Much of U.S. Healthcare is Broken: How to Fix It

Cover of Mad In America is publishing a serialized version of Les Ruthven’s book, Much of U.S. Healthcare Is Broken: How to Fix It. Each week, a new section will be published on this page. The book is available for purchase here.

My views, which are based partly on my experience as a clinical psychologist/neuropsychologist and my 22-year career managing behavioral healthcare for large national employer health plans, are not those of most physicians or the vast majority of the media and general public. I was founding president/CEO of a behavioral health managing firm; my company was unique in the industry at that time (and now) in that our psychologists had a telephonic assessment with every employee or covered member calling for behavioral health services and were referred after the assessment to one of our 10,000 contracted psychologists, clinical social workers or addiction specialists in all 50 states and Puerto Rico. Sixty-five percent of these callers (approximately 100,000 outpatients) complained of anxiety and/or depressive symptoms. In recommending psychotherapy or behavioral treatment for these problems, our psychologists never recommended the popular and standard of care—namely, psychiatric drugs—for these problems. Since my company did not follow the conventional wisdom as a defensive measure, I soon began a review of the existing drug/behavioral outcome research, which found no support for the necessity of drug treatment for the large majority of behavioral health disorders. I expanded my review of research to include non-psychiatric health problems and my 22-year review of the health outcome research has culminated in this book.