An Interview with IACAPAP International Contribution Award 2024 Winners

1. Reflecting on Your Journey: Can you share some of the key highlights of your career in child and adolescent mental health, including any defining moments or experiences that shaped your path?

A key highlight was my experience in the Boston Change Process Study Group, where I studied infant research and learned about the critical importance of the first 1000 days of life and how infant-caregiver relationship forms the foundation of the future success of the older child and adult that the infant will become.  I became proficient in analyzing videotape and began to bring this new knowledge and skill to orphanages in El Salvador and then student nurses in North India.

Another highlight was introducing the Newborn Behavioral Observation, a tool designed to support the infant-caregiver relationship, to my colleagues in Pakistan. During the pandemic my Pakistani colleague onsite administered the NBO, with me coaching her remotely, to mothers and infants from the villages. The trial was a great success and formed the basis for teaching an adapted infant parent mental health curriculum (“Building Baby Brains”) to Lady Health Workers in rural Pakistan. I continue to meet with these remarkable women in monthly mentorship groups.

The last highlight I will mention is my return to El Salvador to collaborate with a local institution to create a residential program for young pregnant teens in which we care for them and their infants during the pregnancy, delivery, and the neonatal period. What I am continuing to learn about resiliency from these young girls and their infants is challenging my psychoanalytic and developmental science theories and challenging me to open my mind to alternative theories that enrich my work as a clinician and a teacher.

2. Advice for Early Career Professionals: What advice would you give to early-career mental health professionals who are looking to make meaningful contributions to the field?

I would advise early-career mental health professional to include experiences treating children and families from low-resource, high-risk communities, especially families from cultures other than your own, in your clinical practice. I would also encourage young professionals to learn some basic tools of research--quantitative or qualitative--to demonstrate the effectiveness of your therapeutic work.

3. The Role of Mentorship: How has mentorship played a role in your professional growth, and what qualities do you think make a great mentor?

Mentors have always played a big role in my life, from my undergraduate years, through medical school and psychiatric and psychoanalytic training. In turn, I value mentoring young people. In fact, mentorship is one of the important missions of my nonprofit, Supporting Child Caregivers.

4. Impact of IACAPAP: How has IACAPAP influenced your career?

I have enjoyed IACAPAP conferences, but most of all, I appreciated the honor of receiving the International Contributions award.

5. Future Directions: Looking ahead, what do you believe are the most pressing challenges or exciting opportunities in child and adolescent mental health globally?

I think the most pressing challenges are 1) studying and facilitating the implementation of preventive infant and child mental health practices; 2) combatting gender bias in traditional cultures; and 3) funding initiatives in global child mental health.

1. Reflecting on Your Journey: Can you share some of the key highlights of your career in child and adolescent mental health, including any defining moments or experiences that shaped your path?

My career in child and adolescent psychiatry has been both transformative and deeply fulfilling. My passion for mental health emerged early in my medical training when I realized the significant impact of mental well-being on individuals, families, and society. One of the most defining moments in my journey was recognizing, on the one hand, the huge population of children & adolescents in India (more than 40%) and the highest in the world, along with tremendous diversity. On the other hand, the critical gaps in India’s child and adolescent mental health services, a realization that motivated me to advocate for policy reforms, raise awareness, and improve mental healthcare accessibility.

In the early days of my career, India had very few trained child and adolescent psychiatrists, and services for this age group were largely fragmented and inadequate. A major barrier to progress was the deep-rooted stigma surrounding mental health, which discouraged individuals and families from seeking help. During my residency at NIMHANS, Bengaluru, the country’s premier institute, I received specialized training in child and adolescent psychiatry, and I recognized that child & adolescent mental health requires a unique skill set and individualized care approaches. The need for multidisciplinary interventions and community engagement became evident as I worked with children facing developmental and psychological challenges. 

As a faculty member at AIIMS Delhi, another premier institute, I have trained future psychiatrists and collaborated with the government to shape child and adolescent mental health policies. Witnessing the effects of neurodevelopmental disorders and childhood trauma, I became committed to addressing root causes rather than just symptoms. I played a crucial role in establishing inpatient psychiatric services for children at AIIMS and contributed significantly to India’s National Mental Health Program. My contributions laid the groundwork for a structured approach to child and adolescent psychiatry in India, helping to bridge the gap between policy and practice. 

Over the years, I have worked extensively on national and international projects, contributing to research, policy-making, and capacity-building efforts. My leadership has had a direct impact on mental health strategies in India. My work underscores the importance of a global perspective in addressing mental health challenges, as cross-border collaboration and knowledge exchange have proven vital in shaping best practices. My IACAPAP International Contribution Award is not only a personal honour but also represents the progress of India’s child and adolescent mental health sector on the global stage. 

2. Advice for Early Career Professionals: What advice would you give to early-career mental health professionals who are looking to make meaningful contributions to the field?

I offer three fundamental lessons for those entering the field of psychiatry. The actual impact is achieved through interdisciplinary teamwork involving educators, policymakers, and community leaders. Holistic mental health solutions require engagement across healthcare, education, and social services. Mental health advocacy often encounters resistance and slow policy change, but meaningful progress requires patience and long-term commitment. Professionals must push forward despite obstacles to ensure mental health remains a national and global priority. Psychiatry is an ever-evolving field requiring professionals to stay updated with emerging research, treatment modalities, and best practices. Clinical practice, research, and policy advocacy must all be informed by the latest scientific knowledge. My approach has reinforced the significance of evidence-based strategies in advancing mental health care.

Many young professionals worry about limited resources or lack of opportunities. I advise them to focus on leveraging existing resources innovatively. I encourage connecting with like-minded individuals to build strong professional networks that foster growth and change.

3. The Role of Mentorship: How has mentorship played a role in your professional growth, and what qualities do you think make a great mentor?

I acknowledge that mentorship has played a critical role in shaping my career. I believe great mentors are essential for the next generation of child psychiatrists. I also emphasizes the need for young professionals to embrace a learning mindset, recognizing that mental health care requires continuous adaptation to societal changes. 

Beyond providing academic and professional guidance, a good mentor inspires curiosity, encourages independent thinking, and offers emotional support. Mentorship is a two-way learning process—while mentors offer experience and wisdom, mentees provide fresh insights. I believe in setting an example for mentees by tackling challenging tasks myself, demonstrating resilience and dedication. This approach helps young professionals gain confidence to take on complex mental health issues. Exposure to diverse perspectives and fields has helped me understand mental health from policy, research, and clinical angles. I emphasize critical thinking, research involvement, and a supportive environment for innovation as vital elements of mentorship. This philosophy has contributed to the development of a new generation of psychiatrists who are equipped to address emerging mental health concerns with a forward-thinking approach. 

4. Impact of IACAPAP: How has IACAPAP influenced your career?

IACAPAP has provided a global platform for knowledge exchange, international collaborations, and policy advocacy. The organization has been instrumental in advancing child and adolescent mental health in low- and middle-income countries. IACAPAP’s role in crisis interventions, such as conflict zones and humanitarian crises, has been particularly impactful. The organization has developed free training resources for child and adolescent psychiatry trainees. Through this association, I have been able to highlight India’s unique mental health needs, advocate for culturally appropriate interventions, and learn from global best practices that can be adapted to the Indian context. Presenting symposiums at IACAPAP congresses and engaging with experts worldwide have broadened my perspective on effective mental health interventions for Indian communities both within the country and in the global diaspora.

I see organizations like IACAPAP as catalysts for meaningful change, ensuring that child and adolescent mental health remains a priority on the international agenda.

5. Future Directions: Looking ahead, what do you believe are the most pressing challenges or exciting opportunities in child and adolescent mental health globally?

Emerging challenges in child and adolescent mental health include increasing mental health disorders in youth, including anxiety, depression, and self-harm. The impact of digital technology on young minds, both as a risk factor and a potential intervention tool, must be addressed. A lack of integration of child and adolescent mental health services into primary healthcare and education systems remains a critical issue. Expanding technology-driven interventions can enhance access to mental healthcare services. AI and telepsychiatry can help reach underserved populations. Strengthening grassroots programs for early intervention and awareness is essential. Training teachers, parents, and healthcare workers can create support networks for children. My insights highlight the urgent need for comprehensive, technology-driven, and community-based mental health initiatives to tackle the evolving challenges faced by today’s youth.

Sharing best practices internationally can help improve treatment strategies and policy frameworks. Partnerships between governments, academic institutions, and organizations like IACAPAP can drive progress. I envision a holistic, preventive, and culturally sensitive approach to child and adolescent mental health. My work aims to reduce stigma, expand access, and ensure quality mental health care for all children. My vision aligns with IACAPAP’s mission of resilience and well-being for children worldwide. I remain a vocal advocate for sustained investment in mental health, calling for increased research, better funding, and greater collaboration across sectors to ensure lasting progress.

1. Reflecting on Your Journey: Can you share some of the key highlights of your career in child and adolescent mental health, including any defining moments or experiences that shaped your path?

The experiences that most marked me in my training and throughout my career were those at the two pediatric hospitals in Buenos Aires (R. Gutiérrez and J.P. Garrahan). In those settings, I had the opportunity to work with patients with severe psychiatric and organic pathology.

Very early on, I had to coordinate the psychiatric inpatient unit. Due to administrative issues, we faced the challenge of not having a dedicated ward for our patients’ hospitalization. This led my team and me to develop a new model of hospitalization: psychiatric hospitalization in a general ward. The contact and care of the patients and their families had to be much closer, which resulted in more intense experiences and significant learning. I discovered that obstacles could serve as an incentive for growth and creativity.

I must also mention the profound influence of my experience at the Western Psychiatric Institute and Clinic (University of Pittsburgh) under the guidance of my dear teacher and friend, Boris Birmaher, on my subsequent professional development.

2. Advice for Early Career Professionals: What advice would you give to early-career mental health professionals who are looking to make meaningful contributions to the field?

I believe that the foundation of knowledge in our discipline is clinical work. Engaging deeply with our patients, prioritizing their needs, and helping them overcome obstacles that hinder their development of a full life should be our primary focus. This transcends any theoretical framework or technical knowledge we acquire. Our commitment must be to our patients, not just to the knowledge we have gained. From this, we will be able to further develop and acquire new insights. This initial foundation of intense clinical experience will serve as a compass, guiding us toward the crucial areas we need to explore more deeply.

In an era of rapid changes—whether under the “shadow” or “light” of AI—I believe that the human experience of clinical work remains irreplaceable, at least within the foreseeable future.

3. The Role of Mentorship: How has mentorship played a role in your professional growth, and what qualities do you think make a great mentor?

While deep and broad training in our discipline is essential for a mentor, I believe that their human qualities and interpersonal skills are just as fundamental. These attributes are not merely complementary but are vital tools for guiding young colleagues on their professional journey.

Our discipline revolves around human interaction, with all the complexities it entails. The emotional impact of these interactions requires skills that must be learned and cultivated. In this regard, the mentor’s role is just as crucial as their ability to guide treatments and provide scientific and bibliographic support.

I also believe—and this was my own experience—that sometimes, one may not have a single mentor figure. In such cases, the curiosity and creativity of the aspiring psychiatrist, along with a continuous search for knowledge, will enable them to engage with multiple experienced colleagues. These individuals, though not formal mentors, can still contribute significantly to professional development. The proactivity and creativity of the junior psychiatrist are invaluable tools. Sharing experiences and discussing cases with colleagues not only improves patient outcomes but also enhances learning.

4. Impact of IACAPAP: How has IACAPAP influenced your career?

Although I had known about IACAPAP for decades, my active engagement with the organization intensified while I was deeply involved in our national association, AAPI. As President of our institution, I came to appreciate IACAPAP’s support whenever it was needed—whether for our congresses or in response to the economic challenges our country has faced.

The scientific contributions through webinars are invaluable for the continuous education of our colleagues. We are committed to making these resources more dynamic to enhance accessibility for the majority of our members.

The global exchange fostered by IACAPAP’s activities reaches its peak during the congresses, which are of the highest academic standard.

At the most recent congress in 2024 in Rio de Janeiro, I had the privilege of receiving the International Contribution Award. Beyond the immense personal satisfaction at this stage of my career, this recognition affirmed the democratic and transparent values that I believe the Association should take pride in.

5. Future Directions: Looking ahead, what do you believe are the most pressing challenges or exciting opportunities in child and adolescent mental health globally?

In child and adolescent psychiatry, we are witnessing two opposing phenomena: a sharp increase in the demand for care for severe psychiatric conditions and a shortage of child psychiatrists. This presents both a challenge and an opportunity—to expand training and educate professionals with a broad understanding of the child and their family, considering social, cultural, and educational factors alongside advances in neurobiology, psychopharmacology, and genetics. Training in psychotherapy is also of great importance.

The development of preventive programs for both longstanding and emerging pathologies—many of which are exacerbated by technological advancements—will be essential (e.g., addictions, gaming disorders, etc.). Additionally, large-scale initiatives in collaboration with other professions and governmental support will be crucial to integrating marginalized children and adolescents into society.

Finally, another significant challenge will be the integration of new technologies, including AI, which will not only reshape various professions but also fundamental aspects of culture and human existence. Understanding and addressing these changes—already unfolding—will be an unavoidable task for our field.

This article represents the view of its author(s) and does not necessarily represent the view of the IACAPAP's bureau or executive committee.

IACAPAP Bulletin, Issue 77