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Mad In America: Bad Science, Bad Medicine, And The Enduring Mistreatment Of The Mentally Ill Hardcover – January 1, 2002

4.7 out of 5 stars 519 ratings

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In Mad in America, medical journalist Robert Whitaker reveals an astounding truth: Schizophrenics in the United States fare worse than those in poor countries, and quite possibly worse than asylum patients did in the early nineteenth century. Indeed, Whitaker argues, modern treatments for the severely mentally ill are just old medicine in new bottles and we as a society are deluded about their efficacy. Tracing over three centuries of "cures" for madness, Whitaker shows how medical therapies-from "spinning" or "chilling" patients in colonial times to more modern methods of electroshock, lobotomy, and drugs-have been used to silence patients and dull their minds, deepening their suffering and impairing their hope of recovery. Based on exhaustive research culled from old patient medical records, historical accounts, and government documents, this haunting book raises important questions about our obligations to the mad, what it means to be "insane," and what we value most about the human mind.
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Editorial Reviews

Amazon.com Review

Hot on the heels of an optimistic film about Nobelist John Nash's schizophrenic journey comes medical journalist Robert Whitaker's disturbing exposé of the cruel and corrupt business of treating mental illness in America. Mad in America begins by surveying three centuries of mental health treatments to discover why positive outcomes for schizophrenics in the U.S. for the last 25 years have decreased--making them lower than those in developing countries. Whitaker asks, "Why should living in a country with such rich resources and advanced medical treatments for disorders of every kind, be so toxic to those who are severely mentally ill?"

One of Whitaker's answers draws upon the historic and current assumptions of a physical cause for schizophrenia. This resulted in cruel and unusual physical treatments--from ice-water immersion and bloodletting to the more contemporary electroshock, lobotomy, and drug therapies with dangerous side effects. This physical cause model leads to Whitaker's more provocative explanation: that mental illness has become a profit center. He offers disturbing details about how good business for drug companies makes for bad medicine in treating schizophrenia. From drug companies skewing their studies and patient/subjects kept in the dark about experiments to the cozy relationship between the American Psychiatric Association and drug companies, Whitaker underlines the mistreatment of the mentally ill. This courageous and compelling book succeeds as both a history of our attitudes toward mental illness and a manifesto for changing them. --Barbara Mackoff

From Publishers Weekly

Tooth removal. Bloodletting. Spinning. Ice-water baths. Electroshock therapy. These are only a few of the horrifying treatments for mental illness readers encounter in this accessible history of Western attitudes toward insanity. Whitaker, a medical writer and Pulitzer Prize finalist, argues that mental asylums in the U.S. have been run largely as "places of confinement facilities that served to segregate the misfits from society rather than as hospitals that provided medical care." His evidence is at times frightening, especially when he compares U.S. physicians' treatments of the mentally ill to medical experiments and sterilizations in Nazi Germany. Eugenicist attitudes, Whitaker argues, profoundly shaped American medicine in the first half of the 20th century, resulting in forced sterilization and other cruel treatments. Between 1907 and 1927, roughly 8,000 eugenic sterilizations were performed, while 10,000 mentally ill Americans were lobotomized in the years 1950 and 1951 alone. As late as 1933, there were no states in which insane people could legally get married. Though it covers some of the same territory as Sander Gilman's Seeing the Insane and Elaine Showalter's The Female Malady, Whitaker's richer, more detailed book will appeal to those interested in medical history, as well as anyone fascinated by Western culture's obsessive need to define and subdue the mentally ill. Agent, Kevin Lang.

Copyright 2002 Cahners Business Information, Inc.

Product details

  • Publisher ‏ : ‎ Basic Books
  • Publication date ‏ : ‎ January 1, 2002
  • Edition ‏ : ‎ First Edition
  • Language ‏ : ‎ English
  • Print length ‏ : ‎ 304 pages
  • ISBN-10 ‏ : ‎ 0738203858
  • ISBN-13 ‏ : ‎ 978-0738203850
  • Item Weight ‏ : ‎ 1.35 pounds
  • Dimensions ‏ : ‎ 6.25 x 1 x 9 inches
  • Customer Reviews:
    4.7 out of 5 stars 519 ratings

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Robert Whitaker
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Robert Whitaker is the author of four books: Mad in America, The Mapmaker's Wife, On the Laps of Gods and Anatomy of an Epidemic. His newspaper and magazine articles on the mentally ill and the pharmaceutical industry have garnered several national awards, including a George Polk Award for medical writing and a National Association of Science Writers Award for best magazine article. A series he cowrote for the Boston Globe on the abuse of mental patients in research settings was named a finalist for the Pulitzer Prize in 1998.

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4.7 out of 5 stars
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Customers find this book well-written and essential reading, particularly for those in the psychology field, with one customer noting it provides a thorough history of psychiatry. The information quality receives positive feedback for its critical content. The book's pacing receives mixed reactions, with several customers describing it as frightening and disturbing. Customers disagree on the side effects of medications discussed in the book.

65 customers mention "Readability"65 positive0 negative

Customers find the book highly readable and well-written, with many considering it a must-read, particularly for those in the psychology field.

"...She died from "treatment." Mad in America is the best book I’ve read about the cruel, corrupt, non-scientific medical field...." Read more

"...and the Enduring Mistreatment of the Mentally ill' is not only well written, but eye-opening for the mentally ill patients and the general public...." Read more

"...This was seen as perfectly acceptable and state-of-the-art medical care less than a hundred years ago...." Read more

"...This is an extremely well written text; very easy to read, thoroughly engrossing, and to our unlimited shame, absolutely true." Read more

10 customers mention "Value for money"10 positive0 negative

Customers find the book to be a must-read, with one customer noting it is comparatively inexpensive.

"...2012, Open Dialogue Therapy Again, this book is fantastic! One of the most informative books I’ve ever read...." Read more

"...the rise of modern chemistry offered psychiatrists a simple, comparatively inexpensive and more controllable form of brain damage that offered a..." Read more

"...Now I understand everything. This book is an absolute must read, particularly for anyone who is engaged in a Public or Community Mental Health..." Read more

"Incredible book. I really enjoyed reading all the history. Some parts were quite disturbing so reader discretion is advised...." Read more

15 customers mention "Pacing"6 positive9 negative

Customers have mixed reactions to the pacing of the book, with some finding it frightening and disturbing, while others describe it as dense.

"...I really enjoyed reading all the history. Some parts were quite disturbing so reader discretion is advised...." Read more

"...Eye-opening and disturbing. More so since it appears that the atrocities continue. It also serves as a valuable resource for further reading...." Read more

"This was a very disturbing book for me to read...." Read more

"This is by far one of the best books I have ever read, and one of the scariest...." Read more

6 customers mention "Side effects"3 positive3 negative

Customers have mixed opinions about the side effects of medications discussed in the book, with several noting their terrible side effects, while one customer mentions that they may allow individuals who are a danger to themselves or others.

"...book examines treatments and their effects, as well as drugs and their effects...." Read more

"...Neuropsychiatric drugs cause akathisia. In one study, 79 percent of people on neuroleptics who tried to kill themselves suffered from akathisia...." Read more

"A cautionary, compelling, frightening story of the mistreatment of the mentally ill by many of those entrusted with their care." Read more

"...His conclusion: medication worsens psychosis and causes more frequent relapses. The faulty reasoning is obvious...." Read more

Top reviews from the United States

  • Reviewed in the United States on July 29, 2022
    Format: KindleVerified Purchase
    "This is a field where fads and fancies flourish," Joint commission on Mental Illness and Mental Health, 1961

    Who is considered insane? In 1959, Jonika Upton's family committed her to a Sanatorium. The reason being, they were upset that Jonika had run off to Santa Cruz, California, several weeks earlier with a twenty-two-year-old artist boyfriend. She’d also had a boyfriend they suspected was “homosexual,” and she walked about carrying ‘Proust’ under her arm. Proust is one of the most influential authors of the 20th century, but apparently Jonika's parents were unhappy about their daughter's intellectual and social pursuits. The admissions record for Jonika described her as “alert and cooperative but [she] makes it plain that she doesn’t like it here.” Well, who would?

    At the Sanitarian, doctors ran high-voltage electric shock currents through Jonika sixty-two times in three months. Electroshocks, severe trauma to the head, were usually done to a bound, terrified person. They can lead to permanent impairment, lowered cognitive function, memory less, and diminished intuition and imagination, however the message given to the public was that it was safe, effective, and painless, yet it was barbaric and dangerous physical torture.

    Up to forty percent of patients suffered bone fractures with electroshock. If a patient resisted, they would choke him until he came to, then shock him. In California, (oh that progressive state), doctors used electroshock to quiet down noisy patients. Jonika’s doctor in Albuquerque lamented, “She has not become nearly as foggy as we might wish." At the end of treatments, she was peeing on herself, wandering around naked, and confused. She died from "treatment."

    Mad in America is the best book I’ve read about the cruel, corrupt, non-scientific medical field. It’s well researched, and a fascinating, horrifying page-turner. It should be required reading.

    Psychiatry began as a form of social control. It was heartless, judgmental, racist, classist, and concerned about money and power of the practitioners. Eugenics was the rational used for the mistreatment, sterilizations, and experimentations done to people who had experienced trauma, or a temporary break, or were Proust reading, independent young women.

    A dishonest narrative was crafted that people who had a psychotic break are lunatics or beasts to be broken, degenerate stain of humanity, social wastage, malignant biological growths, specimens to be exterminated. The chemical imbalance theory is not science based and has been disproved, but it is still believed.

    In 1883, Galton coined the term eugenics for the science that would improve the human stock. Eugenicists believe there are two classes: eugenic (well born), and cacogenic, (poorly born). Insanity was seen as the end progression of being poorly born, a fault of the germ-plasm that is poisonous slime.

    The unfit, those deemed to have inferior genes, (including many immigrants), were prohibited from marrying and sterilized. A study disproved the genetic link theory, but Dr. Rosanoff manipulated his study by expanding the definition until he got almost an exact match to the number needed to support his hypothesis.

    Gynecologist William Goodall reported that removing a woman's ovaries could cure insanity. in 1907, Indiana passed the first compulsory sterilization law. In 1921, the selling of eugenics in America began. This coincided with the wealthy being concerned about their tax burdens and wanting to do away with degenerates. Eugenicists wanted to send the mentally unfit to detention camps, not therapeutic hospitals, until they were past reproductive age.

    The U.S. was the first eugenics nation. By 1921, nearly 80 percent of the 3,233 eugenic sterilizations done in the U.S. had been performed in California. They wove a narrative that doctors found sterilization to be therapeutic. They said the mentally ill desired it.

    In 1925 Adolph Hitler wrote Mein Kampf, influenced by America, (particularly California), in which he hailed eugenics as the science that would rebuild the nation. Germany had become the most progressive nation in restricting fecundity among the unfit. Theodore Roosevelt was in favor of it too. Then the question arose, "Should a state simply kill it's insane?"

    In 1935, 83 percent of all Californians favored eugenic sterilization of the mentally ill. Alexis Carrel at the Rockefeller Institute for Medical Research wrote that the insane should be “disposed of in small euthanasic institutions supplied with proper gases.” Nazi Germany began doing this in 1940. Over eighteen months, Nazis gassed more than 700,000 mental patients. It’s disturbing to see who was making decisions about who was crazy and who wasn’t.

    After World War II, Americans looked at their mental institutions: inhumane places with prisoner-patients in foul, cruel, disgusting conditions to confine them away from society. The AMA hired John Grimes to head a committee studying mental institutions. Grimes prepared a 121-page report of dismal, inhuman conditions, which is what he found. The AMA asked him to suppress his report, he refused, and was fired.

    Early psychiatry used bleeding, purges, emetics, nausea-inducing agents, surprise plunges into water, a swinging apparatus to make patients dizzy, blistering, shaming, chemical restraints such as morphine, opium, and sedatives, straightjackets, shrink wraps, and starvation diets.

    In the 1930s, those deemed mentally ill were subjected to insulin coma, Metrazol convulsive therapy, electroshock, clitoridectomies to curb masturbation, injected with chemicals and cerebrospinal fluid, had their teeth removed, whipped, fed sheep thyroid, and given prefrontal lobotomies, (icepicks into the eye sockets to pick out the part of the brain that makes us human, gives us motivation, and higher thinking).

    Proust carrying and other people deemed unfit also were subjected to removal of their healthy organs: tonsils, parts of the colon, gall bladder, appendix, fallopian tubes, uterus, ovaries, cervix, and seminal vesicles. They were injected with malaria infected blood, given refrigeration therapy, and nitrogen instead of oxygen.

    All these things hurt or killed people, but the doctors got paid.

    The Metrazol triggered such immense seizures that could fracture bones, loosen teeth, hemorrhage organs and make the victims feel like they were being roasted alive. They cried out "in the name of humanity, stop the injections!" These doctors were torturers.

    Doctors got paid well for saying that a man's wife, or children who didn't behave as their parents wanted, were daft. People were labeled as mentally ill without any real way to measure, or by some sort of prejudice. Masturbation, imagination, a circulatory imbalance - too much blood to the head, a chemical imbalance, exhausted nerves, organic illnesses were said to be the causes.

    Then began the lobotomies, which injured the frontal lobe of the brain with an icepick inducing a childish state, apathy, and "loss of sparkle." Doctors with impressive resumes, who were bought off, pontificated on unscientific theories, and rigged their studies.

    Lobotomy, as many harmful medical fads like plastic surgeries, was sold with heavy disinformation and a strong, dishonest public relations campaigns. Lobotomies could relieve everything from tension to insomnia, panic to hallucinations, and more. Patients were given coloring books, dolls, and teddy bears afterwards. “Too bad,” some of the doctors said, "some of our patients were highly gifted and ambitious," but ya know, they had become sick because they were too inventive. Those damn artists! Besides, lobotomies yielded a pretty penny for the doctors.

    The eugenic conception of the mentally ill allowed doctors to deem frontal lobotomies a success. Some people - mostly women - sought out the icepick-in-the-eyes operation, (that was sold as "minor surgery"), as a cure for simple depression. Families had a say in who was a candidate. How would you like your dysfunctional family having a say about whether you were drugged up, shocked, or given a lobotomy? People were dying, seizing up, left incontinent, and disoriented. Ah, the miracles of medicine. The last lobotomy was done in 1954.

    Families still do scapegoat a person and set them up for a life of false diagnoses and mistreatment.

    In 1954 riding in on a fake white horse came Thorazine, a lobotomy in pill form. It took a decade to turn it into an antipsychotic. The patients were "a bother to no one," in this drugged state. In 1954, a Swiss psychiatrist said thirty-seven percent of his patients treated with chlorpromazine, (Thorazine), showed signs of Parkinson's.

    In 1951, Senator Humphrey cosponsored an amendment to the FDA that "greatly expanded the list of medications that could be obtained only with a doctor's prescription." This turned doctors into the drug vendors they are today and a much more privileged status in society. "Drug companies began showering them and their professional organizations, with their marketing dollars, and that flow of money changed the AMA almost overnight."

    As the money from drug companies poured in, the AMA dropped its critical stance toward the industry. It "stopped publishing it's book on useful drugs, abandoned its seal-of-approval program, and eliminated its requirement that pharmaceutical companies provide proof of their advertising claims." They didn't even require drugmakers to prove drugs were effective.

    Ads in journals exaggerated benefits and obscured risks. Medical journals refused to publish articles criticizing drugs and methods. Pharmaceutical companies ghostwrote the articles. They recast neuroleptics as safe, anti-schizophrenic drugs. In 1954-55 Time and The New York Times hailed Thorazine as a wonder drug. Nothing was said about Parkinson's symptoms or lethargy.

    Gregory Zilboorg, a NY psychiatrist, said the public was being grossly misled. The purpose of the drug was to make hospitalized patients easier to handle. Lawrence Kolb, former director of U.S. Public Health Services' mental-hygiene division said neuroleptics are "physically more harmful than morphine and heroin." Neuroleptics hinder recovery; patients said they turned them into zombies. People treated without drugs function better and relapse less.

    in 1961, The National Institute of Mental Health concluded the exact opposite about neuroleptics than their peers did a decade earlier. This dishonest transformation landed psychiatry as a modern discipline, able to offer "curative" pills. Pharmaceutical firms had lifelong customers and a public clamoring for pills that alter a person's behavior by shutting down vital dopaminergic nerve pathways and impairing the limbic system, (which regulates emotion), thus providing a drug-induced lobotomy. Our perceptions of how we see those with people deemed mentally ill is affected by how we see them drug-impaired.

    In Vienna in 1916-1917, there was an epidemic of the infectious encephalitis lethargica, characterized by among other things, double vision, delayed response, and lethargy. When this epidemic passed, the physical symptoms attributed to schizophrenia were dropped from the definition. The concept of schizophrenia was conceived amid diagnostic confusion. In the 1960s, American psychiatrists applied the schizophrenic tag to a wide range of people who might just be moody or non-conformists, 69 percent, as compared to 2 percent in London. American doctors were preferentially applying the label to people with black skin and the poor. African American slaves were diagnosed as mentally ill when they tried to run away. Asylums were used as poorhouses.

    David Rosenhan did a famous experiment in 1973 where he and seven other normal people went to mental hospitals. They behaved calmly, but feigned auditory hallucinations in the interview process only, saying they heard a word, "thus, empty, or hollow." Once admitted to a psych hospital they behaved normally. All but one pseudo-patient was diagnosed as schizophrenic. Rosenhan wrote, "We now know that we cannot diagnoses sanity from insanity."

    Neuropsychiatric drugs cause akathisia. In one study, 79 percent of people on neuroleptics who tried to kill themselves suffered from akathisia. 75 percent of patients treated with one Haldol injection experienced akathisia. They also became violent and suffered from poor health. In 1969 it came out that Soviets used neuroleptics to punish dissidents.

    The idea that people who struggle mentally were born with a brain that needs lifelong medication to fix a chemical imbalance is a lie. A simple dopamine excess model of schizophrenia is no longer credible. The drugs actually turned normal brains into schizophrenic ones, but that was never told to the public. The studies featured abrupt withdrawal, which is very harmful. People were dropping out of the studies due extreme problems caused by the process.

    In 1968, George Crane of NIMH sounded the alarm about tardive dyskinesia, (uncontrollable movements cause by psych drugs), but he was gaslit within his community. Finally, he talked about how the drugs had turned into cash cows. Psychiatrists compete with psychologists and didn't want to lose their standing. European doctors, however, did not go along with this lie that the drugs were "like insulin for diabetes."

    India, Nigeria, and Colombia have much better long-term outcomes than in developed countries such as the U.S.A. that treats with antipsychotics as the centerpiece of care. Whitaker doesn't have good things to say about antidepressants or benzodiazepines either. Many people are documenting their horror stories with psych drugs. A paradigm shift and call for revolution is needed.

    Some positive alternatives include medication free wards and de-prescribing practices. Also, below I list some hopeful approaches, (which have asterisks), in this timeline of significant events.

    *1800s Quakers: moral treatment, treated people as Brethren, produced remarkably good results.
    *1971, Soteria House in Santa Clara gave care to residents. They were present with them.
    1980s, NAMI embraced the biological model and focused on drugs (boo)
    1984 Borison and Diamond fabricated results about Thorazine - storytelling re: atypicals
    *1987, Hearing Voices Groups
    1990, Clozaril by Sandoz bundled with blood tests at $9,000 year
    1990s, Clinical researchers serving drug companies boomed
    *1992, Swiss Scientists replicated Soteria care
    1998, 92 percent of schizophrenics in American were on antipsychotics.
    *2012, Open Dialogue Therapy

    Again, this book is fantastic! One of the most informative books I’ve ever read. I also recommend the documentary.
    38 people found this helpful
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  • Reviewed in the United States on June 10, 2011
    'Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally ill' is not only well written, but eye-opening for the mentally ill patients and the general public. The mentally ill have had a constant history of mistreatment. From beatings, torture, drownings, sterilizations, lobotomies, electroshock, neuroleptics, the loss of civil liberties in general, and now atypical drugs, the severely mentally ill have been more of a scientific study for psychiatrists rather than patients. In the last half of the 20th century, the mentally ill became nothing more to the psychiatric industry than a means to make money. The greatest era of the treatment of psychiatric patients was the era of "moral treatment" in the midst of the 19th century, and recovery rates were much higher because instead of crowding the "mentally ill" into mental hospitals, the mental patients were treated with love and kindness. Robert Whitaker gives an in-depth review of the history of mistreatment within the psychiatric system, and this book should be required before anyone receives a doctorate in psychiatry.

    As a former psychiatric patient, I am well aware of the the mishaps within the psychiatric system. I have entered a mental hospital twice voluntarily. The first time I went to get clearance to go back to school. I had a disturbing "feeling" that a fellow student was going to commit suicide, so I went to the school authorities warning that something was going to happen to this student. They thought I was, in layman's terms, going crazy, and they mandated a clearance from the mental hospital before I went back to school. I showed up to the mental hospital that night, and three days into the mental hospital, my mom received a phone call from the Vice President of Student Affairs that the student of whom I warned the school had his house burn down. Everyone was stunned, but I wasn't surprised. I don't know how exactly I knew something was going to happen to this student, but I did know. Regardless, my psychiatrist made me stay the entire two weeks within the hospital.

    During the two weeks, I noticed how they were not willing to let me go. I had been taught to stand up to wrong opinions in college, and I felt that the psychiatrist's opinion on how I should think was wrong. Psychiatry taps into many civil liberties violations, and the 1st Amendment is one of those. Without the freedom of thought, we do not have meaningful freedom of speech. With that said, they have to release patients after two weeks. Once I was released from the inpatient program, they made me attend the outpatient program before I would be cleared to go back to school.

    The outpatient program was more of a classroom setting. Once again, I learned in the classroom to STAND UP to the head of the classroom when I believed that person was wrong. Needless to say, I actually caught myself debating with the psychologists and psychiatrists running the system. They had upped my dosage of Seroquel up to 400mg at night, my Abilify was upped to 30mg, I was on Klonopin, and I was also on the antidepressant Paxil. Yet despite all of this medication, I happened to still be thinking very clearly for someone in my position. The more I challenged their opinion, the more they resisted my opinion with coercion. Once the head psychologist within the outpatient program recommended that I go back inside the mental hospital, I denied. At this time, I had a 3.95 GPA with 107 hours complete for school, but I KNEW that psychiatry was wrong. I refused to go back into the hospital, and I did not receive clearance to go back to college.

    I will explain my second institutionalization later, but first, I would like to touch on Whitaker's book. Whitaker most certainly puts up a legitimate argument that the psychiatric system should be reformed. My belief, however, is that psychiatry goes beyond that. Do psychiatric patients not have the RIGHT to be irrational? It is the basis of the First Amendment of the United States to have the freedom of thought. Without it, our speech is utterly meaningless. How do you decide what is "rational" and what is "irrational" when it comes to civil liberties? To be frank, there is no line for freedom of speech! No matter how irrational someone becomes, they have a right to speak. As John Stuart Mill said in 'On Liberty,' "If all mankind minus one, were of one opinion, and only one person were of the contrary opinion, mankind would be no more justified in silencing that one person, than he, if he had the power, would be justified in silencing mankind." In essence, an opinion does not have to be respected nor appreciated, but a person has a right to believe and speak what he/she chooses.

    As for the "pragmatic" solution, psychiatry does need to be reformed, and to do that, Whitaker explains in 'Mad in America' the success of what was known as "moral treatment." Before physicians grabbed hold of the "mentally ill" after the Civil War to replace their war clients, the Religious Society of Friends took a new philosophy with how to handle the "mad," and in 1817, the Quakers opened the first moral-treatment asylum in America. America actually embraced this new idea for the humane treatment of the "mad" because it was a part of the newly formed ideal of liberty in America. In moral treatment, patients were treated with kindness and respect. Instead of the spinning board used by Benjamin Rush, patients attended plays, played games, and were given a sense as an equal human being (Granted, Benjamin Rush was a great pioneer for his time. He brought patients out of the chain links in the basements and allowed for much more freedom for those who "behaved"). Sadly, moral treatment lost it's prevalence in society when Dorthea Dix wanted to spread it to everyone. She had the most well intentions, but passing state legislation called for a much higher number of patients and less quality of faculty. Moral treatment worked because it gave each patient individual attention and individual care. The asylums that practiced moral treatment beforehand made sure that each and every member of authority was not inclined to overreact to the "craziness" of the patients, and that they were level headed. This sincere approach by Dix was the beginning of the end of "moral treatment" as we came to know it, but the final death of the system came when the Civil War ended. Physicians, needing to replace their former Civil War patients, began to once again use "medical" treatments on the insane.

    The pragmatic solution is what we as a society need to embrace once again. To get rid of the psychiatric system is not pragmatic, nor is that what I want; however, it does need to change as we know it. As Whitaker mentions throughout his book, studies consistently show that those who never get on antipsychotics are the patients that are the least likely to relapse. After that, the relapse rate grows, and once you start taking antipsychotic medication, you are at a much higher risk of relapse. Patients should be admitted and attempted to be stabilized the first week (maybe the second), and if they cannot be stabilized, then medication should become the last option. It should not be the first option because of the dangers of going on and off of medication. Anyone who decides to get off of medication should ALWAYS do so with a doctor. I, however, did not do this, and that led to my second stay in the mental hospital.

    As I entered the mental hospital the second time, I was a complete mess. I not only stopped taking my medication abruptly, but I also got hooked on Adderall which I was buying off the street. I felt that Adderall would give me the energy that I had before I started antipsychotics, but it turns out that while it gave me energy, it also gave me delusions that I was speaking with Satan and God through means of other people. It took me a very long time to recover from my mistakes that I committed before I entered the mental hospital the second time, and I even drove up to the college and got arrested by campus police in that time. The most important fact in ALL OF THIS is that none of mistakes nor my arrest would have happened if it wasn't for the malpractice of my first institutionalization. What they should have done was make sure I was stable the first time and then released me. As I said before, the issue of the psychiatric institution runs deep, and I was not about to back down from challenging authority when I felt they were wrong. Egos must be put aside if patients are to get truly "better."

    Robert Whitaker also notes how all the studies shown to support a so-called "chemical imbalance" in the brain have been fundamentally flawed and propagandized to the public as fact. They are not fact. There has NEVER been a study that didn't have the influence of drugs and shown any evidence of a chemical imbalance. As noted in the book, the studies of those who never took neuroleptics or atypicals in the first place are shown to not have any difference in dopamine receptors (Too high of dopamine flow is one "chemical imbalance" theory for the schizophrenics). After the introduction to the neuroleptics/atypical drugs, however, studies actually appear to show that an increase in dopamine receptors is caused by a reaction from the brain. The neuroleptics targeted dopamine and shut down the flow of dopamine receptors. The increase in dopamine has only been shown AFTER the introduction of the drugs into one's system.

    Pharmaceutical companies and their researchers also have never produced a sincere study; however, the FDA does not approve based on the sincerity of the study, but instead they approve based on if the drugs lower psychotic episodes. They base this on short-term studies, and if the antipsychotic does a "better" job than the placebo, then the drug is approved. The problem with the studies and why the studies are fundamentally flawed in the first place lies in that patients are NEVER drug naive. They are abruptly withdrawn from the drugs they are on, and then placed on the placebo, the new drug being tested, or the old drug they were initially on. Sudden withdraw of the psychiatric drugs I was placed on caused me to stare at the sun for 8 hours. To have a true, honest study, the pharmaceutical companies would have to include first time patients experiencing a psychotic episode whom have never been exposed to psychiatric medicine. Luckily, in Finland, they are doing these studies, and for the first time since "moral treatment," it is being shown that quality care is what works- not medication. Granted, there are some people that benefit from medication, but studies show that the majority of people experiencing psychosis are *worsened* by medication. As noted in the Afterword to the Revised Edition of Whitaker's book, Finland is beginning studies that promote doing what I said needs to be done in the United States. Finland is beginning to attempt to stabilize first, and drug later. If one is stabilized without psychiatric drugs, then they are not placed on the drugs. Studies have shown over and over that the unmedicated are the ones that truly "get better."

    I really would have been homeless or dead if I did not enter the mental hospital the second time, but once I got out, I once again stopped taking my medication abruptly. I spent one day staring at the sun for eight hours which left my vision permanently damaged. If it were not for the care of my family (and eventually my best friend), I may be dead. Online socializing and online poker have also helped me recover. Luckily, I do not see any brain damage. I am actually accomplishing more voluntary reading than I ever have in my lifetime. I am truly happy. I don't have much money, but I have self-respect and love from others. I am drug free (outside of coffee, which is a drug) and ready to take on the world. I WILL pull a Diogenes of Sinope if I must to remain myself.

    This review of this book was a review from my own personal perspective. I could not give a review without giving my personal experience. It is important to note how one reacts when a person believes he/she is falsely incarcerated or being treated disrespectfully. There are a lot of stigmatizing beliefs about how the "mentally ill" cannot help but act out of control, but those who say that should put themselves in the shoes of the mentally ill that are in a mental hospital. How would YOU like to be locked up and be trained like a pet on how to act? In essence, patients feel dehumanized a lot of times in mental hospitals, and I know firsthand why that is. Patients' opinions are virtually meaningless in a mental hospital, and it is more an issue on how the psychiatrist and the psychiatric staff want you to behave. THEY DO NOT CARE about a patient's opinion- they care if the patient behaves accordingly or not.
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Top reviews from other countries

  • C. T. Fernandez Salido
    1.0 out of 5 stars Rubbish
    Reviewed in Spain on November 27, 2018
    Mad in America is a perfect example of not letting reality cloud you prejudices. The author writes extensively about a subject on which he has read extensively, and yet managed to learn almost nothing. I am the father of a person with a mental condition. I am nothing but grateful to the psychiatrists who have helped him and taught him to manage his condition.
  • Edward Fox
    5.0 out of 5 stars Buy it. Read it.
    Reviewed in Canada on February 17, 2019
    This is one of the most important books of our time, spotlighting a silent holocaust masquerading as a medical specialty. Pulitzer prize nominee medical journalist Robert Whitaker assembles and presents the facts soberly without shrill polemics, letting them speak for themselves. As someone who watched a woman friend I've known for decades with good administrative job turned into a basket-case living in a group home, heavily"medicated," on disability, in a little over a year – I feel certain the result of massive drug cocktails combined with 14 sessions of electroshock – I've seen close up what he talks about. I later learned hers is a far from uncommon case of "iatrogenic" (doctor caused) injury. My friend wasn't "crazy," just under extreme duress dealing with a chronically ill husband.
  • DM Willcocks
    5.0 out of 5 stars Brilliant
    Reviewed in the United Kingdom on March 27, 2013
    I very strongly recommend this book. its extremely well written and a real eye opener into how we have been failing people with mental health difficulties for years and how we are duped by the drugs companies and the powers that be. This book and Robert's other book on the subject An Anatomy of an Epidemic should be read by every prescriber of psychotropic medications. It is scary stuff and a massive issue. I do not usually do reviews but this is so important that the information and the facts that he presents need to be out there and to be acted on by policy makers and the profession as a whole. Go out and but theses books!!
  • Amazon Customer
    5.0 out of 5 stars Fantastic read
    Reviewed in Australia on February 22, 2021
    A very well written and disturbing book; it should be carefully studied by those who care for, or about, the mentally ill.
  • Tashi
    5.0 out of 5 stars Great book for physicians and philosophers
    Reviewed in Italy on November 10, 2019
    Format: PaperbackVerified Purchase
    Great book, may be considered the nephew of Foucault's "Histoire de la folie"