Mental Health Inc: How Corruption, Lax Oversight and Failed Reforms Endanger Our Most Vulnerable Citizens

by Art Levine

The mental health system in America is hardly a front-burner issue, despite lip-service about reform after a tragic mass killing. Yet every American should care deeply about fixing a system a presidential commission reported was in “shambles.” By some measures, about 20 percent of Americans have some sort of mental health condition, including the most vulnerable among us—veterans, children, the elderly, prisoners, the homeless. With Mental Health Inc., award-winning investigative journalist Art Levine delivers a Shock Doctrine-style expose of the failures of our out of control, profits-driven mental health system, with a special emphasis on the failures of the pharmaceuticals industry, including the treatment of children with antipsychotics and disastrous PTSD protocols for veterans.

He provides narrative portraits of victims and also of some people who won unexpected victories against their illnesses by getting smart, personalized help, as well as snapshots of corrupt Big Pharma executives and researchers who created fraudulent marketing schemes. Levine also tells the dramatic David vs. Goliath stories of a few brave reformers, including Harvard-trained psychiatrist and researcher Dr. Stefan Kruszewski, who has acted as a whistleblower in numerous cases, leading to major federal and state settlements, as well as spotlighting pioneering clinicians challenging outmoded, drug-and-sedate practices that leave 90% of people with serious mental illness too disabled to work.

By taking a comprehensive look at mental health abuses and dangerous, ineffective practices as well as pointing toward solutions for creating a system for effective, proven and compassionate care, Art Levine’s essential Mental Health Inc. is a call to action for politicians and citizens alike.

Genres: Psychology, Mental Health, Nonfiction, Audiobook, Psychiatry, Mental Illness

352 pages, Hardcover

Published August 15, 2017

About the author

Art Levine, a prize-winning contributing editor of The Washington Monthly and a Nation Institute Investigative Fund grantee, has written for The American Prospect, Salon, The Atlantic, The Daily Beast, Mother Jones, Truthout, AlterNet and numerous other publications. Among other awards, he was honored as “Journalist of the Year” by the Florida chapter of the National Alliance for the Mentally Ill in 2001 for his articles in City Link, a Florida weekly, exploring the criminalization of the mentally ill in South Florida. In 2005, as a Health Policy Fellow with the Progressive Policy Institute, he wrote a prescient major report, Parity-Plus: A Third Way Approach to Fix America's Mental Health System that looked at roadblocks to using effective treatments. Since then, he has exposed a wide range of corporate and government wrongdoing, in a series of articles for The American Prospect, The Washington Monthly and Salon, among others.

Reviews

[Bina · Rating 3 out of 5]

I have mixed feelings about this book. I picked it up hoping to inform myself about mental illness, stigma and barriers to care. While I certainly picked up useful information along the way, the book mainly ended up being a condemnation on over-prescribing to children and veterans, with a couple of chapters written on alternative treatments, and another couple of oddly-inserted chapters about boot camps/residential treatment programs for teens. Don't get me wrong, I appreciate Art Levine's investigations on all these fronts and feel much more informed about them, but the entire book was written in the tone of an exposé, and the language was occasionally hyperbolic so that it was difficult to see him as an objective reporter. Additionally, the chapters about the teen residential treatment programs don't quite fit with the subject matter of the rest of the book and rely heavily on earlier articles Levine published, giving me the impression that they were mainly inserted for that reason. Speaking of sources, he relies mostly on interviews with mentally ill individuals, their family members, psychiatrists, and state and federal agencies, as well as on the previous work of journalists. (He does, however, also cite scholarly journals). While he obviously did his research, again, it feels more like muckraking than exposition.

Despite these elements, I throughly appreciate the centrality that Levine consistenly gives to patients and victims. He exposes the cover ups and greed of politicians and the pharmaceutical industry via the stories of people struggling with mental illness in settings as varied as Florida schools, West Virgnia VAs, rural Maine, and the LA County Jail. Every single greedy act or dismissal damages someone struggling to survive. He clearly and heartbreakingly illustrates that, which is why - even though I wouldn't recommend it to someone who knows nothing about mental illness and is looking to generally educate themselves on the topic - I still appreciate this book.

[Jay Hamm · Rating 3 out of 5]

I found this book to be a bit uneven. The chapters exposing abuses and scandals in youth residential programs seemed to belong in a second book. The final two chapters were strong, though I have to acknowledge that even though he lands in the direction of my own biases, Levine appears to relatively uncritically accept the evidence for the benefits of a handful of psychosocial interventions for persons diagnosed with serious mental illness. Definite positives include an extensive detailing of multiple legal actions and settlements by pharma and others. Also effective at highlighting the political agenda of E. Fuller Torrey et al. and the affinities in Tim Murphy's legislative efforts. Worth the read, but definitely not recommended as an entry point in the realm of psychiatry criticism.

[MadameNovelist · Rating 4 out of 5]

Well-researched, thoughtful delving in the myriad problems facing the mentally ill. Main focus is on reckless prescribing encouraged by pharmaceutical companies, and general disinterest in protecting and empowering the mentally ill on state and federal levels. Very depressing, but necessary, so if you’re tender-hearted, brace yourself. I’m grateful for this book, but has to pace myself in reading.

[David · Rating 3 out of 5]

not a balanced review certainly, but classic muckraking of the best kind, digging deep into Big Pharma scandals, VA system snafus, overmedicating of kids, and more. Particularly strong on the "off-label" use of antipsychotics with serious side effect profiles.

[Joan · Rating 3 out of 5]

important topic, very comprehensive, but lacks context.

[2022-2024 · Rating 2 out of 5]

The author got to the point, but repeatedly jumped topic to topic throughout each chapter making it difficult to following along.
I couldn’t help but feel that this book lacked a solid foundation whilst reading it and the author seemed to centre around three overprescribed drugs (specifically Seroquel) and did not provide proper history on how they came to be overprescribed - rather - he jumped to the present and just critiqued how it’s overprescribed. There are reasons why opiates and mood stabilisers are overprescribed these days, and I feel like he should have touched on the medication’s history to better inform his readers.

Lots of information is provided from within this book, but a bit too abruptly, as he is constantly going from topic to topic, story to story, without giving much of an explanation or a chance for the reader to process what they just learned.

I must note that this book is set in the first “Trump era” and has lots of political critique that has lost relevancy or has been disputed to date. This is not a “timeless” read.

[Elisabeth Young · Rating 3 out of 5]

There's a tedious introduction that seeks to contextualize the importance of this work in the light of the Trump presidency. There's additional interjections of this hyperbolic "what will happen to the mentally ill now?" fear mongering line of logic. 4 years later, it looks pretty hollow in the light of a whole pandemic and still no healthcare action in the Biden presidency. Not to mention the fact that the opiate epidemic spiraled out of control under Obama. Looks pretty stupid not to contextualize this work in a more grounded way. There is very little here about the economic realities of healthcare or the perverse incentives of for profit health care and insurance. Although some attention is obviously paid to the drug pushers at big pharma. The nefarious aspects of drug patents is barely touched. Who funds research and who gets paid, barely touched. This book doesn't have a strong basis or vision, but it is a journalistic account of some fucked up shit that goes on all the time.

[Dana · Rating 5 out of 5]

While this book wasn’t perfect, I was impressed by the investigation that Art Levine conducted into different areas of mental health. As someone who would like to work in mental health reform, I especially appreciated his critiques of organizations such as NAMI, which are often viewed as heroic or perfect. I love the fact that he speaks directly to individuals with mental illness and their families, and does not devalue their thoughts. My favorite part of this book is his focus on individuals with schizophrenia, who often do not receive a voice. He was able to speak respectfully and powerfully about this subject.
One of the aspects of this book that I didn’t like is the fact that he spends an incredibly long time on the VA system, which is disproportionate to the rest of the book. He could have formatted this book better, but on the whole, it was excellent. Definitely an eye-opener.

[William · Rating 5 out of 5]

Important reading to understand today's mental health topology

While I do not agree with everything that mister Art Levine's book posits, about 95% of the book for me is spot-on. From the politics to the public health issues to the medication. This book should be required reading for all students in public health programs.

[Kathy · Rating 4 out of 5]

a fantastic and up-to-date, timely book on mental health treatment in the US today, and I mean today. It has some proposed answers, and it is not shy about naming names.

[Andrea Olson · Rating 3 out of 5]

3.5

[adam moore · Rating 4 out of 5]

Very interesting book you not believe what you read in this book so sad too