American Psychiatry’s Complicity with the State

Why aren’t Americans hearing more from mental health professionals about the biggest mental health emergency of our day? We aren’t being quiet, and the public has never stopped its clamor to hear from us. Rather, the media would not cover us, and the American Psychiatric Association will not retract its public campaign promoting the misperception that mental health professionals are not to be heard from. In this Independence month, as we recall what we owe our nation to, the freedom we enjoy, and how we became a beacon for the world, it would be important to reflect on this stifling of speech and the imposition of ignorance on the people.

It is difficult to assess fully the enormous consequences of the American Psychiatric Association’s (APA’s) actions. Its reinterpretation of “the Goldwater rule,” at the outset of Donald Trump’s presidency, in the opposite direction of science and current practice, has prevented a mental health issue from being dealt with through mental health. And since mental health issues have the problem of eventually affecting the afflicted individual’s (or society’s) very ability to address the issue, this is a serious problem.

There is a good chance that you will have heard of “the Goldwater rule,” which is an aberration, since, before the Trump presidency, it was an obscure rule that many psychiatrists had not heard of. It was considered outdated by the time it entered the books in 1973 and all but irrelevant by 1980, when diagnostic criteria for assessing disorders changed completely, from introspective interviews to objective observations of behavior. It ironically may have escaped abolishing because many considered it too unimportant to bother — scholars of it were scarce — until it was revived to serve a useful political purpose.

First, you may have heard that the rule prohibits professionals from speaking about someone they have not personally examined. This is a distortion, since, as it is written, it restricts “professional opinion,” not “any opinion of a professional.” How are the two different? The first is akin to a diagnosis and is admissible in courts as evidence — in other words, has the same status as fact — the second has no special status. Nevertheless, a professional’s non-diagnostic opinions, informed by a lifetime of education and experience, are useful to the public, and even “the Goldwater rule” itself encourages that we share this knowledge. But this is not what the public heard; the APA went out of its way to reinterpret ethical guidelines to…