Harvard’s newest Health and Human Rights issue features a special section dedicated to institutional corruption and human rights in mental health. The editorial introducing the special section, written by Alicia Ely Yamin (of Harvard University), Camila Gianella Malca (of the Pontifical Catholic University of Perú), and Daniela Cepeda Cuadrado (of the Christian Michelsen Institute), asks an important question: why has progress on paper towards human rights based treatment in mental health not translated to meaningful change in the way mental healthcare systems actually treat people?
The authors argue that question can be answered in part through the concept of institutional corruption. While ordinary corruption typically involves an illegal act such as bribery or fraud, institutional corruption involves systemic, often invisible forces that divert an institution from its stated goals and undermines its trustworthiness.
Institutional corruption in mental healthcare has many forms, including forced psychiatric detention, which the U.N. has compared to torture, and narrow medical models that fail to address people’s real needs, especially in low- and middle-income countries. This concept does not describe a broken system, but one that harms people when it operates exactly as intended.
The Road to Institutional Corruption
The authors point to the Global South as an example of how institutional corruption can fester in mental healthcare systems. Tax fraud and illicit financial practices cost the region $1.7 trillion per year and drive countries into immense debt. The debt has grown so large that 54 countries spend more money managing their debt than they do on healthcare. This enormous debt leads to calls for privatization and cost-cutting measures in systems such as healthcare. Mental healthcare, often a low priority already, is especially vulnerable to these types of cuts.
As public money is diverted away from mental healthcare, private money and foreign interests fill the gap. As governments grow to rely more on private providers, pharmaceutical companies, and donor-driven programs, decisions about mental health care may be guided more by profit, efficiency, or international agendas than by local needs or human rights principles.
Many of the articles included in the special section are also critical of the dominant biomedical model of mental health. This approach tends to medicalize mental health issues, locate them within individuals, and treat them with stigma inducing diagnoses and dangerous psychiatric drugs.
While medical care may be appropriate for some service users, many of the authors argue that overreliance on this model can detract from systemic and social causes of poor mental health such as poverty, discrimination, trauma, lack of access to suitable housing, employment issues, and lack of community support, while leaving mental healthcare systems “trapped in colonialist dynamics and mentalities.” When combined with industry interests and international agendas, this narrow focus may reinforce systems that prioritize profit and Western ways of thinking and being rather than humane and effective treatment.
Featured Papers
The first paper in the special section, authored by Alicia Ely Yamin and Camila Gianella Malca, argues that the initial step in adopting approaches to mental healthcare that are truly rights-based is to go beyond calling for equity of access and to interrogate the power structures that often harm service users. The authors call for upending the dominance of the biomedical model of mental health, confronting institutional corruption, exploring how institutional corruption leads to bad policy, and questioning the prioritization of favorable metrics that prop up harmful practices and existing presumptions.
Lisa Cosgrove’s contribution to the special section explores the marketing of postpartum distress as a “silent health crisis” and the expensive, dangerous, likely ineffective drug (zuranolone) approved by the FDA to treat it. The author argues that the medicalization of distress after childbirth is essentially an advertisement for zuranolone, made possible by the completely legal influence of industry money and power over regulatory agencies and professional associations. To combat this kind of institutional corruption, Cosgrove calls for a “moral renaissance” in mental health narratives; a monumental shift away from medicalized models towards human rights-based frameworks.
Robert Whitaker’s piece explores the global export of the biomedical model of mental health and the institutional corruption that made this model possible in the first place. The author explains that the American Psychiatric Association (APA) pushed the chemical imbalance hypothesis of “mental illness” as an extraordinary medical breakthrough in order to gain prestige. The pharmaceutical industry saw this “breakthrough” as an opportunity to sell more of its products and showered the APA and its members with funding. Ultimately, this partnership established the chemical imbalance hypothesis as a fact in popular discourse.
However, research could not validate the chemical imbalance hypothesis, long-term studies of industry drugs showed no benefits, and this model led to poor public health outcomes. Despite these facts, the chemical imbalance myth and the biomedical model of mental health have been exported across the globe. Whitaker argues that this model and its global export were only possible due to psychiatric professionals abandoning their obligation of informed consent and refusing to be reliable narrators of their own research.
Alberto Vásquez Encalada writes about how lack of investment in mental health and weak regulations have paved the way for private pharmacy chains to commodify mental health in Peru. Lack of access to mental health resources and trained professionals leads many people in Peru to seek mental health services through pharmacies. These private pharmacies exploit regulatory loopholes and engage in ethically suspect practices such as price fixing, sales without prescriptions, collusion against competition, blatant conflicts of interest in recommending their own expensive drugs over generics, and using their considerable resources to influence laws and regulations.
The result of this institutional corruption is a mental health system that prioritizes private profits at the expense of service user health. The author recommends both short-term solutions to make drugs more accessible through public systems that may not be as influenced by profit, as well as a longer-term move away from medication-centric models of mental health.
Other papers in the special section provide case studies of institutional corruption in South Africa, Serbia, Eastern Europe, treatment of adolescents in Peru, and the global marketing of weight-loss drugs.
Conclusion
Collectively, the authors featured in this special section call for a more honest and politically informed approach to mental health reform. Human rights must be paramount both in individual treatment decisions and at the level of institutions, funding structures, professional cultures, and global health governance. This requires mental health professionals, service users, and the general public to question dominant models, call out conflicts of interest, and center the voices of people with lived experience.
The authors argue that transforming mental health systems requires more than good intentions or new laws. It requires confronting the deeper institutional forces that quietly shape how care is delivered, and how human rights are violated. Only by reckoning with these forces can mental health systems truly serve the people they are meant to support.
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Yamin, A. E., Malca, C. G., & Cuadrado, D. C. (2025). Examining Institutional Corruption in Mental Health: A Key to Transformative Human Rights Approaches. Health and Human Rights, 27(2). (Link)
Creating policy is only one tool when the data shows loss of lives in a false economy. How to witness better ethics in collaborative decision-making in learning to learn as a pathway into awe and discovery?
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Respecting peoples human rights should have already been the default way the system operated to begin with. The fact that peoples constitutional rights have been violated for decades says a lot about the values of this society. People have been being abused for decades by this corrupt system and so few people have spoken out against it. There is something incredibly wrong with the society we live in because this never should have been acceptable conduct to begin with. Millions of people have been harmed by the poisons they call antidepressants and antipsychotics and thousands more have committed acts of suicide and homicide because of them. It concerns me greatly that things have been allowed to reach this terrible state without any real efforts being made by institutions to stop this abuse and harm being done to people.
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The default is to maximise financial gains for the lowest possible output and effort.
If people stopped popping pills, pharma would collapse.
If people stopped listening to fads and trends and propaganda pharma would collapse.
If people stopped wanting immediate gratification and instant fixes, pharma would collapse.
Wondering how much money LMIC individuals spend on pharma, that could otherwise be spent on proper foods. ?? If a pharmacist is accessible then likely a grocery store or supermarket or produce market is also available.
If mobile phones and services can be acquired and paid for, then why not purchase some fresh produce as well. ? ?
The enjoyment of eating fat greasy highly processed fast foods offset by the choice of popping a pill.
Interesting.
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Harvard is a terrible university which violates the rights of people in their “mental health” hospitals so this article is ironic and hypocritical. I asked if people even have a say in their treatment and if they are allowed to refusing taking drugs. The full hospitalization program at McLean wouldn’t answer me so I’m going to assume that means no. The partial program doesn’t force people to take drugs but provides medication education which is nothing but brainwashing and indoctrination made to make people think that brain destroying poisons are a good idea to try. This is shameful behavior by everyone involved. It’s beyond unethical and immoral but they don’t care. All they’re doing is contributing to this corruption. It’s nothing but a sick and twisted joke.
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And where does the University’s funding come from ? Directly or indirectly ? Would the answer be Big Pharma and other similar players ? Science. Research. Technology. All chasing recycled innovations that bring in the pots of gold.
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Maybe the following comment starts oddly, but I hope it ends somewhere near a relevant point.
A thought about the living: all life is, in some sense, one living thing. All life on Earth is now thought to have begun in a single cell—LUCA, the last universal common ancestor. That name itself is misleading, as if our origin were something long dead and left behind. But the life animating LUCA did not die. It divided.
One cell became two. Two became four. Four became eight. This was not a multiplication of life, but a division of it. Fast forward to today, and that same continuous life, still dividing at a cellular level, now experiences the universe through incredible diversity.
The nature of this living whole appears to be love. What does life love? Diversity. Variation. Difference. Experimentation. That is how and perhaps why life persists.
The systems that govern us, however, were not built with this understanding—or concern. They arose from conquest, domination, and the interests of “winners”: kings, conquerors, and those who benefited from concentrated power. These systems reward conformity to a deeply flawed idea—that order must come from hierarchy, enforced through law, money, and authority.
In doing so, humans have gradually lost touch with what seems to be life’s very reason for being: the flourishing of diversity through which to experience this universe. Were collections of humans left to their own, a wide variety of life and ways of living would prevail.
Hierarchical systems that span across communities, states, and nations suppress natural local variation. Authority exercised from a distance replaces relationship with compliance. When power is concentrated, diversity is not merely neglected—it is actively eliminated, because difference threatens control.
This is where the mental health system enters the picture. The psych industry has tasked itself with treating the psychological consequences of living within these arrangements. Much of what is labeled “mental illness” is, in reality, a rational response to chronic insecurity, social fragmentation, loss of agency, and forced adaptation to systems misaligned with human needs.
In that sense, the mental health industry functions as a handmaiden to broader societal dysfunction. It absorbs the suffering these systems produce, medicalizes it, and attempts to return people to “functioning” within the same conditions that produced the distress in the first place. A system can’t really heal people while the environment making them unwell remains intact.
It overlooks the root sources of suffering by locating them entirely within individuals’ brains, chemistry, or behaviors—thereby reinforcing the very (loveless) systems that require such interventions to begin with.
That’s why these systems are ultimately doomed to fail. They operate against the nature of life itself. By design, they narrow possibility so that a small number of power-seeking, small-minded people can decide for everyone else.
Life does not thrive under uniformity.
It thrives under freedom, difference, and mutual coexistence.
Any system that can’t tolerate this will eventually collapse—because life won’t conform to dysfunctional human systems forever.
As George Carlin pointed out, it’s not the world that’s going to go away; it’s not going to be the end of nature. It’s US who’s going away. As he said it: “Pack your shit, folks, we’re going away.”
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Well said. Couldn’t have put it better myself. I agree these systems are destined to fail. I just hope that for mankind’s sake that it’s sooner rather than later. These systems are already being propped up by artificial means and should have collapsed a long time ago. It shouldn’t be much longer now but who knows for how much longer they can continue to drag this out.
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I think they are literally designed to fail. Success means losing clients! We can’t have our clients getting better! Where will we get our multi-billion dollar blockbuster drugs?
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“Success means losing clients!”
Just adding a one person report.
I was mis diagnosed in perimenopause (25 years ago) as having Bipolar Disorder. I had a hormonal headache everyday for 12 years – which went away when I passed through the change. Psychiatric Polypharmacy, I believe, would have killed me, if I hadn’t simply walked away. 8 years ago, and counting – no symptoms, no doctors, no hospitals. I never cleared my name. The mis diagnosis stands in the EHR I fled.
What is staggering to me (now) is that I have apparently cured myself of stage 3 Chronic Kidney Disease (a diagnosis I have had for 20 years – also stemming from the same health care system responsible for the mental illness mis diagnosis), by drinking 4 cups of water in the hour of the blood test – per my new PCP, in a new location.
I don’t even know how to think about, what is yet another mis diagnosis? This mis diagnosis involves a blood test. There once was a Potassium level in a blood test that alarmed everyone. They gave me the talk about a transplant. That Potassium level never repeated.
Did the polypharmacy cause that? Unknown, of course.
FWIW – my conclusion was that badly behaved health care system was exploiting my living body for every insurance dollar they could claim.
A major metropolitan area, by the way.
Success, for me, was betting on Mother Nature (because I had nothing to loose – “they” obviously didn’t know). Imagine that? Drinking water and NOT consuming fist fulls of multiple pills has resulted in a healthy 70 year old woman (for now). Yes, I eat my vegetables.
Without trust – “they” have nothing.
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Did you take Lithium? Lithium is famous for messing with your kidneys.
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“Without trust – “they” have nothing.”
Exactly. Few people question their doctor’s diagnosis, let alone the “treatment” that follows — treatments that often create more problems than they solve.
The mental health system runs on misplaced trust.
But it goes deeper than this: ego/identity/self-image is involved, meaning doctors often are threatened when their knowledge is questioned by patients.
Many doctors have a god complex.
The same goes for many psychotherapists.
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Could you say more about the “God complex”?. To deepen an appreciation for self determination when better knowledge seemingly is discovered and shared on this site and beyond are grounds for further questions! Maybe even one creates a space in thought to engage? Tks for the queries.
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Hi, Bill,
This appears under my name but I don’t believe I am the one you were replying to. Can you clarify the intended recipient?
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This reply to Steve McCrea, though difficult to place when the only reply afforded in the system of this site (since an extended conversation was occurring, is to “report comment”. When Birdsong made the statement, “Many doctors have a god complex” I replied with a capital G, which if a reader ponders the theology or one more of a lower case “god”, the idea would be appreciated for further exploration of the idea. My peculiar journey was tensioned by the family doctor who was also my uncle. And to understand family history and the migration of the parents adds insight. To understand each state and the beginning of the “medical arts” may elevate the discourse if a systems approach were used. As the technologies have improved, and a keyboard can convey typed words, the conscious and unconscious meaning of having a conversation with MadinAmerica Readers or staff is important. But the underlying question for me has been one of social justice and individual justice, when no attorney seemingly could be found to address the lack of administration and governance. To witness one lose their life while in the “care” of the State while being forced to take the medications if one wanted to be released seems to have some problems with the Patients Rights. And even then to have “rights”, to find the legal profession to enforce the rights after the fact, may not necessarily need more laws but a higher intelligence and learned minds to really ask the questions in need of being asked. Hence, to clarify the intended recipient, is within myself, but perhaps is a small piece of all of us. Sometimes within the indenting format, I have lost the context of when the readers post and to whom. Since now all that is left is “Report Comment” I thought this post and where it will land would be understood in context.
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Howdy, Bill!
You don’t need to over think it — just ask your favorite flavor of AI what a “G(g)od complex” is. Here’s the definition I use:
God complex: a pattern where someone behaves as if they’re infallible, uniquely superior, or entitled to unquestioned authority — and the experience of being around someone who refuses to recognize their own limits or the autonomy of others.
And yes — this describes a lot of people in the medical and “helping” professions. Surprising, right.
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perhaps the best most important article ive read on these pages (and Im only on like the second paragraph)
thank you
person being murdered way too slowly with the torture of criminal unprosecuted psychiatry, due 100% to corruption because I did not seek or need psychiatry
all sorts of yes corruption documented
occ witchhunt
link shared on bluesky fyi
robert whitaker, I dream of winning the lottery (who doesnt?) and giving Mad a boat load. is there a contingency plan for the next generation of leaders at Mad?
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“This concept does not describe a broken system, but one that harms people when it operates exactly as intended.”
Make t shirts raise money awareness
Psychiatry is not a broken system, but one that harms people when it operates exactly as intended.
idea?
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That same sentence resonated with me as well. I think it applies equally to our systems of governance—political, economic, social, and even religious—which foster the conditions under which mental distress flourishes.
These systems are not malfunctioning; they are largely designed to concentrate power and condition people to be dependent on institutions and their “leaders.” Concentrated power doesn’t exist in a vacuum—it is taken from individuals the moment people are viewed and managed as masses rather than as persons and communities.
What may be missing, and increasingly denied, is a meaningful degree of self-determination. Without it, distress is not an anomaly to be treated, but a predictable outcome of systems operating exactly as designed.
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The mental health system isn’t broken at all. It’s working exactly as it was designed to work. And that’s the real problem: it’s built on the absurd — and highly profitable — belief that emotional pain is medical defect that always requires professional “intervention”.
Translation: Psychiatry business is misinterpretation, not medicine.
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Odd to talk about “commodifying mental heath services in Peru” and not mention that the commodification of “mental health” services is the entire purpose of the Western psychiatric system, and that it happens in all countries, including the richest and most powerful. The idea that this is somehow worse in the third world seems a bit bizarre. The same forces corrupt everyday “services” in every country on the planet.
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This blog provides a critical and necessary examination of the systemic failures within global mental healthcare systems, powerfully arguing that institutional corruption and profit-driven structures have created systems that harm the very people they are meant to support, despite legal reforms.The model of care provided by the DEAN Foundation offers a powerful counterpoint to the institutional corruption described in the article. Operating in India, the foundation demonstrates how a truly human rights-based approach to end-of-life care can function. They provide holistic hospice and palliative care that treats patients as whole persons, addressing not just physical pain but also the social, emotional, and spiritual suffering they call “Total Pain.” Their work is centered on empowering patients, allowing them to ventilate feelings and find strength in themselves, which stands in stark contrast to systems that prioritize profit or narrow biomedical models. By providing this dignified, person-centered, and non-discriminatory care, the DEAN Foundation exemplifies a system intentionally designed to serve human needs, not exploit them.
Website – https://deanfoundation.org/hospice-and-palliative-care.html
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The only way I can answer your question Steve, appears to be in this non chained reply. I think you are the moderator, so know that I have no expectation that you post this reply.
I had taken Lithium – not long term (maybe a year or 2), not high dosage (less then 900mg), and I had not taken any lithium in over a year, at the time of the CKD kidney diagnosis. The stage 3 kidney disease was blamed on the lithium, as you know.
This is all apparently malarkey. 20 years later, twice now, 2 separate PCPs, 2 separate labs, 2 separate states – 4 cups of water, within an hour of the test, and the Creatinine is fine. I’m cured! What this PCP says is that I never had stage 3 CKD, because stage 3 CKD doesn’t get cured. It’s progressive and incurable.
On some level I must have known. I only saw a nephrologist twice, decades ago.
It is another mis diagnosis out of the same institutionally corrupted healthcare system responsible for the mental health mis diagnosis decades ago. Just for a description – major metropolitan area controlled by 3 corporate health conglomerates. All predators.
What I recall from that era – 20 years ago, was going to a different doctor each week, and they all were telling me that I was going to die. When I had no idea what they were talking about? All that was wrong with me was that I had a hormonal headache.
I stopped going to any doctors!
Decades ago, in hindsight, it could have been sexism heaped on the shoulders of a woman in a doctors office, without a witness?
They did a pregnancy test on a 62 year old woman! (me) There can only be one reason for that – the insurance money.
Feel free to delete my original reply, if this personal account is inappropriate posted here. I am still grappling with the shock of a 20 year deadly disease not being true.
Between institutional corruption and making humans patients for life … I responded.
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Your personal account is entirely appropriate and very touching, actually. It amazes me consistently how off base doctors can be, and how absolutely INSISTENT they can be that they are right, even when the evidence shows the opposite. Which of course means those doctors don’t learn anything and continue to perpetrate the same nonsense. Fortunately not ALL doctors are like that, but I screen my care providers very carefully in general, and anyone who thinks they get to push me around and tell me what to do quickly becomes a former provider. But I know not everyone has the skills, knowledge or freedom to do that. Many if not most learn “the hard way,” as you did, that trusting the doctor unquestioningly can be very dangerous to your health!
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I did a little thinking about this term “institutional corruption”, having never applied this term to what I experienced, before.
#1 all of the over diagnosis, over testing, over medication came from this 3 conglomerate metropolitan area. As compared to 4 other states I have acquired healthcare in.
Probing A.I. a little to see what it knows … something about a “all claims” database, there is plenty of evidence this is not some personal failure of mine, but a systematic issue … not only in this location, but across the U.S. Effectively – it is a scam. I was scammed, because I trusted “the white coat”.
It is apparently widely known that an elderly woman should never confront the U.S. healthcare system alone (without a witness). I am stubborn. It shouldn’t be this way.
I’m not sure what I am supposed to know, that I don’t know … but I moved when I confronted that healthcare system for the last time, and the PCP was trying to sell me a peeing specialist. “He’s really good!” Now I don’t know much, but I do know that peeing for elderly people, doesn’t work the same way it did in our prime – and this is not a medical problem, it’s a management problem. It was an obvious upsell, from a doctor who has a conglomerate for a boss.
For the benefit of others who may not know the way out of this trap – if you can private pay $100 a month … secure a doctor running a “direct primary care” concierge service – it is the way out of the insurance model. That doctor earns their money from your subscription – not by exploiting your body via the insurance model. Estimated cost $1200 a year. All the access you want.
Maybe you can’t move. I still miss my home. And there are plenty of screw ups with individuals running their own businesses. But at least they are honest efforts, rather than institutional corruption.
Thanks for applying this term “institutional corruption” to the mental health business, but indeed – this term applies across the entire US healthcare system. Going without healthcare probably has been the greatest gift of my life.
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Hi I’m just curious to know what exactly was your health issue. It was not a mental health problem or your kidneys, did you ever receive any diagnosis for your initial headache problem. I’m curious because I believe I’m might be being treated for mental health issues that could actually be a psychological problem and/or I’m on too many medications, the wrong ones or dosages. Also possibly if I do have a mental health issue I might be being treated for the wrong one?
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Harvard along with the CIA subjected people to experiments under the MK Ultra program. What they did to those people was beyond immoral and unethical. As far as I know Harvard has never apologized to any of the people that it allowed to be harmed on its campus or tried to help them recover from the damage done to them. They could start to make a things right by doing that. One of the people who was subjected to these experiments went onto become the Unabomber. The legacy of this cruel and sadistic behavior continues on today in their mental health hospitals with the usage of ECT, antidepressants, and antipsychotics. They still see other human beings as objects they can freely experiment on. Where is the accountability for all the people who have been injured by these barbaric practices? Until those who are harming others are held responsible for their actions nothing will change.
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Excellent article! One of the very best I’ve come across on this site. Thank you.
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post of Robert Whitaker’s article on Bluesky summary
occ witchhunt Robert Whitaker, founder Mad in America, piece a MUST READ. I believe slain filmmaker Rob Reiner would have been greatly moved by this information. Chemical Imbalance is a farce used to give psychiatry a false legitimacy. Outcomes for depression schizophrenia suicide have worsened.
I shared this piece with PBS in a rebuttal to a horrible piece, aired dec 24, a commentary from a politician who was physically attacked by his son, who then committed suicide. All the cliches were repeated.
I am trying to push Whitaker, Brooke Siem, Rob Ripond onto the mass media. It’s a no win fight so far, but I encourage others to spread names of better informed talking heads to the mass media, in letters to the editor, with the aim of stopping the spread of misinformation.
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