Mad In America Bad Science Bad Medicine and The Enduring Mistreatment of the Mentally Ill
Mad In America Bad Science Bad Medicine and The Enduring Mistreatment of the Mentally Ill
A riveting social and medical history of madness in America, from the seventeenth century to today.
In Mad in America, medical journalist Robert Whitaker reveals an astounding truth: Schizophrenics in the United States currently fare worse than patients in the world’s poorest countries, and quite possibly worse than asylum patients did in the early nineteenth century. With a muckraker’s passion, Whitaker argues that modern treatments for the severely mentally ill are just old medicine in new bottles, and that we as a society are deeply deluded about their efficacy. Tracing over three centuries of “cures” for madness, Whitaker shows how medical therapies have been used to silence patients and dull their minds. He tells of the eighteenth- and nineteenth-century practices of “spinning” the insane, extracting their teeth, ovaries, and intestines, and submerging patients in freezing water. The “cures” in the 1920s and 1930s were no less barbaric as eugenic attitudes toward the mentally ill led to brain-damaging lobotomies and electroshock therapy. Perhaps Whitaker’s most damning revelation, however, is his report of how drug companies in the 1980s and 1990s skewed their studies in an effort to prove the effectiveness of their products. Based on exhaustive research culled from old patient medical records, historical accounts, numerous interviews, and hundreds of government documents, Mad in America raises important questions about our obligations to the mad, what it means to be “insane,” and what we value most about the human mind.
User Ratings and Reviews
4 Stars Mad in America: Bad science, bad medicine, and the enduring mistreatment of the mentally ill
I found this a powerful and well written review of the history of mental health treatment over the past 200 years. It creates a great overview of the capture of the mental health industry by Big Pharma, and the crowding out of alternative viewpoints. It shows well one of the reasons that prognosis is generally much poorer in developed countries than some developing countries (refer WHO studies). I have sent copies of this book to numerous policy writers locally as Christmas presents. I would recommend it to anyone who finds a sense of truth in the addage that ‘anyone who goes to a psychiatrist needs his/her head read’.
5 Stars Comas, eugenics, labotomies, and drugs
Mad in America reads like a horror novel. This book takes a historical look at America’s treatment of schizophrenic patients - from the Quakers gentle caring to today’s drug therapies, our treatment of the “insane” has been just that, insane. Schizophrenics fare worse in western nations than in the poorest - the opposite for most other diseases! While the reader must keep in mind that this book has a bias, it is one that I don’t believe has been explored previously. Whitaker has done a tremendous amount of research and it shows. This book is well written and captivating.
A must read for anyone interested in insanity. This book will definitely make you think twice about the treatment of a loved one with schizophrenia!
4 Stars Raised the questions that need to be raised
After reading many of the negative reviews of this book, I believe many of these reviewers miss the point of this book. Granted, the slant is negative towards drugs and psychiatry as a whole, but that does not mean that the questions the author raises are not valid ones. The facts are (from a number of sources, not just this one) that psychiatry as a science has a whole lot of work to do to just understand the causes and effects of mental illnesses and the drugs that may treat them.
Many if not most of these agents are given to people in a “trial and error” fashion that suggests the prescriber can not know beforehand exactly how the agent will work in this particular person. That is a tremendous drawback to treating illness. If the same type of treatment were given to people with antibiotics, most of the patients would be dead by the time the “right” drug were given. Diagnosis in infection is mostly not by trial and error–there are tests, assessments, and protocols that give the treating doctor some indication of how to cure the illness. This is not true at all in psychiatry at the present time, and THAT fact is the one that this book tries to bring home.
By using the past history of the psychiatric profession as proof of the very real mistakes it has made over the years being so “certain” about “effective” treatments, the book raises an important issue about scientific bravado, and the propensity for psychiatry in general to err on the side of “first do great harm” instead of the opposite.
This is an unacceptable way to do business, and that seems to be the major point in this book which is an accurate one.
The only way for the science of psychiatry to redeem itself is to buckle down and breakthrough to a new paradigm where skepticism is the norm and patient comfort and care is the primary goal. Intolerable side effects are a reality for many in psychiatry today, and unfortunately it is a high price to pay for these unfortunate souls to take a medication (or medications) that will only relieve symptoms (at best) and never cure anything. There has to be a better way, and this book is one that raises that issue. I think by reading it you can come away with a better understanding of how history has repeated itself and the dangers of being too certain about anything.
5 Stars Truly groundbreaking: first critique of the “atypicals”
I am a psychiatry professor, with a social rather than biological orientation. I teach medical students and psychiatry residents about the way culture and society influence mental illness and its treatment. I have been an observer of the interaction between pharmaceutical manufacturers and psychiatrists for years, so, in the 1990’s when the “atypical” neuroleptics appeared, I was very curious to see if they would live up to the heady claims being made for them by manufacturers.
A great many practicing psychiatrists now recognize that they have not; in part this is the result of a large study funded by the government rather than by the manufacturers themselves. However, Robert Whitaker, in his chapter “Not So Atypical,” reached the same conclusions four years before the study was published, through the kind of unbiased review of safety and efficacy data that the psychiatric profession does not undertake, because there is no financial support for it.
When Mad In America appeared, nothing like it had been published in the psychiatric literature and I was chagrined that something so important within psychiatry should have to be pointed out to us by an outside researcher. Whitaker’s analysis was highly sophisticated; I gave a copy of the book to our training director, and he gave a copy of the book to all the residents in our program. We discussed the book with them; they were angry and upset at Whitaker’s message (and at his histrionic book title) and I don’t believe they changed their prescribing practices and returned to the “typical” drugs. Residents now, however, are being taught the serious limitations of the newer drugs; perhaps in the future we will practice with these drugs in a more balanced way. If so, Whitaker will have been one the century’s first to move us in this direction.
5 Stars Almost Unbelievable!!
That America, which is known for it’s Declaration of Independance that states, “All men are created equal, with certain unalienable rights (life, liberty and the presusit of happiness)…” would stoop to such lows in treating it’s mentally ill patients is not only shocking, but almost unbelievable. Except for Nazi Germany, no other country has had such a cruel history of abuse in treating the mentally ill. And what about the Statue of Liberty which proclaims, “Give me your tired, you poor and you hungry?” At times this boook may leave you so horrified that you want to gag and move to another country. And don’t think that these horribly abusive treatments of patients are totally a thing of the past and have been repented of. Many hospitals still use shock treatment and the modern medications used to treat mental illness cause a host of serious problems for the patient.On pages 73-74 of the book, we are told that some of the past therapies psychiatry embraced include insulin coma, metrazol conclusive therapy, electroshcok and prefrontal lobotomy that all worked by damaging the brain. The author then says, “And from there one can follow a path forward to the the therapeutic failure documented by the World Health Organization in the 1990s when it determined that schizophrenia outcomes were much better in poorer countires of the world than in the United Stated and other “developed” countries.”Kudos for the Quackers over the quacks, as one excellent review was titled. Their hospital for the mentally ill treated patients with good food, gardening (fresh air and sunshine), indoor and outdoor recreation, rest, a set schedule (time to start the day), a library of good books, and counseling. Many of these patients recovered and where able to return to society and lead normal lives.
Filed under: Mental Health Books