Report on Improving Mental Health Outcomes


Dr. Peter G√łtzsche, Dr. David Cohen, Dr. Chuck Ruby, Faith Myers and I just published our Report on Improving Mental Health Outcomes (Report). It is intended to be used to advocate for the elimination of unwanted psychiatric interventions and to promote the humane, effective, voluntary approaches we know work, such as Peer Respites, Soteria Houses, Open Dialogue, Hearing Voices Network, & eCPR. It has extensive citations to support its case for fundamental changes to the mental health system.

Illustration: Birds on lines organizing into the shape of a bar graph

Executive Summary

The mental health system‚Äôs standard treatments are colossally counter-productive and harmful, often forced on unwilling patients. The overreliance on psychiatric drugs is reducing the recovery rate of people diagnosed with serious mental illness from a possible 80% to 5% and reducing their life spans by 20 years or so. Psychiatric incarceration, euphemistically called ‚Äúinvoluntary commitment,‚ÄĚ is similarly counterproductive and harmful, adding to patients‚Äô trauma and massively associated with suicides. Harmful psychiatric interventions are being imposed on people without consideration of the facts about treatments and their harms, and are a violation of International Law.

The most important elements for improving patients‚Äô lives are People, Place and Purpose. People‚ÄĒeven psychiatric patients‚ÄĒneed to have relation-ships (People), a safe place to live (Place), and activity that is meaningful to them, usually school or work (Purpose). People need to be given hope these are possible. Voluntary approaches that improve people‚Äôs lives should be made broadly available instead of the currently prevailing counterproductive and harmful psychiatric drugs for everyone, forever, regime often forced on people. These approaches include Peer Respites, Soteria Houses, Open Dialogue, Drug-Free Hospitals, Housing First, Employment, Warm Lines, Hearing Voices Network, Non-Police Community Response Teams, and emotional CPR (eCPR).

By implementing these approaches, mental health systems can move towards, and even achieve, the 80% possible recovery rate.

As bad as it is for adults, the psychiatric incarceration and psychiatric drugging of children and youth is even more tragic and should cease. Instead, children and youth should be helped to manage their emotions and become successful, and their parents should be given support and assistance to achieve this.

The White Paper published last April included universally applicable information as well as Alaska specific circumstances. See, White Paper Presents Case Against Forced Treatment, Mad in America, April 27, 2023. I thought it would be beneficial to present the universally applicable information without the Alaska specific material to make it easier for people to use in their own locales, and the Report was born. The White Paper had a strict deadline and in my view the Report is somewhat better on this material because we had additional time.

The Report is a comprehensive, and I think authoritative, analysis of the counterproductive nature and tremendous harm caused by psychiatric drugs and unwanted psychiatric interventions, such as incarceration, euphemistically called “involuntary commitment,” and forced drugging. The section on approaches that should be used instead of the current system is not as comprehensive or authoritative because there is so much innovation going on, but I do think it is a good overview of the principles involved and a good summary of both the most well-known approaches some not so well known.

Readers of Mad in America will find much, if not all, of the material in the Report familiar, but we hope Mad in America readers will be intermediaries for the intended audience. In other words, we hope Mad in America readers will present the Report to policy-makers and potential funders in their advocacy to achieve the promise of the Report.

With the Orwellian named C.A.R.E. Court statute recently enacted in California soon to be implemented, Mayor Adams’ vow to use existing law to sweep up the homeless into “mental health treatment,” and similar efforts in other places, this is a particularly important time for people to advocate against unwanted psychiatric interventions and the availability instead of voluntary, humane and effective approaches.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion‚ÄĒbroadly speaking‚ÄĒof psychiatry and its treatments. The opinions expressed are the writers’ own.


Mad in America has made some changes to the commenting process. You no longer need to login or create an account on our site to comment. The only information needed is your name, email and comment text. Comments made with an account prior to this change will remain visible on the site.


  1. Thank you for all you do, Jim, Dr. Peter, Dr. David Cohen, Dr. Chuck Ruby, Faith Myers.

    An update on my loved one, who suffered from a first ever, likely drug withdrawal and/or alcohol withdrawal induced, manic psychosis recently. A brief course of benzos did not work. He’s back in the hospital, this time by way of the police. And he did behave in a manner that was a danger to himself.

    I spoke with a young ER psychiatric intern, he was very respectful, and confessed he too was a critical psychiatry psychiatrist, for which I was grateful. However, my loved one was knocked out with an antipsychotic this time. But he was not continued on them, and he was not admitted to the Behavioral Health part of the hospital. He still was quite manic today, however.

    I will say, since my loved one was brought in by the police, he did have a non-medically trained “companion” to keep an eye on him today – as opposed to restraints of any kind – which is a much kinder approach.

    We’ve yet to meet with the hospital psychiatrist, but the neurologist said he had no neurological problems, so he had to see a psychiatrist. So I think that my loved one’s recent formulation of words and uncontrolled movement walking issues are likely withdrawal issues of the benzo, but obviously since he’s now “manic,” via the “symptom” of talking a lot – which is exhausting for me and my mom – his inability to speak is now improving.

    Although the “medical professionals” did deny my loved one’s symptoms could be potential adverse withdrawal effects of a benzo, despite his adverse effects from the benzo being known as common adverse effects of the benzos. So hopefully, we’ll be able to meet with one of the – too busy psychiatrists – tomorrow.

    Please say a prayer for my family, to those of you who believe in God. I’ve thrown up twice, in the past three days – and I haven’t thrown up in decades – likely due to the stress.

    Report comment

    • Dear Friend, try looking up the book “Prescription for Nutritional Healing,” Fifth Edition, commonly available at any local GNC store for about $18. This has helped me more than any medication take control back of my life and my health from doctors, who often do not really know what they are doing. Although I am now on several medications, I have also had to deal with my share of forced hospitalizations in the past. Often psychosis and mania can be temporary and brought on by stress, but if your body does not have adequate nutritional deficiencies then symptoms will build up. I also highly recommend looking into “Blue Shield EMF.” Although their products can be very expensive and frankly, the affects are invisible, it’s also helped me recover my health more than anything. Mental/physical health symptoms have declined in sharp correlation with the rise of each new Generation in cell phone technology and due to Billions of dollars investment in censorship Blue Shield is likely the only valid current scientific research available on harmful EMF waves. You will be surprised to hear some of their personal testimonies and facts from case evidence. I really hope this helps, and more than anything, hope you and your husband feel comfortable being honest with each other and yourselves about your struggles! Having paranoia, delusions, psychosis, or hallucinations can easily drive a person insane to suicide if they are not able to tell someone else how they feel, so no matter what, keep talking!! I really hope this helps!

      Report comment

      • Thanks for the insights, Joseph. And I am stressing the importance of nutrition to my loved one, who is not my “husband.” Nonetheless, I did start taking Ensure today, since I’ve been so stressed that I don’t even want to eat, but I am.

        Maybe I’ll buy the book from GNC and gift it to my loved one, and read it myself. I will give a further update. My loved one was let out of the hospital after three days. The neurologist signed off without giving me a diagnosis, but my loved one’s primary doctor finally confessed to me that he had a form of encephalitis, which I understood, but encephalitis is technically a neurological disorder not a psychiatric one. And the whole situation was made worse because my loved one’s PCP neglected to put him on a new blood pressure med, when she rather abruptly took him off the two blood pressure drugs, that were causing kidney failure.

        So my loved one’s care at the hospital was quite good, at least I was finally given the actual diagnosis. And honestly, psychiatry could switch from force drugging and traumatizing people, to having respectful, non-medically trained “companions” sitting with people who appeared dangerous, instead.

        That being said, my loved one is not doing well right now, and I’m not sure he will be able to live independently again. But there is hope, since we know the human brain is neuroplastic, and does heal itself.

        Thankfully, I did find a peer respite not too far away that agreed to take my loved one for a week, so my mom and I can clean up the mess my loved one created when he was manic and likely also psychotic.

        I just need my loved one’s doctor to call back, and make the recommendation to the peer respite, which she did not do today. So I likely will call my brother’s hospital “critical psychiatry” psychiatrist tomorrow, and ask him to recommend the peer respite. Why not let a “critical psychiatry” psychiatrist be a hero, in my story?

        Report comment

  2. This article should have been clearly labeled as opinion at the very beginning. As a person with mental illness, I was very discouraged to see no scientific data to back up these claims. I don’t necessarily disagree with the article, though I am someone who needs to be on medication for the rest of my life. I would hate to see that opinion taken away from me based on someone’s opinion of what effective mental health treatment looks like.

    Report comment

  3. These bizarrely named laws are just versions of one of Hitler’s “final solutions.” They supposedly will cure the problem of homelessness by taking the homeless off the streets.

    Again, it’s a final solution. It is no coincidence that the first group of people exterminated by the German Nazis were psychiatric inmates. And we will see the same thing if our American Nazis take over, which may be very soon.

    Report comment

  4. I agree. I’m petrified of being forced against my will to go to hospital. It adds so much unnecessary stress on top of my already stressed out life. It literally makes me shut down even more and less willing to communicate my needs. The moment I read about the judge sending someone to a mental institution against their will. I really wanted off of this planet faster than you can blink. I’m done with society if this is what normal people think is ok for others. I had issues as is talking to my psychiatrist about anything just for the simple fear of being sent away. Now a judge can just do that!?! Time to go find a cave and hope no one finds me. They did nothing but hurt the already mistrusted mental community when they did that.

    Report comment