The Dark Underbelly of Psychiatry

By the end of World War I, leading psychiatrists abandoned the movement. Nevertheless, eugenics did not die when psychiatry withdrew its support and this nefarious legacy persisted well into contemporary times.

Rather than evolving into a continuum of care, psychiatric institutions such as Danvers State Hospital, Trans-Allegheny Lunatic Asylum, Byberry mental hospital, Pennhurst, Pilgrim Psychiatric Center and countless others perpetuated harrowing acts of torture and neglect.

In 1972, ACLU attorney Bruce Ennis began a class-action lawsuit on behalf of the 5,400 residents of the Willowbrook State School for mentally disabled children in Staten Island. Senator Robert Kennedy referred to Willowbrook as a ‘snake pit.’ Journalist Geraldo Rivera’s expose of Willowbrook Public triggered public outrage and greater regulatory control over the quality of care patients received in these institutions.

In 1967, California passed the landmark Lanterman-Petris-Short (LPS) Act, which virtually abolished involuntary hospitalization except in extreme cases.

Board and Care Homes

By 1975, board-and-care homes had become big business in California. Many of these for profit board-and-care homes, such as Beverly enterprises, had close ties to Governor Reagan and, in fact, were reportedly contributing large sums of money to his campaign.

In exchange, Reagan emptied state hospitals. Sociologist Andrew Scull said of the board-and-care industry:

“The logic of the marketplace suffices to ensure that the operators have every incentive to warehouse their charges as cheaply as possible, since the volume of profit is inversely proportional to the amount expended on the inmates.”

Under President Ronald Reagan and the de-institutionalization movement the streets became the asylums of the 80s. Reagan’s Omnibus Budget Reconciliation Act repealed Carter’s community health legislation ending the federal government’s role in providing services to the mentally ill.

The repercussions of deinstitutionalization entailed massive homelessness and an increase in incarceration and episodes of violence amongst the mentally ill.

Psychiatrist Thomas Szasz asked:

“Is psychiatry a medical enterprise concerned with treating diseases, or a humanistic enterprise concerned with helping persons with their personal problems?”

He added:

“Psychiatry could be one or the other, but it cannot–despite the pretensions and protestations of psychiatrists–be both.”

Big Pharma

As we detour into the psycho-pharmacological revolution beginning in the 1950s and a seemingly more positive framework for psychiatric intervention, we are inescapably led to the current collusion of Big Pharma and psychiatry promoting psychotropic drug use of endemic proportions.

The concerns voiced by Szasz appear to be supported by statistics that reveal a global rise in sales of antidepressants, stimulants, anti anxiety and anti psychotic drugs totaling more than $76 billion a year, and estimates of at least 20% (one in five) of children being prescribed Ritalin.

Undeniably, virtually every major mental health institution is financially interconnected with Big Pharma.

Under the Sunshine Act, drug manufacturers are required to report payments given to physicians and teaching hospitals. It was discovered that roughly three out of four physicians seeing patients took money from Big Pharma. Some took only a few dollars. Others received millions.

Big Pharma pays psychiatrists to deliver seminars, act as consultants or enroll their clients into final testing of new drugs. Along these lines, award winning investigative reporter Gary Null, Ph.D., has written about another stream of income known as patient brokering, a practice in which doctors and hospital staff falsify diagnosis and medical records in order to obtain payment for treatment that, whatever its value to patients, was not covered by their health plans.

Patient brokers make commissions and finders fees from deceptively committing insured individuals to psychiatric facilities.

In my opinion, the high-profile doctor most responsible for the explosion of kids on psychiatric drugs is Dr. Joseph L. Biederman, professor of psychiatry at Harvard Medical School and chief of pediatric psychopharmacology at Harvard’s Massachusetts General Hospital.

The New York Times described Biederman’s studies as “so small and loosely designed that they were largely inconclusive.”

Yet temper tantrums were persuasively masked as mania, resulting in an aggressive medication regime exposing thousands of children to neurotoxic chemicals. Reportedly, Biederman’s take from Big Pharma, specifically Johnson & Johnson, was $1.6 million.

When Rebecca Riley, a four-year-old girl died from an overdose of drugs prescribed to treat pediatric bipolar disorder and attention deficit hyperactivity disorder repercussions against Biederman and his followers ensued.

APA and Government-Sanctioned Torture

Lastly, current news within the geo-political sphere concerns the recent investigation of the APA’s involvement with the Department of Defense and the CIA,rand the APA’s endorsement of government-sanctioned torture at Guantanamo Bay.

This blatant violation of medical ethics involves the participation in forced tube feedings. The APA has since imposed a ban prohibiting psychologists from participating in national security interrogations.

In closing, when I step back to absorb and analyze the totality of harm exacted under the guise of benevolence, it is disorienting and disillusioning. I am astounded by the ubiquitous sadistic exploits and abject indifference in my chosen profession.

Still, I am reminded of the virtues in this work and the duality of humanity. As I reflect on the enormity of malevolence in the world and within my chosen profession, the conundrum of what is by design and what is of corruption is a pervasive concern.

Ultimately I recognize that the most I can do is return to the source of my truth where I humbly embrace my moral limitations and do my best to consciously align with my humanity. And, I keep in mind the words of existential psychiatrist Irvin Yalom who wrote:

“Psychiatry is a strange field because, unlike any other field of medicine, you never really finish. Your greatest instrument is you, yourself, and the work of self-understanding is endless. I’m still learning.”

Abstract image available from Shutterstock

The Dark Underbelly of Psychiatry

Rev Sheri Heller, LCSW

Rev. Sheri Heller, LCSW, is a seasoned NYC psychotherapist with 25+ years experience in the addiction and mental health fields. Sheri is also an interfaith minister and playwright, and the founder of The Sistah Tribe - Phoenix Project, a therapeutic theater event for at-risk women and girls in the public sector of NYC. For more information, visit


APA Reference
Heller, R. (2016). The Dark Underbelly of Psychiatry. Psych Central. Retrieved on February 16, 2020, from


Scientifically Reviewed
Last updated: 30 Jan 2016
Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2016
Published on All rights reserved.