2023 in Review: A Paradigm Shift Is Underway


At the end of each year, I like to ask this question of ourselves: Are we fulfilling our mission? Here is our mission statement:

Mad in America’s mission is to serve as a catalyst for rethinking psychiatric care in the United States (and abroad). We believe that the current drug-based paradigm of care has failed our society, and that scientific research, as well as the lived experience of those who have been diagnosed with a psychiatric disorder, calls for profound change.

And now, a slightly long-winded answer to that question.

When I am asked today about what it is we do, I like to say that we serve as an alternative media on matters related to psychiatry and mental health. It is in that role that we serve as a catalyst for radical change. Readers of Mad in America will encounter a narrative that is quite different from what appears in, say, The New York Times, or other major newspapers and magazines. And here is the encouraging news: a new narrative is springing to life.

The disease model that was born in 1980, when the American Psychiatric Association published the third edition of its Diagnostic and Statistical Manual, has collapsed. We have been writing about its lack of scientific foundation and its therapeutic failure for the past 11 years, from the day that Mad in America was founded, and now that understanding is filtering into the general public domain.

The “evidence base” for the collapse, which MIA readers know well, is this: psychiatric diagnoses are now understood to lack validity; the chemical imbalance theory has been (mostly) abandoned; the burden of mental disorders has notably increased over the past four decades; and there is increasing reason, based on evidence of many types, to conclude that psychiatric drugs, over the long-term, do more harm than good.

Moreover, as we reach the end of 2023, there is a potential “game changer” that looms for psychiatry. If the mainstream media picks up on the STAR*D scandal, which we have written about extensively, the general public will suddenly be confronted with this basic truth: American psychiatry cannot be trusted to provide us with an honest account of its own research. In the STAR*D study, we were told that 67% of the patients remitted after four stages of treatment, when in fact only 35% did.

In short, our society has organized its thinking around what I like to call a “false narrative of science,” and as that becomes known, it sets the stage for society to “rethink psychiatry” and imagine new possibilities.

We can see this paradigm shift in societal thinking happening even within prominent institutions. The World Health Organization, in two lengthy documents, has twice called for a radical change in psychiatric care, away from the disease model and toward one centered on human rights and the social determinants of health. That is a narrative that is moving the locus of “mental illness” away from the individual’s “brain” and into the community. The former United Nations Special Rapporteur for Health, Dainius Pūras, similarly issued calls for radical change along these lines.

A Recap of Our Operations in 2023

In 2023, we have published:

  • 241 reports on scientific publications
  • 182 blogs
  • 62 MIA Reports
  • 44 personal stories
  • 28 podcasts
  • & more: we host an online support group for parents, an online meeting space for artists, art galleries, and reader-nominated “songs of the week.”

As for our readership, it continues to grow. This year we will have around six million unique visitors to Mad in America, and around one million more to our affiliated websites. Our podcasts have now been downloaded more than a million times.

These are numbers that tell of a growing community eager to “change the narrative” that governs societal thinking. And that is how paradigm shifts occur: the collective voice for radical change grows ever louder.

Mad in the World

This October, we had our first in-person meeting with the editors of our 13 affiliated websites (soon to grow to 15 affiliates). The meeting in Copenhagen brought together the MIA board and 40 editors from the 13 sites, and if there was one “take-away” from our days together, it was a glorious sense of a shared mission.

Meeting of Mad in the World editors

The affiliates, which include sites in Central and South America, Europe, and a newly launched Mad in South Asia, are run by a mix of professionals and people with lived experience. While Mad in America provides infrastructure resources for each site (hosting the domain, technical support, software support, and so on), the editors of each site have editorial independence.

The affiliates, of course, focus on publishing content that is most relevant to their specific cultures, and in that sense, they do not speak as “one voice.” However, all share a common understanding that the disease model was exported around the world and to ill effect: worsening public health outcomes, the adoption of the impoverished philosophy of being that is found in the DSM, and the pathologizing of children (in some countries much more so than others).

At the end of the meeting, the group decided to rename itself Mad in the World. We are now working on improving our sharing of stories across this network. There is now a content section on our front page that features articles published throughout the Mad in the World network. At the same time, we are seeking to make it easier for the affiliate sites to republish our science reports and other content that may be of interest to them.

Our hope is that this sharing of information will serve to “cross-pollinate” all of the sites with new ideas and accounts of promising new initiatives.

Looking Ahead to 2024

As we have often noted, we are supported entirely by reader donations, and we want to thank all who contributed to Mad in America in 2023. Your generosity is what has enabled us to do what we do.

From all of us at MIA, we wish everyone a happy holiday season.

—Robert Whitaker


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of 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. I am happy to have MIA as a source of a full range of information about the mental health “care” system.

    And I am happy to see the increased intent in certain communities to protect patients from human rights violations.

    Next: We need to find how to heal people for real in the field of the mind.

    It has been discovered that many symptoms are caused by body problems, and that many acute symptoms subside with rest and nutrition – nothing more. This has always been known, and we should not accept a system that ignores these most basic realities.

    But breakthroughs are needed in the field of the mind, NOT the body! And that discussion is not happening. This seems to trace back to vested interests who do not want to give up the cash cow of dispensing drugs and other “treatments” to make people “well.” We cannot accept this; it’s a scam. But what I have found here is a deliberate – almost committed – effort to avoid a full and far ranging discussion of these issues, which is what is needed.

    Obviously, patients who have been harmed by the current system don’t have a “vested interest” in preserving it. Yet all sorts of intellectual barriers seem to exist to prevent a breakthrough in the discussion, much less a breakthrough in actual practice.

    Not being able to implement reforms is one problem. But not even being able to talk about them? Let us break through those barriers and begin to have those discussions!

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  2. I am a 28 year survivor of unskilled psychiatry. The abuse I have experienced over the years, in the corrupt and sick American Psychiatric system is hard to handle. They took everything but my life and I nearly lost my life to the pills as well. On the pills I was very sick and practically disabled. Off the pills I am doing great and I have become an outspoken advocate against the system and for the environment. Thank you so much for your journalism and feel free to reach out to me if you want to hear my story.

    Erinn Dolezal

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  3. This is wonderful news!!!

    MIA’s growing influence around the world (which I believe is due MOSTLY to the efforts and struggles of ORDINARY people) is something I hoped would somehow happen in some way ever since childhood. I didn’t know how it would happen, but deep down I knew it HAD to happen, because I believed then as I do now: in the ultimate invincibility of the human spirit — something I sensed psychiatry almost gleefully crushing with its cruelly narrow-minded diagnoses, toxic “mediations”, not to mention a stupid “psychotherapy” with its willful blindness to the everyday cruelties of modern life which it wrongly benefits from.

    Therefore, I’m deeply grateful to all at MIA who have dedicated and continue dedicating their lives to making this happen for EVERYBODY.

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  4. I greatly appreciate the work Robert Whitaker and MIA have done. I am a Social Worker and work as a therapist in mental health. At times it can be lonely working in the archaic medical model of care. However, being connected to MIA and being able to keep updated with ongoing articles that provide alternatives has been helpful. Again thank you for the work you do!

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  5. The failure of psychiatry in the scientific realm is but one example of shortcoming in terms of supporting people in spiritual crisis. Mainstream religion has failed in that task as well. We are learning more about how physical health affects the function of the brain and thus changing our approach to mental health. Religions also have to adapt to the change in perspective regarding the meaning and purpose of human life as growth in human knowledge sheds light on our understanding of our place in the universe. Magical thinking divorced from reason doesn’t help people.

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  6. I’m not quite sure how I stumbled on this, but yes, yes, yes! I was prescribed Xanax 15 years ago. My Dr. wrote script after script without me receiving any therapy or even a psychiatrist. Now I’m physically addicted to it. I decided to tritrate down to not taking it on my own. The withdrawals are a bitch to put it mildly. I wouldn’t wish this on my worst enemy. Its been a month and I still feel awful every day. I’m 13 years sober from crack and alcohol, I know I can beat Xanax addiction, but I wish Dr’s would quit prescribing it. Thank you whoever brought me here!

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  7. I hope for optimism; if one is stuck and worsening in the system, those who are free and even more ill, forcing people to never escape the system, are more likely to benefit from your new paradigm shift. Yet, again, those stuck still do not get out. How did the world go so wrong, and Mammon is deemed success?

    Statistics show a small percentage of people working with corrupt systems, police, lawyers, and journalists are more likely to have psychopathy. Yet, they will benefit from new systems again to cause suffering and punishment. I only recommend not punishing oneself, not punishing others, or getting punished. I pray heaven will see the injustice in the suffering punishment system, yet those above the law truly know what’s going on and explain it to people. How can they know for sure? Nobody can, but I pray; I don’t want to provoke bad solutions. I hope for things to get better. If you want to revolutionize things, it could even go worse. Why not do it in safer ways by developing the safest route for the greater good?

    The diagnosis of leaders doing mass murder by war is all there; why do they have the right to go above the law and claim it in holy names when they can’t prove if it’s holy and more likely to facts it’s evil? I condemn and hope for peace and already systems for betterment improved for the safest for all human beings without forcing things even worse. I am not the judge, but some parts of this have some truths, and I am not after anyone specific; I just say it’s crazy, and the one manipulating even more can get Faust updating the DSM system to diagnose all previous Religious Leaders, or Leaders explaining why it happened and get them punished. If the systems update to go against one in evil’s favor, it’s not good. I hope for the good; I cannot solve this mess alone and risk the life of others; we are over 8 billion human beings. Human Rights are a good solution, but some parts, not all, like I hope it’s adjusted in the safest way for most possible to help most possible, also in psychiatry and health fields. I hope for the best and peaceful solutions. I respect all, and I am not after someone specific, and it’s a mess. I can only recommend people stay away from drugs and psychiatric drugs; I need help to get out of them in a safe way, especially from doctors. I hope I get out of the Faust concept if it’s not a myth. And if you see it as propaganda, I am not even the best manipulator of words, so surely you can do better, hopefully for the good.

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  8. It is amazing how ineffective, and often harmful, the modern “helping” professions have become. I am including religious helper types as well – as the tendency in those communities neglects the psychological (mind & emotion). This spiritual neglect of soul care coupled with the “disease model” of the secular psych models has resulted in, likely, the most emotionally & relationally dysfunctional society in the history of mankind. However there is hope as there’s always a remnant like Mad in America! From Hobart Mowrer’s Integrity Therapy model to Johann Hari’s debunking of the addiction treatment industry to Stephen Hayes’ ACT model to the excellent work of David Bonnano’s The End of Trauma (just to mention a few) and the rise of wisdom-informed faith based psychologists and counselors there seems to be a thread of hope connecting like-minded healers. And don’t get me started on sex & sexuality – my specific area of expertise – it is an entirely different level of dysfunction in this arena!

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  9. What I wrote before was out of hallucinations, and what I write now has no conclusion or statement.

    I don’t know myself, and I can’t blame anyone. I only try to cope with myself.

    Medicin is there for now, and there is upcoming medicine.

    The brain chip is here.

    They used to write that psychotic people think they have been chipped or can be chipped in the diagnosis description; now it’s possible, and no one knows how quick it will develop or how.

    If it’s to help people, that’s good.

    If its to force things in people by using the naive population of all with a few to be helped to worsen all in the end, its not good.

    Black-and-white thinking Maybe I hope you figure out if you know exactly what the solution for medicine or the chip in the brain is: the proper adjustments.
    I just, as a patient, hope for the best problem solutions to the critique to help the best possible outcome for most. That’s my hope as a patient.

    The only thing I can do is change my life. If I have slightly just one percent of good in me, I can only give it as advice to others for their lives; the bad parts I cannot recommend.

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  10. Thank you Robert and thank you to all the team involved. I’m deeply grateful for all your work. Wishing the very best for everyone connected with the Mad World, and may we all keep walking into the truth for a safe, thriving and warmly connected lives together.

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  11. “Journalism is printing what someone else does not want printed: everything else is public relations.” George Orwell

    I guess by this definition MiA succeeded when Mr Whitaker was called a “public enemy” by one of the psychiatric thought leaders. However, this was some time back right? A little more friendly with the powers that be these days.

    What I do know is that in the State in which I live the ‘mental health system’ is being used as a means to conceal arbitrary detentions, kidnappings, torture and involuntary euthanizing of people who can be made into ‘patients’ post hoc….. via what the State calls “editing” of legal narrative. This and a lack of vigilance on the part of those charged with protecting ‘our’ human rights (lawyers prepared to conspire to pervert the course of justice when requested by the Minister, and a Chief Psychiatrist who provides “expert legal advice” to the Minister, and yet who would not pass a first year law course? Care to read the letters Mr Whitaker?)

    Though I note no ‘chapter’ of MiA in Australia, and it would be negligent to allow journalists to be exposed to a place where they could be subjected to such ‘treatments’ for writing the truth (when the State demands compliance with their false narratives) We could ask Jamal Kashoggi …… of how it all works ….. oh wait, he got the ‘Australian treatment’ too.

    So how can you measure how effective you are being in a place where the State is concealing it’s human rights abuses by using the ‘mental health system’ and perverting the rule of law via post hoc ‘editing’ of legal narratives to conceal their abuses?

    The data you present may be as flawed as the data from STAR*D? The paradigm shift may be an illusion whilst the torture and ‘unintended negative outcomes’ are being concealed by never seeing the light of day? Because ‘journalists don’t report certain abuses, especially when it comes from ‘whistleblowers’ right?

    Are you sure you wouldn’t like to read this ‘forged’ letter from our Chief Psychiatrist Mr Whitaker? Where his delusions of grandeur have him removing the protection of the law from ALL citizens? Isn’t that meant to require the involvement of Parliament? Or do we remain silent because they are threatening our families? Forging documents to conceal their criminal conduct? Subjecting people to forced treatment for illness they make up on the spot? No need for a psychiatrist, a Community Nurse can diagnose over the phone and have police dispatched to bring the ‘patient’ in for ….well, now they can call euthanasia treatment and ‘edit’ documents post hoc….. too easy.

    Yes, I was here at MiA all those years ago, and appreciate the help I did receive……… but the truth is yet to be spoken. I guess life at the top means biting your tongue, even when you appear to be on opposite sides to the organised criminals huh?

    Fascinating watching the police trip over themselves to provide their services to such criminals (stealing my laptop and phone to find out “who else has seen the documents?” ….wow)….. almost like watching the Keystone Cops again….. only the ‘statistics’ are actually real lives.

    Keep up the good work.
    Regards Boans

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  12. I guess this is a consequence of the need by our ‘elected representatives’ to protect the public from the truth/facts about the ‘mental health system’? Carte blanche as even the cover ups can be concealed. Especially with the help of ‘journalists’. Is this why we hear the rumours, but no one is prepared to actually confront these criminals in our Halls of Power? No one wrote much about what was going on in Auschwitz at the time either.

    Fair enough, …. i mean all they need to do is call Police and tell them your a ‘mental patient’ and they will ensure your prepared for interrogation by causing an ‘acute stress reaction’ ….. you will talk. And if you talk, they can put words into your mouth…. easily (corrupt practice of verballing is encouraged for our police via Creative Writing classes. The consequences even more disastrous when it is being encouraged by ‘mental health services’ …. and I have the proof that it is)


    ….. and the “editing’ means your complaint proves the ‘illness’ you have been diagnosed with as a result of your ‘treatment’ at the hands of these people who care…… tag team politics.

    ‘Spike’ them with benzos, have police cause an ‘acute stress reaction’ in the ‘mental patient’ then forge the documents (a prescription to make the date rape drugs their “regular medications” ….. an attempt to pervert the course of justice right?) that makes them a patient once they’re in custody and have been subjected to the smear of faeces that is a diagnosis. Confidentiality? Sorry about your documents being accidentally released (ask me how…… the ‘edited’ version of course…. all your confidential ‘confessions’ handed out to the public, and you think the law protects your information? waaahahahaha sorry, “they take their oaths as a cover”).

    Unfortunate also that the Chief Psychiatrist doesn’t know that this is criminal under s 336 of the Criminal Code huh? Procuring the apprehension or detention of a person NOT suffering from a mental illness (our protection from human rights abuses which he doesn’t even know exists? Or at least he has rewritten the law to remove from the Act)

    In a State where lawyers can be corrupted to engage in conspiring to pervert the course of justice in regards torture and kidnappings (don’t think they knew about the attempt to ‘snuff” but …. best ask them), what chance would a journalist have?

    The ‘Professor’ (“these are human rights abuses, This is a cover up”) who ‘reported’ to the ‘authorities’ and was never heard of again would also be a good resource in that regard. It was all looking pretty ugly until they got their heads together to decide they could keep it under wraps if they all worked together, rather than that accountability stuff and conspiring ….. they care very little about the law when they can ignore it, with the assistance of Police.

    Also hilarious watching police tryiong to NOT take the proof of some extremely serious crimes, while they provide a window of opportunity for the criminals to snuff the complainant. They obviously need to be careful, because they might be being ‘set up’ when asked to turn a blind eye to know crimes.

    Major points for bringing to their attention that they still have a problem as a result of not retrieving these documents right? Best shut it down before anyone else figures out he was speaking the truth (though I get the feeling a few here made the connection, oh how they must have laughed at the incompetence…….the Hospital Emergency Dept at their disposal and they still couldn’t arrange a little ‘accident’?)

    I get the feeling that many find it more convenient to believe the lies, rather than accept the truth. The Martha Mitchell effect (“they will say you are mad” Slander and fraud their best protections….. that and the vicious attack’s and threats on anyone who dares question their right to break the law)

    Paradigm shift? Nah, they’re just getting better at silencing their ‘opponents’. And with a shift from journalism to P.R., it’s getting easier.

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