Despite spending more on psychiatric services and prescribing psychiatric medications at a higher rate than almost any other nation, mental health in the United States over the last two decades has only been getting worse.Rates of depression, anxiety, suicide, overdose, chronic disability due to mental health conditions, and loneliness have all been rapidly increasing. No quantity of psychiatric drugs or hospitalisations appears adequate to reverse these trends.Despite this, the US medical and psychiatric establishment has persistently refused to use its substantial political power to demand the transformation of care by expanding non-medical support systems to address the root social causes of mental illness, such as poverty, childhood trauma and incarceration, rather than focusing on reactive treatment via lucrative medication-centric norms. This failing status quo has created an opening for President Donald Trump and Secretary of Health Robert F Kennedy Jr’s emerging plans to remake the nation’s approach to mental health, with disastrous consequences now coming into focus.Trump and Kennedy have hijacked legitimate anger at a broken system to justify destroying public care infrastructure, including Medicaid, food and housing assistance, harm-reduction and overdose prevention programmes, and suicide-prevention hotlines for LGBTQ youth, while promoting wellness scams and expanding the police state. They focus on the “threat” supposedly posed by psychiatric medications and call to reopen the asylums that once confined approximately 560,000 people, or one in 295 US residents, in horrific conditions, until protests against their cruelty led …
