASD.

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Isaac Baldwin @ibaldwin.bsky.social · 16/10/2025

Thought-provoking as always. My main question mirrors the post-script. Is there anything we can do with nosology or language in ASD that would *guarantee* benefit for autistic people and maintain an honest recognition of the complex truths scientists know (and don’t) about the autism spectrum?

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Isaac Baldwin @ibaldwin.bsky.social · 30/09/2025

“Boredom proneness overlaps with inattention and impulsivity but does not capture hyperactivity, working memory deficits, or problems with planning and organization.” Excellent article. An example of this distinction: the higher risk of car accidents is probably not due to boredom proneness alone.

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Isaac Baldwin @ibaldwin.bsky.social · 18/09/2025

An interesting look at integrating several emerging heuristic models in psychiatry. With some discussion of what it would really take to create a paradigm shift.

cambridge.org

New diagnosis in psychiatry: beyond heuristics | Psychological Medicine | Cambridge Core

New diagnosis in psychiatry: beyond heuristics - Volume 55

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Awais Aftab @awaisaftab.bsky.social · 31/08/2025

The RFK Jr + MAHA alliance may very well ensure that the psychiatric harm movement is eventually remembered not for saving lives from medical overreach, but for wrecking public health in America. The irony of this outcome will not be lost on observers and future commentators.

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Isaac Baldwin @ibaldwin.bsky.social · 29/08/2025

Recent articles about the use of AI in psychotherapy make me feel the way an older generation of psychiatrists must have felt watching the interpersonal aspects of their practice being discarded with applause from the business world and media.

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Isaac Baldwin @ibaldwin.bsky.social · 05/08/2025

This post made me think of the many times I’ve heard a patient describe their past treatment with misleading metaphorical language, oftentimes inherited from a physician. It’s humbling to remember that our metaphors are carried outside our offices and may shape self understanding for a lifetime.

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Eric Michael Garcia @ericmgarcia.bsky.social · 16/05/2025

Robert F. Kennedy calls autism an epidemic and treats it like a crisis. But the Trump administration has cut autism-related research by 26 percent since he took office. www.reuters.com/business/hea...

reuters.com

Exclusive: Trump administration cut autism-related research by 26% so far in 2025

Health Secretary Robert F. Kennedy Jr has vowed to address rising U.S. autism rates as a top health priority for the Trump administration .

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Isaac Baldwin @ibaldwin.bsky.social · 15/05/2025

Thanks to @autismsciencefd.bsky.social for giving me some time to talk about how catatonia is diagnosed in autism. Some really excellent questions at the end. Enjoyed being with you all!

youtu.be

May 14, 2025: Diagnosis of Catatonia

YouTube video by Catatonia and Severe and Challenging Behaviors SIG

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Isaac Baldwin @ibaldwin.bsky.social · 03/05/2025

The MAHA vision is of a type of utopia, where those able to utilize lifestyle practices such as organic food to improve health can live a full life. For disabled people and those lives improved by psychiatric medications & public assistance, however… it’s not clear there is a plan for them.

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Isaac Baldwin @ibaldwin.bsky.social · 03/05/2025

4. And what are those motives? Based upon everything we’ve seen so far, it appears to be the promotion of libertarian ideology that sees suffering and disability as individual responsibilities. To replace medical care and social support with “beneficial lifestyle changes” Piece by Jesse Meadows

open.substack.com

Unshrunk and MAHA: A Diagnosis-Critical Case Study

a tangent inspired by my new video :)

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Isaac Baldwin @ibaldwin.bsky.social · 03/05/2025

3. We are now seeing what appear to be efforts by the government to address longstanding issues (insufficient evidence and awareness regarding the risks of medications). Still, it is clear there are ulterior motives. Piece by @awaisaftab.bsky.social

nytimes.com

Opinion | What Kennedy Gets Right, And Wrong, About Antidepressants

Prozac is nearly 40 years old. Why are there still unanswered questions?

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Isaac Baldwin @ibaldwin.bsky.social · 03/05/2025

2. Public trust has eroded in medical professions (including and maybe especially psychiatry) for both legitimate reasons (poor communication about certainty, risks, and harms) and because of leaders using rhetoric meant to undermine that trust. Piece by @awaisaftab.bsky.social

open.substack.com

American Psychiatry in the Shadow of MAHA and MAGA

Reflections on medicine, politics, and public trust

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Isaac Baldwin @ibaldwin.bsky.social · 03/05/2025

1. There’s a myth that we used to be healthier in the past, and that we can get back there by shunning the medical establishment. It’s a myth that’s existed for a long time and has more to do with an idea of moral purity than it does with health. Piece by @drrobertchapman.bsky.social

open.substack.com

Neurodiversity and the Myth of Moral Decline

How to spot reactionary critiques of medicalisation

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Isaac Baldwin @ibaldwin.bsky.social · 03/05/2025

I’ve been searching for “the point” behind the MAHA movement and RFK’s policies. All the doctors I know feel like it’s headed for disaster. So why does it have so much steam? Some recent pieces have made it clearer to me: (1/6)

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Isaac Baldwin @ibaldwin.bsky.social · 03/05/2025

If psychiatrists want an effective collective response to the administration’s approach to psychiatric medications, it’s going to take clear-eyed communication like this.

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Isaac Baldwin @ibaldwin.bsky.social · 20/04/2025

Many major autism advocacy organizations representing a huge variety of viewpoints (sometimes starkly opposing one another) released this joint statement. Their points: 1. Vaccines do not cause autism 2. Autistic individuals deserve respect and support 3. Evidence-based policy is essential

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Isaac Baldwin @ibaldwin.bsky.social · 18/04/2025

This is the language of eugenics. Autistic lives are inherently valuable.

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Isaac Baldwin @ibaldwin.bsky.social · 02/04/2025

An important perspective. Thanks for sharing.

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Julia Métraux @juliametraux.bsky.social · 28/03/2025

The Administration for Community Living, housed in HHS, is shutting down. I spoke to disability experts for @motherjones.com about questions they have for what’s next, the services ACL provides, and how this move may lead to more folks being institutionalized. www.motherjones.com/politics/202...

motherjones.com

RFK Jr. moves to close Administration for Community Living

The shutdown will mean "more people forced into institutional settings."

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Robert Chapman @drrobertchapman.bsky.social · 25/03/2025

One way the mainstream "over" (or "under") diagnosis discourse is misleading is the assumption there is some natural, correct number of neurodivergent people. But there is no natural number, as disability is relationally, materially, and socially produced.

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Isaac Baldwin @ibaldwin.bsky.social · 22/03/2025

“The psychiatrist, scrolling through the criticism on their phone, can sigh, close the app, and move on with their evening, while the harmed patient sits, eyes wet, waiting for a response, feeling alone and terrified by the world’s indifference to their suffering.”

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Isaac Baldwin @ibaldwin.bsky.social · 04/03/2025

RFK and friends would have us believe medicine (especially psychiatry) is ruining our country. He would like to return to a golden age before all this. As this article brilliantly illuminates, there is no such time. Reactionary voices have been blaming medicine for “moral decline” for centuries.

open.substack.com

Neurodiversity and the Myth of Moral Decline

How to spot reactionary critiques of medicalisation

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Isaac Baldwin @ibaldwin.bsky.social · 25/02/2025

What a piece. This manages to both review a book and paint a picture of the type of psychiatry I think is worth practicing— one that asks deep questions about agency and iatrogenic harm while remaining committed to understanding that patients’ positive experiences with medications are not illusory.

practicing.one

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Isaac Baldwin @ibaldwin.bsky.social · 28/12/2024

Thanks for sharing! We definitely need more research on cognitive outcomes in ECT

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Aishwarya Rajagopalan, D.O., MHS @aishwaryakraj.medsky.social · 23/12/2024

🧵 It’s certainly not typical to find an article about anti NMDA receptor encephalitis or #catatonia in People magazine, but I was pleasantly surprised to find this important read raising awareness of both topics. people.com/man-29-ends-...

people.com

29-Year-Old in ‘Catatonic State’ After Rare Disorder Causes Debilitating Night Terrors

Ben Tarver, 29, suffered debilitating night terrors, which were the first symptoms of Anti-NMDA Receptor Encephalitis, a rare autoimmune disorder that landed him in the ICU.

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Isaac Baldwin @ibaldwin.bsky.social · 23/12/2024

Thank you for tagging! I had not come across this. We desperately need more public awareness of this condition.

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Brian Goldstone @brian-goldstone.bsky.social · 15/12/2024

"More people died from homelessness than homicide in Nashville this year.” A friend shared this photo from yesterday's memorial at Riverfront Park.

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Lisa Wallace @rwillowfish.bsky.social · 09/12/2024

"When I identify my suffering as illness-like, I wish to lay claim to a caring interpersonal relationship, instead of one which negates my experience and my deliberations on my experience by telling me that I have misunderstood the nature of my suffering." @zsuzsannachappell.bsky.social's paper/

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Isaac Baldwin @ibaldwin.bsky.social · 07/12/2024

An incredible, devastating piece of journalism. How could anyone rebuild trust in health care after a family or community experiences something like this?

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