2023 in Review: A Paradigm Shift Is Underway
At the end of each year, I like to ask this question of ourselves: Are we fulfilling our mission? Here is our mission statement:
Mad in America’s mission is to serve as a catalyst for rethinking psychiatric care in the United States (and abroad). We believe that the current drug-based paradigm of care has failed our society, and that scientific research, as well as the lived experience of those who have been diagnosed with a psychiatric disorder, calls for profound change.
And now, a slightly long-winded answer to that question.
When I am asked today about what it is we do, I like to say that we serve as an alternative media on matters related to psychiatry and mental health. It is in that role that we serve as a catalyst for radical change. Readers of Mad in America will encounter a narrative that is quite different from what appears in, say, The New York Times, or other major newspapers and magazines. And here is the encouraging news: a new narrative is springing to life.
The disease model that was born in 1980, when the American Psychiatric Association published the third edition of its Diagnostic and Statistical Manual, has collapsed. We have been writing about its lack of scientific foundation and its therapeutic failure for the past 11 years, from the day that Mad in America was founded, and now that understanding is filtering into the general public domain.
The “evidence base” for the collapse, which MIA readers know well, is this: psychiatric diagnoses are now understood to lack validity; the chemical imbalance theory has been (mostly) abandoned; the burden of mental disorders has notably increased over the past four decades; and there is increasing reason, based on evidence of many types, to conclude that psychiatric drugs, over the long-term, do more harm than good.
Moreover, as we reach the end of 2023, there is a potential “game changer” that looms for psychiatry. If the mainstream media picks up on the STAR*D scandal, which we have written about extensively, the general public will suddenly be confronted with this basic truth: American psychiatry cannot be trusted to provide us with an honest account of its own research. In the STAR*D study, we were told that 67% of the patients remitted after four stages of treatment, when in fact only 35% did.
In short, our society has organized its thinking around what I like to call a “false narrative of science,” and as that becomes known, it sets the stage for society to “rethink psychiatry” and imagine new possibilities.
We can see this paradigm shift in societal thinking happening even within prominent institutions. The World Health Organization, in two lengthy documents, has twice called for a radical change in psychiatric care, away from the disease model and toward one centered on human rights and the social determinants of health. That is a narrative that is moving the locus of “mental illness” away from the individual’s “brain” and into the community. The former United Nations Special Rapporteur for Health, Dainius Pūras, similarly issued calls for radical change along these lines.
A Recap of Our Operations in 2023
In 2023, we have published:
- 241 reports on scientific publications
- 182 blogs
- 62 MIA Reports
- 44 personal stories
- 28 podcasts
- & more: we host an online support group for parents, an online meeting space for artists, art galleries, and reader-nominated “songs of the week.”
As for our readership, it continues to grow. This year we will have around six million unique visitors to Mad in America, and around one million more to our affiliated websites. Our podcasts have now been downloaded more than a million times.
These are numbers that tell of a growing community eager to “change the narrative” that governs societal thinking. And that is how paradigm shifts occur: the collective voice for radical change grows ever louder.
Mad in the World
This October, we had our first in-person meeting with the editors of our 13 affiliated websites (soon to grow to 15 affiliates). The meeting in Copenhagen brought together the MIA board and 40 editors from the 13 sites, and if there was one “take-away” from our days together, it was a glorious sense of a shared mission.
The affiliates, which include sites in Central and South America, Europe, and a newly launched Mad in South Asia, are run by a mix of professionals and people with lived experience. While Mad in America provides infrastructure resources for each site (hosting the domain, technical support, software support, and so on), the editors of each site have editorial independence.
The affiliates, of course, focus on publishing content that is most relevant to their specific cultures, and in that sense, they do not speak as “one voice.” However, all share a common understanding that the disease model was exported around the world and to ill effect: worsening public health outcomes, the adoption of the impoverished philosophy of being that is found in the DSM, and the pathologizing of children (in some countries much more so than others).
At the end of the meeting, the group decided to rename itself Mad in the World. We are now working on improving our sharing of stories across this network. There is now a content section on our front page that features articles published throughout the Mad in the World network. At the same time, we are seeking to make it easier for the affiliate sites to republish our science reports and other content that may be of interest to them.
Our hope is that this sharing of information will serve to “cross-pollinate” all of the sites with new ideas and accounts of promising new initiatives.
Looking Ahead to 2024
As we have often noted, we are supported entirely by reader donations, and we want to thank all who contributed to Mad in America in 2023. Your generosity is what has enabled us to do what we do.
From all of us at MIA, we wish everyone a happy holiday season.
—Robert Whitaker
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