Morgan Shields is one of the few health policy researchers who focuses on quality of care and issues of coercion within inpatient psychiatry. Her research exposes how current healthcare settings are influenced by power imbalances, profit structures, and organizational priorities that are fundamentally misaligned with the human needs of individual patients.
Dr. Shields completed her Ph.D. in Social Policy at Brandeis University and is currently an Assistant Professor at the Brown School of Social Work at Washington University in St. Louis, where she also directs her own research group. She has published over 25 peer-reviewed articles in outlets such as Health Affairs, Psychiatric Services, and the JAMA Network.
She has also completed several policy reports for entities such as the U.S. Health and Human Services Office, and has served as a legal expert in cases related to psychiatric patient discrimination. In doing so, her research has effected change at the state and federal levels, prompting internal investigations and structural reforms within agencies such as the Veterans Health Administration and the Massachusetts Department of Mental Health.
In this interview, Dr. Shields discusses her current work, which aims to identify strategies for implementing patient-centered and equitable treatment within existing mental health care structures—toward a wholesale re-imagining of inpatient psychiatry.
The transcript below has been edited for length and clarity. Listen to the audio of the interview here.
Julia Lejeune: You are one of the few health policy researchers out there who’s chosen to dedicate your career to studying inpatient psychiatry and the quality of care in that setting. I’m curious to hear a bit more about your journey to get there, your background, what has gotten you into this work, and what’s kept you committed to it.
Morgan Shields: Now, I’m at a point where I have a faculty position, and I was very open about my who I am in my job applications, which was very risky, and it worked out wonderfully. I mean, it just was so great. Now I kind of feel very empowered and free to be a bit more relaxed about explaining why I truly am interested in what I research.
I’ve always been interested in mental health care and inpatient psychiatric care for multiple reasons. I grew up with a father who was diagnosed with bipolar disorder, and he really did struggle. He was homeless for most of my childhood. We would see him, and he would sometimes be sleeping at different people’s homes or on couches or in his car. We had a close relationship with him, he was in our lives.
The hospital was always this place that my mom would fixate on when my father would be experiencing a manic episode or psychosis, she would say if we could just get him to the hospital. She would dream up strategies of trying to trick him or like get him, just get him into the hospital because if he could just get him into the hospital, then he could sleep and maybe he could get better, but at least he’d be safe in the meantime, and there’d be some reprieve.
I grew up thinking the hospital is this place of safety—it’s where someone could get treatment. The fact that my father did not go to the hospital voluntarily was his fault, and so I was very frustrated with him. He was the cause of why his life was stressful and why my life was stressful.
I have other family members who have what you might consider to be a serious mental illness and have been hospitalized over a dozen times
But then I had my own experience, my first experience in a psych facility when I was 16. Without sharing too much, too many details, or anything too heavy, the sequence of events was this: there was a hugely traumatic event that happened in my life. My mother’s boyfriend took me someplace and raped me, it was a big deal. Then the police were involved, and it was very stressful. Shortly after that, I just couldn’t cope with the stress, so I was hospitalized. While there, the frontline staff, who were comprised mostly of men, made fun of my breasts being too small, and I went through strip searches.
There was a nine-year-old boy who was crying, and frontline staff said, “You need to just man up and stop crying. If you would just behave yourself, you would not be hospitalized.” I got upset and told the staff, “Stop yelling at this boy.” Then I got restrained.
It was scary, it was a lot of strong men holding me against the wall, being sedated. Then, as punishment, they took away my clothes, and I had to sit in the hallway in a gown and write an apology letter.
That was my first experience in a psych facility myself, and it was extremely humiliating, dehumanizing, and was the opposite of what I thought was going to happen. I really thought that this was going to be a place where people would be nice to me. They would realize that I was suffering, and they would give me treatment. I was very excited about getting some treatment and some positive attention, but it didn’t happen.
I had another experience when I was 20. At that time, I was taking classes at a community college in Florida, and my father was in a manic episode himself. I was also working, and there was a lot of stress. I was put on an ADHD medication, Vyvanse. I went manic, and that was a horrible experience, the mania itself.
I voluntarily went to the hospital so that I could sleep. I was restrained immediately for asking a question in front of my mom. I thought they were trying to kill me at the time. When they injected me with the chemical restraint, I asked them, “What did you give me?” They didn’t answer me, and I thought for sure it was a lethal injection, so I thought I was dying when I was going to sleep.
Then anyways, there were a couple of hospitalizations with that. It was extremely traumatizing and abusive.
I was not a great student, but what ended up happening is I moved to Ohio and went to Kent State University. Due to the kindness of an instructor there, I was invited to work in a lab, in a psych lab, and I fell in love with the research process.
I learned in interacting with the world that I could not talk about my experiences because if I did, then people would no longer think that I’m smart and capable. They would discount me, and I was afraid that they would send me back to a psych hospital. Then I kind of started talking about it with my colleagues, and grad students, and they seemed to not be aware of these realities in the hospital.
You really have to experience it in your own flesh and blood to really appreciate what it feels like to be so dehumanized. I then went to the literature, and I saw that there was almost nothing in the United States being done on this. I had all kinds of questions like, why did I go to this place that seemed to be for people that no one cared about? Why was everyone there not white, basically? I was the only white person. Clearly, there was a clustering of certain patients and facilities that were worse than others, but why was that?
I became very jazzed about this, very passionate, and upset, and straight from undergrad, I went into a public health master’s program at Harvard and went in with a proposal to interview patients and frontline staff to really understand what’s their experience like, what’s happening, how does it vary, how common was my experience.
From there, I’ve been very hyper-focused. I got a Ph.D. in social policy, continued researching this, and did a postdoc in implementation science and academic community partnerships at Penn, and now I’m faculty at WashU and the Brown School of social work, public health, and social policy.
Throughout this process, I just get more and more energized because I realized that there isn’t much going on. When I speak with patients, and I hear their stories, it just really ignites me, it upsets me.
It’s not so much my own experiences that fuel me anymore, really—it’s folks that I speak with and that I interview in my research and the stories that I hear, and also my knowledge of how messed up our accountability and data infrastructures are. The more I learn, the more outraged I get.
Lejeune: Thank you so much, Dr. Shields, for just sharing, and your willingness to be candid and open about what you’ve been through and what drives you. I appreciate you speaking about that experience of being silenced or feeling like you can’t share the truth of who you are. What do you see as the structures in place that are justifying the lack of data available on inpatient psychiatric facilities?
Shields: This is a population—and it’s weird to talk about the population as a population when I identify as being part of the population and my family—but it is a population in general that people are afraid of.
They have discomfort towards mental illness in general. I hate to use the word stigma, but it really is the othering of people who experience psychological distress or find themselves inside of psych facilities, so much so that people don’t even understand who is being hospitalized in psych facilities.
I get frustrated when I hear researchers who have certain questions having to do with “serious mental illness,” and they conflate inpatient psych patients with people with “serious mental illness.” I say to them, what exactly do you mean by the term serious mental illness, and why do you think these are one in the same? This is a catchment tank for all kinds of stuff. It’s basically the system in our society not knowing what else to do with someone.
I’ve spoken with people who have been hospitalized because they’re trying to get away from an abusive spouse, people who’ve consumed substances and had a psychotic experience as a result of substance use, ending up in these facilities. And then there’s all the social determinants, homelessness, etc.
I think that fundamentally it’s the othering of this population, a discomfort, and because of that, people are kind of afraid to touch it. Also, researchers feel like they’re not qualified to touch it like it’s this special, special population. I know so many of my colleagues do research on so many aspects of the healthcare system that they have no lived experience with, like nursing homes, and they feel totally qualified to do it and to ask all these questions. But when it comes to inpatient psych, they’ll say, “oh, that’s not my expertise.” Really? But you could ask the same questions you’re asking when it comes to nursing homes. Why do you think you’re an expert on nursing homes when you have never been in a nursing home? I think that the root cause is the othering of the population.
The only reason that the system is going to care about psychiatric patients or accountability of psych facilities and improving our data infrastructure, at the end of the day, is if they are faced with pressure. A system is not just going to change just because it’s altruistic or everyone thinks it’s the right thing to do. It takes resources, for one. It takes political will, and it takes pressure.
Now, I believe that the advocacy coalitions and organizations that otherwise would be putting pressure on this issue don’t want to touch it. There is this tension where we think that if we advocate for improving psych facilities, then we’re essentially advocating for more resources towards the psych facilities when actually we should be putting those resources towards the community and alternatives for hospitalization.
There isn’t necessarily a clean fix to this, but without some sort of explicit organized pressure, nothing is going to change.
Lejeune: So some of that work of reimagining alternatives is great but only focusing on that leaves a black box, and it’s hard to show what’s happening in there.
Shields: I’m happy you said that term black box. There are multiple stakeholders that are invested in keeping it a black box, so it’s not just provider organizations, its policymakers, regulators
For example, there’s a state I’m aware of that they had these psych facilities, and they happen to all be for profits that were doing—they were conducting fraud, right? They had unlicensed, unsupervised staff; patients were dying in their care. They were not following the rules to maintain their license, so, therefore, they should have, in theory, lost their license; that’s the consequence. If that’s not the consequence, then it’s fake, right? There’s no point in having rules, and if the facilities know that, then why should they invest in adhering to those rules?
They were afraid to take the license away because they needed the beds. They were afraid politically of having too much ED boarding (when someone is in the emergency department for a long time). The hospitals are pretty powerful lobbyists, and you want to keep people happy, and you don’t want there to be a news article about ED boarding of psych patients.
But again, it just kind of exemplifies that they are responsive to pressures. It’s just how do you make them be responsive to patient-centered pressures because they don’t want the journalism coverage of the ED boarding, but they also did not like the journalism coverage of patients dying. Eventually, a psych facility or two ended up closing, but it took a lot of spotlights.
Lejeune: What would that pressure look like? What do you imagine those pressures being at different points in the system? Who is currently benefiting from the structure as it stands?
Shields: Some of the fundamental issues I see with psychiatric care, in general, are deeply structural within the mental health care system, but also outside of it.
I think that the medical model, unfortunately, might be inappropriately used for mental health, but we have invested a lot of energy and resources, and there are powerful entities that really benefit from us anchoring mental health treatment within the medical model. All of our structures are surrounded by the medical model, insurance coverage, literally everything.
I think that the issues we see are a derivative consequence of our dependence on the medical model.
I don’t necessarily think that any single psychiatrist or necessarily an association of psychiatrists like that some patients get hurt in psych facilities. I think that there is, in my opinion, a knee-jerk defensiveness to any sort of critique, and I think that comes from a fear of losing their authority. I think that that is exacerbated by the realities that within medicine, psychiatry is seen as kind of it’s a stigmatized profession, so they kind of have insecurity there.
I think that the defense of their profession and their footing and their stake really gets in the way of progress, and is kind of what is sustaining our status quo, and preventing us from doing anything truly radical and truly alternative to our current models of “treatment.”
I find nurses and social workers to be way more sympathetic and understanding because, actually, what makes these environments better for them is better for patients.
Then there are other profiteering companies that also subsequently benefit from psychiatry maintaining power in the mental health space. I think there are other stakeholders that benefit from not having to be bothered with the really, really hard, heavy work of reimagining true transformation. I think it’s hard, and that’s for anything, not just mental health, any sort of huge change like policing, for example.
What change is needed? I’m optimistic, but I’m also pragmatic. I think the root issues here are power imbalance. For me, any sort of intervention that I try to dream up, I try to anchor it towards how it is addressing power imbalances between patients and the other actors.
One tool that I have been really anchored around has been measurement reporting and incentivizing a patient experience. It seems like a good first step since all of the rest of health care is doing that—so why aren’t we doing that for psychiatric patients? It smells like discrimination to me that we’re not systematically measuring patient experience at the national level, and incentivizing performance on those measures.
But the reality is, is that those measures could be gamed. But anything that truly puts more power into the hands of patients, either at the individual level or as collectively as an advocacy coalition, I think is the way to go.
I support testing out alternatives, and I would love to research that in future iterations of my work. But I am also worried about how it is going to be co-opted and how it’s this tension between accountability and true patient-centeredness. It’s tough because you need there to be accountability, but it ends up turning everything into a formula, and everything becomes standardized and measured against the medical model at the end of the day, which isn’t really what we want. Then it kind of repeats itself. I support understanding what alternatives are best and for whom, but I’m cautious about their implementation in our existing structures.
Lejeune: Given this messiness that you’re laying out and how complicated it is to fit into these systems or make changes within these systems, I’m curious how you define patient-centered outcomes for inpatient psychiatry.
Shields: For me, I’m just focused mostly on what I think is the first step, which is patient experience measurement. You can think of patient experience as an outcome, but it’s really like a process. You can categorize it as an outcome, but it’s really the patient is evaluating the process of care.
The reason why I view that as a first-order priority is because we don’t want care to cause harm, and we want patients to be treated with respect, and that is important.
When it comes to other outcomes, the classic outcomes that are currently being measured are readmission and follow-up. Did you have contact with a healthcare provider within seven or 30 days of discharge? Were you readmitted? Those are not necessarily patient-centered outcomes. Those are very much payer-centered outcomes. We measure those because they’re easy to measure, because you can look at readmission and you can look at the utilization of outpatient providers in claims data, and it’s something.
The feasible measures end up being readmission and follow-up. But those are so crude, and they’re not necessarily the outcomes that are most important to patients. Then the problem with them also is that when you speak with health care providers and the hospitals, their argument is how can we be responsible for their follow-up or their readmission? We’re just a stopgap. They come here, you don’t pay us enough to actually provide them any treatment. This is their argument. They’re only here for a few days. We can’t possibly give them any sort of treatment. We’re just trying to stabilize them. There are all these other social issues that they’re dealing with when we discharge them. We can’t control outpatient capacity, we can’t control housing. It’s not fair that you’re making us responsible for that. That’s this tension.
I would say instead of measuring those utilization outcomes, we could just ask patients directly, “did you feel that your care benefited you?” That would be an intermediary outcome that we can assign responsibility to the hospital, but doesn’t creep too much into the realm of community care and all of the other factors that influence those outcomes that are outside the control of the hospital. So that’s my first step in patient experience measurement. Then just ask the patient, how did this impact your trust, your willingness to engage in care, what was the impact on you?
If the hospital wants to game those measures, maybe one way they could try is actually to be nice to the patients. The payers are saying we actually do care about what the patients think, so you can’t just discount them. I do think that that could help reorient priorities.
I had dinner with a social worker years ago, and they were explaining how they respond to these quality measures. She said, ”Well, what we do is we’re discharging the patient, and then we schedule an outpatient appointment, so then it shows that they have this follow-up.” But to the patients, the patient doesn’t view it as a follow-up because it’s part of their discharge process. It’s not like they came back three days later, and so that’s how they’re able to control their performance on their follow-up measure.
Lejeune: Since you’ve started shining a light on the harms and injustice done within these facilities, what kind of responses have you gotten from institutions at the state or federal level?
Shields: I have found that frontline staff at psych facilities are, in general, enthusiastic even about my research so long as I make it very clear that I’m not blaming them and that I think they also are victims of a very toxic system.
We’re talking about systems issues. It’s not that one individual is evil at all. I have found the frontline staff to be, in general, not as defensive as psychiatry, as a group. I get mostly psychiatrists who review my papers, and they can be very defensive.
They’ll say that’s not my experience in the hospital I work in, which, okay, well, we’re talking about research, research methods 101. It’s frustrating.
I’d say the biggest pushback I received was when I was a Ph.D. student. I filed public records requests in the state of Massachusetts for my dissertation. That made some people feel a little bit uncomfortable. They were curious about what my motives were and what I was going to do with these data. I was quoted $500,000, for data on restraint and seclusion. I don’t have that money. They were just trying to shut me down.
I wrote a letter to the secretary for Health and Human Services in Massachusetts. I documented two years of trying to get the information. I was giving all this feedback, and I was upset at how much it cost—these data should be publicly reported, they should be on the internet. I’m a Ph.D. student who can spend all my time doing this and gathering this information. What about patients and their families? They can’t.
At some point, it reached the commissioner of mental health. I ended up having a meeting with the commissioner of mental health. My first meeting with her was lovely-ish. In my second meeting with her, I was getting her feedback on my dissertation, and I had some questions. I wanted to know if my numbers looked correct in her opinion. I was just trying to do my due diligence, and I didn’t want her to be blindsided.
I met with her, and I left that meeting crying. I’m embarrassed, I should have been tougher, but she just was upset that I did my research. I don’t know what else to say. I went into the meeting enthusiastically, and I did leave the meeting crying. I will say the Department of Mental Health ended up implementing a revised Critical Incident Monitoring system, and they did that after I published some work, but It wasn’t until a journalist covered it and asked them for a quote that then all of a sudden they implemented this new Critical Incident Monitoring system, and they hired a full-time staff person whom I met. But I was frustrated because I really wanted to work in partnership with them.
I love the idea of collaborating with them, but I found that they were less excited about collaborating. It seemed to me that they were most responsive to journalistic coverage of issues, and that’s the way to get anything done.
Lejeune: It sounds like the state took your work and did something tangible to rethink their system but boxed you out of that process. Have there been instances where you’ve been able to be more involved or seen changes within other facilities, or been able to partner with organizations in your work?
Shields: I did my postdoc in Philadelphia at the Penn Center for Mental Health. We submitted this big center application to the NIH, and, if we get it, I’ll be the PI of a project that is focused on trying to understand how to get psych facilities to implement evidence-based discharge planning using financial incentives and patient experience measures. We’re seeing this as a tool to reorient providers towards being more patient-centered.
Penn has an amazing relationship with the city of Philadelphia and the Medicaid payer, and they do projects together. They also have some good relationships with psychiatric facilities. There, I have been able to partner with the Medicaid payer who we will work with to develop financial incentives, and they’re very enthusiastic about figuring out how to do this. They’re also very interested in figuring out how to implement trauma-informed care within their inpatient and residential facilities. They are currently a partner on this grant. If we were to get the money, we would partner with them and partner with the psych facilities in Philadelphia.
I lived there for two years and have been in that space for a bit, and that was totally different experience for me. I felt like I could have so much impact working in partnership with the payer, with the state, and with the psych facilities as opposed to just being an agitator in some ways.
Lejeune: What tensions emerge with you holding these more radical perspectives when collaborating with others who are coming at this from different angles?
Shields: There’s always tension. I think with this topic, inpatient psych, it’s actually hard to have a conversation about it because it seems like people get triggered by certain words, and then they automatically put you in a certain camp. Because I care about how patients are treated, I sometimes think people try to put me in the camp of “you must be anti-psychiatry.” I struggle with that because it shuts down conversation. But it is true that I think that the field of psychiatry has caused a lot of harm.
I struggle with people being able to hold multiple truths and engage in a nuanced conversation that is anchored in really caring about the people being impacted by this care, and figuring out how we can best meet their needs. But I think we all can agree that we don’t have enough data.
There’s not enough research and our current system is not patient-centered, and patients do need more power.
There are always individual differences, so when I talk about the evidence, I’m talking in general. Some people in some families do struggle to access the care they need, and they do perceive their biggest barrier being the fact that they can’t force their loved one into treatment, and that can be valid, but also it can be a more nuanced issue beyond that being true for them, and that’s I just wanted to clarify that.
Lejeune: I also have seen in your work a call to action to include individuals with lived experience as partners in this process as well, either as researchers or in the policy-making process. You’re in a unique position being someone who’s playing that dual role of a researcher and carrying your own experiences. I’m curious if you could speak more about what meaningful inclusion looks like.
Shields: Obviously, there are many things that need to happen. The first one is schools that are training academics who are going to end up researching the mental health care system in some capacity, either at the clinical level or the system’s level policy especially, need to value lived experience as a dimension of diversity and inclusion, because unfortunately, it has been viewed and felt as a liability as opposed to an asset.
It really is an asset because the truth is that we all have biases as researchers. There’s no such thing as objective research. We’re all coming to the table with bias, and it’s really a question of how we can make that bias more equitable.
I would argue that the way we should be viewing bias is by trying to put more weight and more value on the types of biases that are more marginalized or underrepresented because there’s an inherent power imbalance. One way to address that is to put more weight on those who have less power. That’s what we need to do in the academy. Disability and lived experience just are really not prioritized in diversity and inclusion efforts, and they should be.
I’ve met some people who have lived experience and have leadership roles, so they exist. It’s hard to find allies because everyone’s trying to hide it. Then, it’s a structural issue, so we need funders like the NIH to really value this community partnership in a meaningful way where they put money on the table. But at the end of the day, these grants are reviewed by our peers and other academic researchers. It really takes people buying into this as something that’s important because if the reviewers don’t think that that’s important, they’re not going to be critical of how meaningful the partnership is between the researcher and the community partners.
It is important that we partner with community members, both individuals, and organizations, because we are only one person, so we don’t have the diversity of experiences that we should be tapping into. We have our own privileges that biased our own experiences. Also, just having a Ph.D. makes someone incredibly privileged. Sitting in a different spot, no matter how your experiences were prior to getting a Ph.D.
But academic research is such that we do depend on grant money, and the grants run out, and it’s hard to maintain continuous relationships with community partners because we can’t always pay them for their expertise or for partnering with us. Then if we don’t pay them, we’re exploiting them.
There’s a lot that should be addressed to change the incentives of researchers so that we could support them in being able to do this work. We have to talk about this and try to change the minds of our colleagues so that when they’re at the table, they’re on our side, and they can be convinced and maybe even speak up on these issues because that’s what’s going to take.
Lejeune: Are there any examples of ways that you’ve collaborated with partners or individuals with lived experience in your own work?
Shields: Yes, so doing the research where I’m actually interviewing and collecting information from people with lived experience and asking them what exactly do you think needs to change and then letting those data inform what I prioritize studying moving forward. The problem that I have faced as someone who’s early in my career is I haven’t had money to be able to pay for an advisory board, which has been my dream.
I would love to have two different types of advisory boards that I collaborate with on a continuous basis. I don’t necessarily go to them with a project idea always, but we co-develop project ideas. I’d like to have one more national with lived experience and maybe some representatives from advocacy organizations. Then one that’s St. Louis based, because I would love to do research that has a positive impact on the folks in St. Louis.
I’m trying to listen and kind of just get a sense of the landscape and not dive right in, but just kind of understand who has existing relationships. Setting up meetings with folks who do this type of work at the school, and then eventually, I’m going to start having meetings with people in the community.
Then I mentioned the project in Philadelphia. We do have an advisory board for that. We don’t even know exactly the intervention that we’re going to be testing. We’re going to co-develop the intervention in collaboration with our advisory board of stakeholders, and we’ll be engaged in a process of implementation mapping where we take all the information we gather from interviews with providers, and then we sift through it and then we use that information to figure out, okay, what do we prioritize and how do we go about doing it? That’s done in partnership with community members.
I try to hire RAs with lived experience, and I partner with students at different universities who have lived experience. I try to do my best to support the workforce if someone reaches out to me and wants to collaborate on a project, I try to be generous. But I’m also trying to figure out how to juggle lots of things currently and manage everything and not be a terrible mentor.
Lejeune: I’m curious if there are any ways the people listening to this podcast could connect with you or get involved or share their story if they feel moved to do so.
Shields: Absolutely, I would love that. I get really energized when I am connected with people with lived experience. I love it. Sometimes it is hard to hear some of the stories, I will admit, but I am very open. People can reach out to me. I do have a lab that I’ve started, and I have hired a couple of people, so I do think my capacity will be increasing in the near future. I would ask people to have some grace if I take a while to get back because that might happen. I am definitely very open to people reaching out, collaborating, or just getting in touch.
Lejeune: What do you hope for in the future of these systems, or what do you see as your long-term vision for how things might look differently?
Shields: Being pragmatic. I would love it if, in my lifetime, I could at least see people caring about these issues and trying to address them. Recognition that there is an issue of people being dehumanized in our systems, and just a reckoning of the violence that’s been inflicted on people.
I am afraid right now, there’s not an awareness of the issue, the true issues, and that we’re still debating reality. Is reality, reality? Should we even treat psychiatric patients as people? That’s the debate that I’ve been hearing, and that’s unfortunate. I would love for us to get to the point where we agree these are humans, we are humans, and the way we’ve been operating our mental health care treatment system has been absolutely unacceptable, and we have to figure out how to do a better job and have humility in that process because a lot of people have been participating in it. That’s the nature of life in these systems, we all are implicated, so that’s my future hope.
Lejeune: Is there anything else you are hoping to add today?
Shields: I do want to just reiterate that the current mainstream argument that we need more psychiatric beds, that’s the loudest argument right now, I have a lot of issues with it.
But it’s important that people really be clear-eyed and not forget that we do operate in a market-based system. If you want a provider organization to be incentivized to add more beds or open new psychiatric facilities, ask yourself what you think some of the unintended consequences might be.
For some reason, we view psychiatric care as if it’s a bunch of benevolent people. We seem to be able to be critical as a society of health care in general and then also other consumer goods like shoes and clothing and exploitation of the labor force and all that. But for some reason, with mental health care, it seems like if you even bring up this critique, it’s almost as though people get offended or it’s too much to process.
I would just ask people to have some appreciation for it being a complex issue and potentially that there are issues of profiteering and exploitation of patients.
Editor’s note: As we were finalizing this interview, Morgan shared with us that she had lost a close friend to suicide. She has set up an online memorial and fellowship fundraising page for anyone wishing to know more or to contribute.
MIA Reports are supported, in part, by a grant from The Thomas Jobe Fund.