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If You Are Pro-Psychiatry, Should You Be Anti-RFK Jr.?

— Kennedy's proposed policies are clearly anti-psychiatry

MedpageToday
A photo of Robert F. Kennedy Jr.

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Much has been written about Robert F. Kennedy Jr.'s radical health plans to eliminate fluoride from the drinking water and suppress vaccines, among other lame-brain schemes. But relatively few people are aware of his anti-psychiatry views, possibly endangering the health of a large swath of the populace.

Kennedy is pitching the idea that users of illicit drugs be sent to "wellness farms," and that users of antidepressants and attention deficit-hyperactivity disorder (ADHD) medications should join them. He claims they would stay there for several years, growing and eating organic food, and the wellness farms would be financed through taxes on cannabis products. (I suppose Kennedy thinks smoking "pot" is okay or is better therapy for major depression than taking selective serotonin reuptake inhibitors [SSRIs]).

Here are Kennedy's : "I'm going to create these wellness farms where they can go to get off of illegal drugs, off of opiates, but also illegal drugs, other psychiatric drugs, if they want to, to get off of SSRIs, to get off of benzos, to get off of Adderall [dextroamphetamine/amphetamine], and to spend time -- as much time as they need, 3 or 4 years if they need it -- to learn to get reparented, to reconnect with communities." Kennedy made these remarks during a town hall this past summer.

A large number of people could be affected by Kennedy's proposed policies should his nomination as secretary of the Department of Health and Human Services be confirmed by the Senate. Approximately one in 10 adult Americans take antidepressants, and about 4% of people ages 5 to 64 years use ADHD medication, according to the CDC.

Kennedy's views are dangerous. He has no understanding of mental illness or addiction medicine. He is an environmental attorney who lacks the credibility to be making medical decisions for millions of Americans. Worse yet, his stance on mental health is clearly anti-psychiatry. The notion that individuals can be reparented was decades ago, along with similar ideas about "schizophrenogenic mothers" causing schizophrenia and conversion therapy "curing" gays and lesbians.

The anti-psychiatry movement has existed for a long time, perpetuated by prominent figures such as Thomas Szasz, MD (1920-2012), whose seminal work The Myth of Mental Illness argued that mental illnesses are not real diseases but rather constructs used by society to control and stigmatize individuals who deviate from normative behaviors; and R.D. Laing, MD (1927-1989), a Scottish psychiatrist who wrote The Divided Self and challenged the traditional view that schizophrenia was a biological disorder, instead proposing that it was a meaningful response to an untenable social and familial environment.

Ongoing efforts by the Church of Scientology have also attempted to discredit the field of psychiatry. Since its inception, the Church has been vocally critical of psychiatry, viewing it as a harmful and pseudoscientific practice. This opposition is rooted in the teachings of Scientology's founder, L. Ron Hubbard (1911-1986), who denounced psychiatric treatments and institutions as abusive and detrimental to individuals' mental and spiritual well-being. Hubbard's views are outlined in his book Dianetics: The Modern Science of Mental Health, published in 1950. This book introduces the core concepts of Dianetics, which later evolved into the broader framework of Scientology.

The anti-psychiatry movement was not merely an academic exercise; it had practical implications and led to the establishment of alternative mental health practices. For example, Scientology's anti-psychiatry position is institutionalized through organizations like the Citizens Commission on Human Rights (CCHR), which the Church established in 1969. The CCHR campaigns against psychiatric practices, particularly the use of psychiatric medications and procedures such as electroconvulsive therapy. It argues that these treatments are often coercive and harmful, promoting instead Scientology's own, controversial methods for addressing mental health issues.

Critics of the anti-psychiatry movement argue that it downplays the suffering associated with severe mental illnesses and fails to acknowledge the benefits that psychiatric treatments, including medications, can provide for many individuals. They also point out that while the movement has effectively highlighted the need for greater empathy and respect in mental health care, it has not always offered practical alternatives to biomedical approaches, nor has it recognized irrefutable scientific findings that, fundamentally, serious mental illnesses such as schizophrenia and bipolar disorder stem from disorders of the brain.

There have been significant efforts within the field of psychiatry to address and rectify previous criticism. Professional organizations such as the American Psychiatric Association and the Royal College of Psychiatrists have played pivotal roles in advocating for the scientific and clinical value of psychiatry. These organizations work to enhance public understanding of mental health issues through educational campaigns that emphasize the effectiveness of psychiatric treatments, the importance of mental health care, and the medical training of psychiatrists. Indeed, psychiatry residency have been increasing yearly since 2011, and in 2023 psychiatry was one of just 10 specialties with increases of more than 10% over the past 5 years.

Research initiatives funded by government agencies and private institutions aim to advance the field by developing new therapies and improving existing ones, thereby demonstrating the tangible benefits of psychiatric care. Additionally, mental health professionals engage in public discourse through media appearances, publications, and community outreach to dispel myths and misinformation propagated by anti-psychiatry advocates. I doubt such initiatives would be allowed to continue under Kennedy's domination.

Collaborative efforts with patient advocacy groups such as the National Alliance on Mental Illness also help to amplify the voices of those who have benefited from psychiatric care, providing personal testimonies that counteract negative perceptions. These combined efforts strive to foster a more informed and supportive environment for mental health treatment, ultimately promoting the greater good by ensuring access to effective and compassionate psychiatric care.

This type of empathetic, evidence-based treatment will not be found in wellness farms or labor camps, and it cannot be obtained through ersatz parents.

Arthur Lazarus, MD, MBA, is a former , a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia. He is the author of several books on narrative medicine, including and .

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