Essays by a diverse group of writers, in the United States and abroad, engaged in rethinking psychiatry. (The directory of personal stories can be found here, and initiatives here).

We Need Your Help!

Mad in America, which was founded as a webzine in 2011, is now operating as a 501(c)(3) non-profit. This provides us with both a new challenge, and this is the exciting part, a chance to dream big. The challenge is to raise the money to pursue our bigger visions for the future.

NCMHR Does Not Speak for Me

I am appalled to read a press release by the National Coalition for Mental Health Recovery that lauds the proposals emerging from the Vice President's Task Force and accepts in principle a national database of individuals with mental health diagnoses that is "limited to those with a known history of violence."

Optimal Use of Neuroleptics, Pt. II; The Monkeys Were Not Psychotic

A major research group mentions in a paper published in an academically rigorous psychiatric journal (and I get it that some readers consider that an oxymoron) the possible influence of super-sensitivity on increasing the risk of relapse when neuroleptic drugs are stopped. Yet those of us who raise this as a reason to moderate our use of these drugs are considered biased or scientifically naive.

Making Sense of Being Crazy in a Crazy World: A Community Poll

Hey Mad in America Community! Happy New Year! I want to share an exciting project with you that's going on at The Icarus Project. Members of The Icarus project have been imagining maps and roads and labyrinths that would lead us in our journey and ground us in the moment. These have been called “wellness maps” or “mad maps” – reminder documents we create for ourselves and the people around us about our wellness goals, warning signs, strategies for health and who we trust to look out for our best interests when we’re not at our best. As I've been saying for years, “The act of figuring out what it means personally to be healthy is about learning to leave a trail back to how we want to be. The clearer we articulate it, the easier it is to get back there.”


I am quarantined in Stabilization. In front of me an old woman with cherry lipstick and a clipboard asks questions about sexual abuse, but my mind is through the square window on the door behind her. In that room I see a steel bed surrounded by emptiness. On top of it lay leather straps that are uneven in width where they’re wearing thin. Each strap has a set of holes to fasten the buckles tight, and I can see quite clearly that the ones nearest the end are circles while the ones furthest away have stretched into ovals. Tonight will be a Haldol night.

Schizophrenia Twin Research as Reported in The Gene: An Intimate History — Getting the...

In his 2016 book The Gene: An Intimate History, cancer physician and researcher Siddhartha Mukherjee chronicled the initial idea of the gene, taking readers through the history of genetics up to the current “post-genome” period by interweaving science, social history, and his own personal narrative. In the process he documented some of the crimes of the eugenics movement and the monstrous atrocities committed by German National Socialism in the name of eugenics and biology, while noting the Nazi’s promotion of twin research. He also criticized aspects of intelligence testing and genetic theories of racial inferiority based on IQ tests. At the same time, Mukherjee supported and promoted many contemporary behavioral genetics positions.

Site Updates and Posting Policy

Shortly after Mad In America launched at the beginning of the year I was invited to take over the site’s web development and to...

Chapter One: Journeying Back to Self

This blog is an attempt to make sense of what brought me into the world of psychiatry as a child and of where it...
Madwomen in the Attic logo

Making a Mad Community, from Attic to Attic: Part Two

Editor’s note: This is part two of a two-part essay. The first part described Jessica’s personal experiences with involuntary commitment, the psychiatric system, and...

Hey; Don’t Just Shoot the Messenger!

Global leaders in the critical psychiatry movement met on 18 Sep 2015 for a one-day conference to address an urgent public health issue: the iatrogenic harm caused by the over-prescription of psychiatric medications. We were treated to an expert review of the ways in which the widespread use of harmful and barely (if at all) helpful medicines has become the mainstay of psychiatry’s contribution to society. At gatherings such as this, when people discover I am a psychiatrist I often become a lightning rod for their anger and frustration. It’s okay; it comes with the job, but a couple of things happened at Roehampton which reminded me why this can happen, and why all of this is so much more complicated than the simple black-and-white “Pharma and psychiatry bad, everyone else good.”

We Are Failing Our Kids: A Few Remedies

Are colleges unrealistic in their demands academically, or are we failing to equip our children with the tools they need to live mentally and emotionally healthy lives? I’m leaning toward the latter. We need to provide more support for today’s college students and raise awareness that mental and emotional distress is not something one should suffer alone. It is our responsibility as a society to prepare our kids for life.

The Future of Mental Health Interview Series, Part II

The Future of Mental Health interview series continues with interviews this past week with James Maddux (on positive clinical psychology), Lucy Johnstone (on critical psychiatry and psychological formulation), Michael Cornwall (on being present to “madness”), Monica Cassani (on beyond meds: everything matters), Tim Carey (on parenting skills and family mental health) and Sharna Olfman (on the science and pseudoscience of children’s mental health. Here some highlights...

“Come Out for Health Week”: March 26-30, 2012

My personal + professional advocacy and mission work didn’t start with mental illness. I Chaired the University of Washington’s Lesbian, Gay, Bisexual and Transgender student...

It’s Not Just the Drugs; Misinformation Used to Push Drugs Can Also Make Mental...

I was recently talking with a young man about his anxiety, which he experiences as extreme.  When I asked him what the anxiety was...

No New Prozacs: A Dry Pipeline for New Psychiatric Drugs

In 1988, the introduction of Prozac was hailed as a breakthrough in the treatment of depression. A quarter of a century later, the prospect of a similar breakthrough in psychiatric medications seems remote. On August 19, 2013, the New York Times ran an article called, “A Dry Pipeline for Psychiatric Drugs".

Peace Making

Many of us feel at a loss to fight back against the tidal wave of negative opinion against us. We are wasting our breath arguing that the vast majority of us never commit acts of violence, that the medical model fails everyone and coercion drives people away, etc.

Reforming Prisons, Housing, Medication & Community-Based Support: Part I of a Common-Sense, Common Ground...

Is it possible to create a “Rainbow Coalition” with a common agenda of (1) reforming prisons, (2) providing affordable housing, (3) limiting the use of psychotropic medications, and (4) providing community-based mental health and psychosocial support? Prominent psychiatrist Allen Frances asked us at the Mad in America Film Festival to join such a coalition. Rather than rejecting Frances’ agenda outright — as I appeared to do in a recent Mad in America blog — we should give his proposal a fair hearing. As always, the devil is in the detail.

“Doubly Brutish”: Forensic Psychiatry and Force

It is difficult to imagine a system that could do any better at ensuring the failure of its patients, and in doing so it accomplishes the very opposite of what it claims — it increases risk for all concerned.

How Come the Word “Antipsychiatry” is so Challenging?

So here we go again; another meeting with another young person who describes how he is in an acute crisis - you may call it - and is diagnosed and prescribed neuroleptics. He is told by the doctor that he suffers from a life-long illness and he will from now on be dependent on his “medication.” As long as people are met this way I see no alternative than showing that there are alternatives. If that means being "antipsychiatry," then I am more than happy to define myself and our work in that way.

All Sorts of Realities

In previous posts in this series, I noted that the standard treatment of conditions labeled as schizophrenia (and related disorders) is to start neuroleptics early and to continue them indefinitely. This is based on the belief that untreated psychosis is bad for the brain and that relapse is much higher when the drugs are stopped than when they are continued. The rationale for this approach, and my discussion of the limitations of these assertions, were the topics of previous blogs in this series. In this final post I want to discuss how realistic this paradigm of care is.
opioid epidemic

Companies That Fueled the Opioid Epidemic Should Fund Efforts to End It

The quickest way to restore safe use of opioid prescription is to insist that the drug companies that promoted the overuse of opioids now create a pot of money to develop powerful TV, radio, and print ads, free continuing education offerings, and drug rehabilitation research.


It's amazing how much life or death conversation and thinking psych drugs inspire. In a way this seems to miss the point since our lives are obviously about something far more profound than weird chemical combinations that we don't understand. Yet they are what our first-world society has in place to respond to the life or death existential (and holy) questions and crises people tackle.

Study 329: MK, HK, SK and GSK

It is appropriate to hold a company or doctors who may be aiming to make money out of vulnerable people to a high standard when it comes to efficacy, but for those interested to advance the treatment of patients with any medical condition it is not appropriate to deny the likely existence of harms on the basis of a failure to reach a significance threshold that the very process of conducting an RCT will mean cannot be met, as investigators' attention is systematically diverted elsewhere.

Resolving to Make This Year Mean More

Every year around this time, millions of people make their New Year’s resolutions. In many ways, our resolutions mirror the willful approach that is needed to overcome psychological conditions, even those of a severe nature. We must be cautious about agents which serve to dull us to our particular circumstances and state of mind, whether it be medications or otherwise.

Return to Asylums? Let’s Not!

A recent JAMA opinion piece calling for a return to asylums – not the bad kind, the authors insist, but a “safe, modern and humane” kind of asylum – led to a radio debate. Joseph Rogers, executive director of the National Mental Health Consumers’ Self-Help Clearinghouse, talked about his experience in a state hospital: “When I hear the term ‘asylum’ I get my back up because there was no asylum. These places ... are not safe places ... You were warehoused.”