Is Psychiatry Insane, Dangerous and Compromised?

I rarely tell people I am a nurse anymore. I understand why some nurses enjoy the praise that comes with the job: “hero,” “so caring,” “frontline worker,” and all the familiar language. But I no longer feel that way. Covid years changed my view, and so did my time working in psychiatry. These are my reasons.

During my years as a psychiatric nurse, I often wondered whether I was helping people or quietly doing them harm. That doubt followed me when I gave medication and when I watched diagnoses being made after brief assessments. Seeing someone labelled after a 30-minute consultation felt rushed, arbitrary, and deeply troubling.

I still struggle to understand how anyone can make such a serious judgment about another person so quickly. Even if I spent an hour a day with someone for a month, I might still not understand their deepest fears. We barely know ourselves, never mind the people we love. Yet psychiatry can assign a diagnosis with astonishing confidence after a short consultation.

I believe mental health care now sits within what many critics call the Mental Health Industrial Complex. Ordinary experiences such as anxiety, sadness, nervousness, grief, restlessness, and fear are increasingly turned into clinical labels. Those labels can offer explanation and support, but they can also hide the deeper sources of distress.

Human emotions and behaviours developed over thousands of years as we adapted to an unstable world. Psychiatry, in less than a century, has claimed the authority to sort those messy and often normal responses into neat diagnostic categories, often without enough attention to philosophy, sociology, psychology, theology, environment, or the wider story of a person’s life.

I have seen it too many times: a patient in a cold clinical room, facing a professional who barely looks up, asks closed questions, takes notes, and moves the conversation along before anything real can surface. Then comes the verdict: this is the problem, this is the solution, this is the treatment plan. Usually, medication follows. Everyone leaves with something to hold on to—the clinician with authority, the patient with a prescription—but how can anyone truly know another human being in 20 or 30 minutes?

If a person went to a doctor with arm pain, no competent clinician would declare it broken without evidence. They would order an X-ray. Psychiatry often operates differently. Who decides what counts as mental illness, and on what authority? How do defiance, melancholy, hyperactivity, risk-taking, immaturity, or nonconformity become disorders? These questions matter because psychiatry carries unusual power: it can label people, medicate them, detain them, and override refusal in ways most branches of medicine cannot.

My concern is not that suffering is unreal, or that nobody needs help. People clearly suffer, and sometimes urgently. My concern is that psychiatry often turns human distress into medical categories, then responds with drugs that may create dependency rather than healing. A humane medicine should be honest about what it knows, what it does not know, and what harm it may cause.Of course suffering is real. Depression can crush a life. Anxiety can shrink a world. Psychosis or mania can tear relationships apart. But that does not mean every wound is a disease, or every unusual mind is broken. Much of what we call mental illness is inseparable from loneliness, pressure, poverty, trauma, alienation, humiliation, spiritual emptiness, and a culture that expects human beings to perform like machines. When people finally crack, we call the crack the problem instead of asking what made the pressure unbearable.

The COVID era exposed a familiar kind of medical hubris: the insistence that experts know best and that questioning them is itself a problem. Psychiatry has long suffered from the same arrogance. Too often, psychiatrists behave as though they understand a person’s inner life better than the person living it. Yet real care should help people develop insight, agency, and self-understanding—not trap them in permanent dependence on professionals who mistake compliance for recovery. Thomas Szasz argued in The Myth of Mental Illness that psychiatry can turn problems in living into medical disease, pathologising behaviour that falls outside social norms. That critique still matters.

A medical degree may teach anatomy, pharmacology, and diagnosis, but it does not automatically teach wisdom, humility, or how to sit with someone who wants to die.R. D. Laing, another psychiatrist I admire, tried to understand madness as meaningful suffering rather than meaningless pathology.  Laing’s work matters to me because he tried to sit with deeply distressed people without immediately reducing them to symptoms. He listened for meaning in their darkness. That is what good care should do: take the person’s inner world seriously before trying to correct it.

A psychiatric diagnosis should require strict criteria because a label can follow someone for life. Yet diagnostic pathways seem to have loosened. Telehealth assessments can now diagnose people without a doctor ever sitting in the same room. Access may be easier, but the threshold also feels softer. The space between “this is how I am” and “this is a diagnosis” has narrowed dangerously.

The Diagnostic and Statistical Manual of Mental Disorders (DSM), psychiatry’s central diagnostic manual or bible, matters in all of this because it gives labels institutional force. A diagnosis can shape treatment, school, work, courts, custody, military service, media narratives, and personal freedom. The first DSM appeared in the 50s, in the same Cold War atmosphere that produced Joseph McCarthy’s Red Scare, blacklists, loyalty tests, and a culture in which labels could destroy lives. Around that period, the CIA was developing secret mind-control research (Operation Moonstruck) later exposed through MKUltra. I am not saying the DSM was MKUltra, or that every diagnosis is political. My point is simpler: diagnostic language becomes dangerous when it is given too much authority. Its defenders call it a common clinical language; its critics see it as one of the engines of a multibillion-pound psychiatric and pharmaceutical industry. That is why it matters.

I have sat in rooms where acronyms were fired across the table like official ammunition: OCD, ADD, ADHD, BPD, GAD, PTSD, SAD—the whole alphabet soup. It went on until the person almost disappeared behind the letters. That is what I call acronym medicine: take a human being in pain, strip away the story, flatten the suffering, and replace it with a tidy cluster of capitals.

For much of its history, psychiatry was treated as the poor relation of medicine. The DSM helped give it the appearance of certainty and the status of “real medicine.” But diagnosis should be only be a shorthand, not a cage. It should only slightly illuminate a person’s story, not replace it. Once the diagnostic machinery expanded, the pharmaceutical industry moved in beside it. For every new category, there seemed to be a new pill.

The darker force behind much of modern psychiatry is pharmaceutical power. I do not use that phrase lightly. In the 1950s and 1960s, psychedelics showed promise in psychiatric research, but that work was largely pushed aside as more profitable making factory-made drugs targeting neurotransmitters, especially SSRIs, became dominant. After decades of use, the benefits of antidepressants are still contested, often modest, and sometimes difficult to separate from placebo effects, while the side effects and withdrawal problems can be severe. So the question remains: why has Western medicine so often favoured long-term drug dependency over approaches that might require fewer doses, deeper therapy, and a more honest encounter with suffering? The answer is complex, shaped by fear, politics, regulation, culture, and profit. But one thing seems clear to me: psychiatry has too often served systems that want people managed, not liberated.

The most revealing thing about antidepressants, antipsychotics, and anti-anxiety drugs is hidden in the prefix: anti. They suppress. They blunt. They stop the nervous system from rising too high or falling too low. That may mean less panic, less terror, less unbearable sadness—but it can also mean less joy, less excitement, less aliveness. I am not romanticising psychedelics or pretending they are a miracle cure. No substance can neatly empty a lifetime of pain in one perfect session. But there is a profound difference between a treatment that helps a person feel and one that teaches them not to feel at all. People do not walk into clinics saying, “I want to be chemically muted.” They say, “I want to feel like myself again.” That matters. Feeling is hard. Most of us spend our lives trying to escape the emotions that frighten us. Yet the way out of suffering is not always through sedation, compliance, and indefinite prescriptions. Sometimes it is through meeting the pain honestly, with support, time, and courage. Strip away the institutional language, the business interests, and the psychiatric slogans, and the whole structure begins to look frighteningly fragile.

Ask a few basic questions and the certainty of psychiatry starts to crack.The house of cards of psychiatry can fall very quickly once we explore it. Where is the blood test? Where is the scan? Where is the objective proof that a person’s distress is a discrete brain disorder? Terms like “chemical imbalance” gave the public a simple story, but simplicity is not truth. If psychiatry wants the authority to label, drug, and sometimes detain people, then it should be forced to carry the same burden as any other serious branch of medicine: evidence, humility, and honesty.

I remember working in an acute unit with a kind, eccentric old Dublin psychiatric nurse. During medication rounds, as we placed tablets into small containers, he would whisper, “Fill the plastic cup with water, Paul. That’s the only good thing they’re getting today—not these bleedin’ tablets.” At the time, it sounded cynical. Looking back, I think he was right.

My father, also a psychiatric nurse, had the same suspicion of the psychiatric system. At a Dublin conference, while people discussed street drugs and young dealers, he stood up and said the biggest drug pushers in society were not on corners but in clinics. He meant the psychiatrists. It was outrageous, funny, and uncomfortable because it contained a truth no one in the room wanted to touch.

Although I am critical of psychiatry’s medical model, I also think I have to be realistic and reasonable. Having briefly worked in acute psychiatry, I understand that mental health professionals are forced to act in the absence of certainty. Psychiatrists and nurses cannot wait until the exact mechanisms of depression, bipolar disorder, or psychosis are fully understood before responding to people in crisis. Patients arrive needing immediate care, and doing nothing is not a serious option. Still, psychiatry should be honest about its limits. It is not an exact science, and too often it presents uncertain theories as firm knowledge. I am not saying psychiatry is entirely evil or useless. In a crisis, medication and hospitalisation can save lives. But the way ordinary human suffering is treated once a stigmatising label is attached is deeply wrong. We should humanise these experiences. Instead, too often, we turn pain into pathology, label the person, and treat their protest as further evidence of illness. That is not care. It is dehumanisation.

In my view, the field can be paternalistic, overconfident, and too heavily influenced by pharmaceutical thinking. I have seen patients carefully manage conversations with psychiatrists to avoid abrupt medication changes that could seriously harm them. I have also seen patients who were better informed than the clinicians treating them. Fifteen-minute medication reviews are inadequate. Good psychiatric care should focus on understanding what has happened to a person, not just labeling what is supposedly wrong with them. Too many clinicians also seem overly tolerant of serious side effects, relying on familiar prescriptions instead of working carefully to find the least harmful and most appropriate treatment.

At times, psychiatry feels less like medicine and more like the fashion industry with a stethoscope and a prescription pad. To belong, you must look right, speak right, think right, behave right. But the cruel joke is that no one actually lives like that. Human beings are messy, contradictory, wounded, strange, brilliant, fearful, and unfinished. Psychiatry too often takes that chaos, calls it abnormal, and tries to iron it flat.

Children are especially vulnerable to psychiatry. If Bart Simpson walked into a psychiatrist’s office today, he might leave with ODD, ADHD, and a prescription before anyone asked what his restlessness meant. But children are not machines to be chemically calibrated into obedience. Some are wild, shy, sensitive, eccentric, fearful, brilliant, or difficult. Difference is not disorder. Our task is to nurture children wisely, patiently, and responsibly so they are nourished rather than managed.

Mental health is now also a market. Big Pharma props it up. Wellness brands dress it up. Corporate self-care campaigns soften it. Apps, books, courses, retreats, and packaged solutions are sold back to people as if suffering were a lifestyle problem. Pain is no longer just treated. It is packaged, priced, and sold.

The most damaged people are not always those who visibly break down. Sometimes they are the ones who appear most normal: polite, productive, adjusted, and silent. Their pain has been buried so early and so deeply that they no longer struggle against it. They have adapted perfectly to a profoundly unhealthy society, and that perfect adjustment is itself a kind of wound. In this sense, psychiatry can become a subtle instrument of social control, dressed up as science. Human suffering, sensitivity, despair, and unusual experience should not automatically be pathologised, medicated, or pushed into silence.

The most brutal truth about mental illness is that life keeps moving. Therapy, medication, hospital admissions, care plans, nurses, doctors, family, friends—none of it changes the final fact that we are still responsible for our own lives. That may sound harsh, even cruel, but I have seen it too many times to pretend otherwise. People can help you. They can sit with you, listen to you, prescribe for you, advise you, and hold your hand for a while. But they cannot live your life for you. They cannot want recovery on your behalf. They cannot climb inside your body and choose your future.

At some point, the terrifying responsibility comes back to you. If we are not careful, illness can become a prison we decorate from the inside. We can become so identified with our diagnosis, so dependent on professionals, so used to being managed, that we slowly surrender our own authority. I say this as someone who has worked in the system and seen the limits of its compassion. Yes, some nurses and doctors care deeply. Some are exceptional. But the world does not stop for your pain. People may support you, but then they go home. They return to their families, their problems, their lives. To them, your crisis may be a shift, a note, a handover, a case. To you, it is your existence. That is the difference. So no, this is not a lazy “pull yourself up by your bootstraps” speech. I hate that phrase. Life is messy, unfair, traumatic, and brutally complicated. But there is still a hard truth underneath it all: if we give away responsibility for our lives to the psychiatric and pharma industry, we give away the only power we have left.

Deep reform is needed. We have to dismantle the cultural habit of turning natural distress into diagnosis and treatment plans before we ask what that distress is trying to reveal. In many traditions, suffering can be the beginning of insight and awakening; in the modern West, it is too often treated as a disorder to be suppressed.In my own deepest darkest moments, I have experienced unbelievable clarity and vision. It is not wrong to feel disturbed by the state of the world. It is not weakness to be affected by alienation, moral decay, social breakdown, loneliness, exploitation, and a culture that turns human beings into economic units. Sensitivity to this is not a disease. It can be a form of awareness. If we can see the sickness around us clearly, we may still be able to change it.

In the end, perhaps the only real task is to stop living inside someone else’s script or the tired old psychiatric script. Refuse the role of the passive character. Become the author of your own myth. Joseph Campbell called it the hero’s journey; today, it may look like learning to resist the systems that try to define you. The point is not to escape reality, but to reclaim authorship within it.