American Thought Leaders - The Failures of the Mental Health Drug Revolution | David Cohen

Episode Date: January 21, 2026

An estimated one in six American adults today are taking some form of psychiatric medication. Yet it seems mental health outcomes across America have seen no significant improvement, despite the promises of the psychopharmacology revolution.David Cohen, professor of social welfare and associate dean at UCLA’s Luskin School of Public Affairs, argues that many of the core assumptions of modern psychiatry are flawed.Cohen is known for his research on psychotropic drugs and coercive mental health treatment.In our interview, we also discuss why it is that America has one of the highest involuntary mental hospitalization rates in Western countries, and what it means that suicide rates are exceedingly high among people who were just released from a mental hospital.Views expressed in this video are opinions of the host and the guest, and do not necessarily reflect the views of The Epoch Times.

The highest suicide rate in any known community or group of people that you can separate is immediately after a psychiatric hospitalization. They certainly could have been suicidal to begin with, but certainly that hospitalization did not help. In this episode, I sit down with David Cohen, a professor and associate dean at UCLA. We have close to half the population on some kind of painkiller or psychoactive drug and so forth, as prescription drugs that you ought to take given by our medical men. and the needle has not moved. He argues we're approaching mental health all wrong.

What exactly is this disease that you don't even put your stethoscope on me? You're just talking to me. What kind of disease is diagnosed this way and is like any other disease? It's obviously not like any other disease. This is American Thought Leaders, and I'm Janja Kellick. David Cohen, such a pleasure to have you on American Thought Leaders. Thank you. Pleasure to be here. America has one of the highest involuntary incarceration rates for psychiatric patients in the free world.

Tell me about why that might be. Involuntary incarceration is a glue that holds the social world together. It's one of those mechanisms that we in most Western societies, in fact all societies, We depend on it as an ultimate measure of control of keeping people in the same community, sharing the same values. An involuntary hospitalization is what you call your final backup that a society always has, always keeps it in reserve to use to keep the society, the group going. Now, why would it be a high rate in one country versus another?

It's not really truly understood. You could say, well, it's a measure of social breakdown. It depends on everything else we've got going that builds people up to maintain themselves during times of crises and built communities and families and schools and places of worship and homes. All these institutions need supports. They can't do it all themselves. So they need supports. And a breakdown in one, even if the others are going okay, could lead to the resort to involuntary

hospitalization. A breakdown in several together could lead to more resort to that as a final measure. It may sound a bit abstract, but what I'm saying is why would it behind the United States is because, you know, it could have to do with the source. stories that we tell ourselves about why people break down, why people have crises. We have, you know, stalk words like, it's an emergency crisis or it's a psychiatric crisis. What does that mean a psychiatric crisis? It is a crisis where psychiatrists are involved? Or what does that mean exactly? Is it the nature of the crisis?

Presumably, it's supposed to be when someone is going to harm themselves or others, right? This is the reason that we, at least in theory, incarcerate. people that have committed crimes because they're harming society. Or it could be a harm to themselves, I suppose, but that's the, now we're talking about the psychiatric aspect. That's what I think of. Well, it kind of makes intuitive sense to have those two, if you will, paradigms in mind of when is it that we restrict the rights of people, when is it that we impose a state intervention on them, regardless of what they say they want. The classic one is they've broken the law.

Now, involuntary mental hospitalization, 90% of it, 95% of it, is precisely when a person has not broken the law. So they are innocent, but yet we nonetheless impose an intervention on them. That is, we restrict their liberty, we restrict their right to make decisions for themselves through, you know, or managing their financial affairs or what have you. Even though they have not broken a law, and that's why it's called civil commitment. And there's a very prominent example that's just jumping to my mind is Lindsay Lohan, right? Lindsay Lohan is probably a very good example. She's a well-known example and she sort of, if you will, you know, electrified the issue because she was prominent. And her story is not only was she subject to involuntary detention,

is that then she was subject to involuntary supervision, which is sort of like almost equivalent to parole in the criminal justice. system, the legal criminal justice system, whereas in the civil detention system, which is run by a mental health establishment, you also have a follow-up after your detention. You're still on supervision. You still have to report, you still have to take your medication, you still have to have certain decisions approved by people. That's called a guardianship or conservatorship.

Every state in the United States and every Western country basically has a law that authorizes the detention of someone without them having broken a law. On what basis? And that's where you brought in, well, danger to harm or others. So this is the thing. But it's not just because you're dangerous. It's because you're ill. It's on the basis of mental illness makes you dangerous. So it's a special law of exception because you could be very dangerous to yourself. You could be driving cars over cliffs. In fact, people could pay to see you do it, and you could become very well-known and prosperous.

And rewarded for that. And rewarded, exactly. That could be your identity and you're celebrated for it. When I was young, it was Evil Can Evil and so forth. So you could do that, extremely dangerous. And you can, in fact, endanger people's lives to that are around, working around you, trying to help you set those cars up that you'll jump over, but you will not be committed to a psychiatric institution,

on the basis that you're dangerous to yourself or others. It's only first, if you're mentally ill, and who makes that decision, then we bring in the medical piece of it. But what I'm thinking about, I mean, sometimes people are extremely suicidal, right? And I mean, I'm aware of people who are in extreme suicidality in this sort of situation.

You imagine, yeah, that seems like a reasonable moment to say, I'm not going to take those razor blades away. I mean, I'm being a little bit glibbrier. Yes, you are because... And in fact, I may need to take all those types of things away. You may need to, because when you said, I know someone, or I may know someone, someone is extremely suicidal. What that really means, if we have to operationalize it

in the professional jargon, is that they're talking about suicide, they're talking about maybe perhaps thinking of committing suicide, and they might have a plan to do so. Now, you think at that time, okay, that might be the moment to do something, absolutely, but how would I intervene if this was happening, say, in my office when I used to practice counseling and therapy and so forth, I would, that was the time to really talk about it. Now, in fact, to take away the charge as much as possible and bring it to words and to, let's see. In fact, let's talk more about it, not immediately, say, pick up the phone.

Well, presumably you would exhaust these other methods, right? Yes, presumably, but that's not necessarily what we're trained to do today, where, depending on your level of the level of training or understanding or education of the person you're training to do this, it's either just, you know, check in. It's that five-question, Columbia, rating, suicidal screening, which is, you know, are you talking about it? Did you say you might want to do it? You have a plan. Boom, bang, okay, we got to call someone right away to take more drastic measures. And so, So that's, I think we're training hundreds of thousands of people to do that on millions of people, which is, I think, a huge waste of resources. This is a very rare event when you think about it. It may be going up or down, but it's by, you know, one or two or five hundred per hundred thousand people. So it may go from 16 to 19 per 100,000 people. We commit at a rate in the United States on average between 2 to 350 per 100,000 people,

which is kind of close to the rate at which we hold people in jail for crimes. So many parallels between what we do on the basis that you're dangerous to yourself or other and what we do on the basis that you've committed a crime. But we like to keep both separate because we say for the mental illness, issue, and I put that in quotation, mental illness, it's for your own good. But for the crime issue, it's for our own good. Now, of course, the two are getting a little conflated. The discourse around commitment today is around, I don't want these people on my street, it's around public safety, it's around being comfortable in public places, formerly public places and cities. So,

this is normal. You've got to put it all into a niche of safety, perceived safety, security, lack of public spaces, lack of housing, et cetera, et cetera. So that's why the mental health system. There's also this space, though, the space that I'm most familiar with because I've interviewed a number of people on the topic and also spoken with numerous people who were severe drug addicts on the street as a result, and that's often tied into mental health issues as well. The one thing that actually, they credit the reason that they

alive, 100% of the people that I've spoken with, the fact that someone incarcerated them, or did a very serious intervention that pulled them off the street. Yeah, so, and that's really good. That's good to hear. Now, you know, you've spoken to people, I've spoken to people, and others have spoken to other people, but I could tell you that, well, of course, I serve as a magnet for people who may have been dissatisfied or hurt or tortured, illegally and so forth are in turn for completely the wrong reasons under false pretences and but the stories I hear to are different they include some of the stories you say and so they have to be taken seriously too but they include

stories of just sheer horror at being caught somewhere being stripped being stripped searched being confined being tied to a bed with a handcuff when they were with with with her husband just waiting not having an idea you know, in the waiting room, let's say, of the hospital, not having any notion that this could be going on with an extremely compliant, willing person, all kinds of things, all kinds of stories I hear which are not like the kinds of stories you tell me. In fact, their stories are sometimes, if I hadn't met someone who told me that I could get out of this by doing X, Y, Z within a few hours or so, if I hadn't met this person who told me what to do and what. what not to do just then, or then I would have died. And there's one fact that remains obscured actually. It's discussed in all the journals,

but it's not discussed very openly, which is simply that the highest suicide rate in any known community or group of people that you can separate is immediately after a psychiatric hospitalization. It's the highest rate compared to the general, population, which is anywhere from 15 to 35 per 100,000. Within the month and the year following a hospitalization, the rates go up to sometimes two, three thousand. It's hundreds, tens of

times more than in the general population. So the standard response to that is, well, they were suicidal to begin with. That's why. But it is, it is, it just speaks for itself. too, that, well, they certainly could have been suicidal to begin with, not everyone, but they could, but certainly that hospitalization did not help. That's the first thing we could say about that. So that is not studied carefully or even barely today in the mid-2020s in North America or Europe. We do not study the connection between involuntary mental hospitalization, for suicidal people, forget those who might want to harm others, and the subsequent, extremely high risk of suicide following that hospitalization. That just has to be looked

at. And researchers sometimes take the variables to look at the association, but in their work, they don't look at the association. So we don't have work to do that that speaks to it, except a couple of recent studies that confirm it again. We just have that word mental illness. Today it's, but what are we really talking about? Like, what is the nature of mental health, mental illness? Why do we call it health? Why do we rush to doctors? What, what is the nature? So, 60 years ago, Thomas Saas, that renegate psychiatry, says it's not an illness. It's just a metaphor. It's like an illness. People suffer. It's problems of living. It's terrible problems of living. It's, it's, it's,

It could be chronic. It might be caused by an actual bodily illness, like we used to have syphilis, you know, that then inflames your brain and makes you crazy and give you extra bodily movements and then you deteriorate. And the mental hospitals up until the 30s, up until the discovery of penicillin,

we're filled with people with that third stage of syphilis. And so it used to be palagra, which is a vitamin deficiency. So we then made a distinction between these organic problems that could make you mad, uncontrollable, angry, and others where you were mad, but you had no physical trace. There was no physical lesion. There was nothing bodily that could explain what happened to you. And we called them functional. They were functional psychosis versus organic psychosis. There's a big insight there, huge insight that we've lost. Now we've just said everything is something organic. We don't distinguish

between the two and we don't rule out what could be physical. With an exception, you know, and this is just absolutely fascinating because, you know, for example, I've talked with numerous people on this show at doctors that treat them, people who have vaccine injury. Yes, right? And often because partially because doctors don't want to diagnose that or partially because they don't know how to, they're described as having some sort of functional disease. chronic fatigue syndrome, etc. Yes, yes. Right, exactly.

But the effect of that is that they can't be treated for their actual physiological. So this goes back to this theme of, you know, things being kind of backwards, I suppose. It is kind of backwards. It's a sense that someone recently, an official, a high official, health and human services, not so long ago, asked me, what's the best way to treat mental illness? And I didn't, my answer is not relevant, is what I should have. answered. I didn't quite answer it exactly. I should have answered that the best way to treat mental illness is to first rule out medical, physical illness. First rule out that the person

does not have an infection, some kind of metabolic problem, an undiagnosed brain tumor. Rule out the physical that you say is really there, but you're never finding it. It's so odd that we're convinced it's medical. It's an illness like any other. It's a disease like any other disease. We have supposedly insurance parity for it. Everything is like it, except where's the physical trace? How come to diagnose it? You have to look me in the eyes and see what's not on my lips, in my heart. You have to have all these other theories, but to diagnose my my tuberculosis, you don't even need to see me. You just need an x-ray of my lungs. What exactly is this disease that you don't even put your stethoscope on me.

In fact, you don't even shake my hands anymore. You're just talking to me. What kind of disease is diagnosed this way and is like any other disease? It's obviously not like any other disease. So rule out any other disease first. Involve the medical in it this way. And then if you cannot find the cause,

you can keep searching for it, but don't put 99% of your energy saying, Well, we know what the cause is. It's physical. We just haven't found it yet. Enough is enough already. Why don't you focus on what is the exact problem? The person is first bringing.

And if you feel you need interpretation of that, well, then go get trained and become a psychoanalyst or a cognitive behaviorist, a humanist, or a trauma specialist, and dig into it. But don't keep saying it's a physical disease and we need medicine for it. So I'm going to get you to dig into this a little bit because, What is it that we're saying is a physical disease but isn't? Spell it out for me. It's someone who's...

What is it that we're saying is schizophrenia, manic depressive disorder, severe depression, severe endogenous depression, post-severe depression with a postpartum in the onset. That we're saying is a physical disease. It's got schizophrenia supposed to be, you know, something having to do with your dopamine system. I think a lot of us believe that these things are actual diseases, but you're saying somehow they're not. I'm saying that they've not been demonstrated to be. There's no Nobel Prize for having discovered the cause of schizophrenia. There's no, when we diagnose schizophrenia, we never look at your body.

We just look at what you've been doing and what others have been saying about you and what you're saying about yourself. We don't need to even put a stethoscope to you. we can make that diagnosis and we can then wait six months and still not having maybe touched you once we can then confirm the diagnosis that's fascinating i mean i don't know if most of us are aware of that even we should be that's exactly how we diagnose schizophrenia it's in the diagnostic and statistical manual of mental disorders and it's there along with the schizophrenia schizophrenia spectrum disorders and that's how we diagnose it that's how we diagnose manic depression or bipolar disorder and that's That's how we diagnose obsessive-compulsive disorder, any of the diagnoses in the DSM,

which also, by the way, the DSM also included many diagnoses of dementia, which is another ballgame. There's always a few mixed in that are very conceivably organic disorders, that having to do with a deterioration of the brain that can be measured in some way. We can look at traces of it. But the traces of schizophrenia that we find, any traces like we used to, we used to, find enlarged ventricles, you know, these sort of fluid-filled cavities inside the brain. We used to find thinning of the, goes with it, the thinning of the gray matter and stuff like that. Those are all confounded by the drugs, by the lifelong, 30-year-long, 10-year-long

regimen of the drugs, the antipsychotic drugs that we give, which themselves have been demonstrated to thin the brain and to have, you know, enormous disruption to the entire body. Every organ, especially the brain is directly affected by the antipsychotic drugs. Now they cause, you know, they hit the dopamine system, they cause movement disorders, they had everything to do with cardiovascular system, the kidneys, the liver, the heart, the vessels, everything. The reproductive system, it's all impacted. But you're saying that these drugs are not actually treating anything physiological? Nothing physiological that we know or have discovered to this.

point, despite repeating, despite repeating for close to a century, that it's obviously, like you say, and we believe it, a physical problem. All right? Just show me the trace. Forget even the cause. Give me a trace, a physical trace of schizophrenia. Every year you have a hundred papers that say, we found. We found another, we found a bio barker. We have these six that keep coming up or so. That's great, wonderful. What are you doing with that information? Is that helpful to treating a person? Are you using that?

Are you trying a different drug because of that? Is there anything different in how you're now going to diagnose the next person who comes in? No, it's all behavioral and verbal and sort of history-taking about how you've been behaving or not behaving. And often it's retrospective. It's after you behave badly. Then then we say, well, of course, you were schizophrenic. Look what you did. But up to that moment, nobody knew, nobody saw, nobody thought.

So that's an unusual disease. In the sense, that's a problem in terms of the homeless people on the street that we say, a lot of them, probably about a quarter would be people that have spent years there, who knows how they fail. or were not able to build a life for themselves, to build a home for themselves. It doesn't take a house. It takes a home. A home is built over a generation. What happened? Complicated stories every time. But some of them, you could say, everybody says they're schizophrenic. I mean, I see them. They're talking to themselves on the street.

They're gesticulating. And, well, that's great. You see, again, well, tell me what's going on here. You know, a person talking to themselves. But can you hear what, can you hear their voices? That's just your inference that they are talking to themselves. Yeah, I talk to myself all the time. I'm talking when I shave, when I comb my hair, when I don't know what to do, when I'm confused, when I'm running, when I'm in the car driving, I'm talking, singing to myself. Sometimes I talk, I say, here's what I would have said in that conversation.

Or I say, this is what I should have said to my kid. This is what I should have said to my wife. And I'm talking to myself, okay. But I have a job. I'm functioning relatively well. So you could say well, but it's all behavioral. It's all about how I live. It's not so much what is happening in my body, which we keep claiming.

So I don't want to belabor the point, but to me, it's so simple and obvious. And that, but yet at the same time, the strength of the phrase, mental illness, is that it's taken literally. It's easy to take it literally. Not only is it like a disease in a way, it looks like it. People suffer. They might commit suicide or shorten their lives that way. Although, again, that's an action.

It's not just an event. So we'd like to make it natural. It's an event. There are mechanisms that cause people to do this. On the other hand, what you see is people doing things. So you could say, well, they were cause to do all of this. their brain is misfiring, you can have another framework and say, and they never learned to put all the voices of their childhood together in one single voice,

which is them, because they maybe never got support, because they were traumatized, because they just never had the skills. And solving that might actually do a lot more to help solve their problem than giving them drugs. Absolutely, although 100%. But the drugs goes along with the model that it is a disease, and we have these approved drugs, and we've been using them, and if you stop using them, we're going to unleash madness in the streets, which already we have madness in the streets. Remember, we've had that drug revolution for 70 years. For 70 years, we've had this regime of, it's a disease, it's in the brain, and we have the drugs for it. And we know that the outcomes are not getting better?

The outcomes have not been getting better overall. Any time people have seriously looked at what the outcomes were prior to the large-scale introduction of the drugs, everyone who's looked at this seriously for a moment or two, including the former director of the NIMH, Tom Insel, in 2008 and 90, he started to go around the country saying, the outcomes are not getting good. And I've just spent $20 billion as a director on very cool projects looking inside the brain every which way but loose. And the needle has not moved. So he himself already recognized it publicly.

But no one is willing to take that observation and see, okay, what else could we do? They're just saying we need to double down. In fact, since in cell left, the NIMH has doubled down on biologic. so-called precision medicine genome, what have you. They're going deeper into the infinite reality of our substrates. From one gene now to 300 gene variants that only explain 2, 3% of what might be, you know, a liability for schizophrenia is explained by so the sample sizes and the studies get bigger from 20,000 to 300,000, the number of loci, the place and the chromosome that might harbor a gene or a variant of a gene or so,

those numbers get bigger and bigger, more hundreds, but the number of explanation of why, you know, the correlation with being schizophrenic gets smaller and smaller and smaller. So it's, as I see it, it's kind of, it's been tested and it's failed. It's just not been. supported that we're dealing with a disease according to the best thinking of what a disease could be. What are we dealing with? And what approaches look promising? What looks promising? I'd like to say, I feel like saying there's nothing new under the sun here. This is just, you know, because you know and you've known the kinds of despair that people manifest when we call them mentally ill, seriously mentally ill is something that's been described forever. It's despair, its loss of hope, it's self-destruction. What's promising? Human connection. Human connection is the most promising,

obviously, for durable, for a lasting effect on the serious tragedies, the so-called problems of living that Tom saw 60 years ago said, that's what mental illness is. It's just this myth to make palatable. It's like a bitter pill, but it just makes palatable the tragedies of being alive and finding out how are we going to live and what are we going to do in these difficult situations. So that, what's promising is who do you have around you that can help you? You know, your first line of defense has to be self-defense if that fails. What do you got? Well, we go to family. Our families today are everywhere else, but close to us, as a rule. I think we've passed that halfway point where everyone's dispersed.

So you're basically on your own. And a lot more is on your shoulders to figure out. So you could just begin to see that what's promising is structures of people around you. And if it's not people you know well that are your kin or your neighbors, or your fellow citizens, or your fellow residents, then they're going to have to be credentialed people. And you just hope those credential people have the time and have the models, the mental models that they've been trained with

to want to spend time with you and repair those broken bonds. Your contention basically is that mental illness, I'll use that, you know, the term, is basically just a, label put on the vagaries of the diversity of human experience, some of which can be very difficult. Absolutely. That's exactly what I'm talking about. It's so simple, but yet it's not simple, because some of those vagaries can be very difficult. It's hard to accept that this could happen to us unless there were some cause. And that's where the so-called... Some very acute, some very, yeah.

And for a long time, it's been spoken of that way, that if, you know, Greek philosophers have spoken about it immediately made the connection to physical illness. So this is not a new thing, a modern model. It's an ancient model that it could be the body that's coexisted all along with a model that it could be just how we live our lives. And so it's seductive model.

And we have a whole now, and we've had a medical industry and for 200 years a psychiatric industry that's specialized to solve that problem. That was, that they presented themselves first as medical men devoted to medical thinking. And they entered into the insane asylums with the province of entrepreneurs and the church and the clergy. And then they went into that empire of state hospitals and insane asylums in the countryside, and they colonized it medically. And they said, no, no, we're going to bring medicine now. We're going to bring signs to it. Okay, we're 150 years later, let's say.

Where are we at with it? We have, you know, close to half the population on some kind of painkiller or psychoactive drug and so forth. Under, as prescription drugs that you ought to take given by our medical men. Okay, we can just look. You know, what's the weight of harm, the weight of disorder, or so forth? It looks a bit worse now, actually. We can't blame it all on the medical model. So social atomization would play a role, given everything you've just described.

Everything. Even the things that we value so much, things like giving women's emancipation in the 60s. And the change that made to the role of children and the role of the family. Things like this, that these are trade-offs, things that we want to pursue today at any cost, we're paying some of the cost. So it puts us in a situation of, what do we do? Do we go back in time? What's promising? It's an interesting question that I hear a lot. What's promising? I don't know what's promising.

What's promising is that you have periodically people in the system who've been the benefits, the so-called the beneficiaries, the users, the clients, the patients, the survivors, as they call themselves, the consumers, they occasionally rise up and have a new insight and say, it's not quite like I was told. It's not exactly what I was promised. It's not what I was, it's not like how I was explained it was. And I think it's a bit more like this. They've typically been silenced until lately, until the last 20, 30 years. We've paid more attention first to their families and then themselves.

And now we have to listen. We have to compose with them because they also are educated. Because you see now we've spread the diagnoses everywhere. And they can now, they're not powerless. They're not insane, most of them. They're like you and I. They have a diagnosis. They're drugged.

And they say, boy, is that hurting me to be on there or to try to come off? these drugs and so there is a new new space for these voices unfortunately it has a tendency these new these movements toward more user autonomy user voice their narratives going into the equation they get contained fairly quickly they get neutralized fairly quickly there's a sort of countercounter push but they also these newer narratives also make their way and grow and expand and bring some kind of closure and new answers and ways to solve problems for many people.

So bottom line, as we finish up, I know you don't like the term mental health. I'm beginning to dislike the term mental health now, speaking with you. What are the, for lack of a better term, mental health services that are needed at this point in time, given your critique of what exists? The whole gamut of what we would call real, true, and practical education.

First of all, education and how your body works. To children. Real facts. Not social, emotional learning or sex education. whatever they call it in middle school or elementary school. Real facts about how your body is constituted and what it needs to prosper and thrive and grow well. That's the first thing.

And the second thing is the services are the services that people want. Now, what people mostly want generally is drugs. People love drugs, especially in America. I think we love drugs. We want drugs. But we've been socialized to want them. them too. Yes, we've been socialized to want certain kinds of drugs, though we also want these others, those, and that we probably use more than the prescribed ones, but we're told

those are very bad. But we're still living with that. We won't, we'll have a drug war, but we won't completely come down on it. But people want drugs. People want support. People want support that they can afford. In other words, if they want, call them mental health, services that they can decide, here's what I need. So I'm talking about, yeah, your personal assistant who's with you to help you raise your child, I guess. That's one thing a lot of people could use. In other words, that you could afford it. So if someone comes and says, I would like to increase the level of mental health services in our area, well, I'd raise my hand and say, does that mean I'll be able to afford the service that I want? Or does it just mean,

you're going to put more people out there who are going to want to do something with me that I'm not sure if this is for me. I'm not sure this is what I want, but you're giving me more of those people. So access to me, access means is it affordable and is it pluralistic? Are there different things? Maybe I need relaxation. Maybe I need a specialized retreat. Maybe I need walk therapy, art classes, music classes, practice. Practical skills, interpersonal skills, counseling, deep counseling, psychoanalysis, job training, assertiveness training, all these things should be much more available to people.

Basically, when they want them, and that they should be able to pay for them without having to wait so long and be on a wait list for only things that are going to end up with a drug that is not quite the drug they want anyways. So that's what I'm saying. If you want to be practical, yeah, sure. We know that often the help is going to be something that we do with someone else. But who's that someone going to be? Is it just someone who, have they lived the problem? Do they have practical experience? Are they wise?

Why am I going to see them? Or do they have any knowledge, real knowledge about what I'm going through? Where did they get that knowledge? So these are the kinds of things. we could try to start fixing piecemeal, if you want, bit by bit, that I think would increase the quality of the social response we have to mental illness. You know, one thing that just strikes me, except perhaps the drug aspect, but one, there's an institution that covers a whole range of what you're just talking about.

That's church. So, yes, church. Church is very important in the sense that... Well, I just know people who benefited. and many of the ways that you just described precisely through this. Places of faith, let's call them. Yes. And places of faith, first of all, they give a narrative about what's right and wrong.

Not necessarily why. Some of them very much, why this is wrong and why. But others, it's just this is right, this is wrong. So they teach that too. Your family does that too. But a place of worship is where they do that. And that's very important. And so there's so much.

to these social institutions we have. Foundational to me is the family, which I think is foundational to civilization, of whichever kind you want, is a family with a complete set of caretakers, however you want to define them. One parent is very hard, two parents really helps a lot more, and they have to be somewhat competent, so they need some help. So family, yes, places of worship, schools, playgrounds,

playgrounds, places where people can abandon themselves, but safely, where there are things to do and place to play and you can run, but you won't get lost. You know, there'll be some containment. And so, yes, that's what we need, but that's baseline. That should be baseline. It's not a privilege. In America, it should not be a privilege. But once we have those things, then we can worry about and start to rule out, okay, for the problems that are appearing now, what's physical illness, what's not physical illness that we can establish. And then we can start thinking of other specialized things, many of which we have already. But I'm saying to call it all a disease, to pretend to treat it all as a disease,

while we're saying, as a health care practitioner, I can incarcerate you for your disease. And this is ridiculous. People go entrusting their health care practitioner, and next thing you know, they find themselves detained, sometimes with a handcuff. And what did I do? And so maybe we need an insignia on our healthcare practitioners who practice this form of human relations, of coercion, on the basis of health. So the public has to be educated that you can be coerced in circumstances, but we'll identify the practitioners who do that. So if you want to, you can avoid.

We also need practitioners in that spirit to much better label themselves about what they can do and what they can do. can do, what their experiences are, what they don't know, where they've learned, and so forth. So the public can choose better. Right now we just go because they have a degree and they're a psychologist or a psychiatrist or a family and marriage counselor, but you don't know anything more than that and you get a little one-line blurb. Well, it's like labeling the product. What's in that thing?

What are the ingredients? What am I getting? What am I promised? And then I'll decide. informed consent is your bottom line here. Yes. From the political consent of the governed, right? Again, founding fathers, to, which is the basis for why you and I should consent if I want to, you know, if I propose an intervention that's going to restrict your right or your consciousness or whatever, you should be able to give me consent.

So yes, inform me. Be transparent about what you know and where you know it from and I will happily follow you if I try. you and to, and for me to trust you, you have to earn it. So I think this is why I say, it's not what's promising in terms of new developments. It's the, it's the, I guess, what I would call the foundations of what we know already is supposed to work. Well, David Cohen, it's such a pleasure to have had you on. Yeah, and it's my pleasure.

Thank you all for joining David Cohen and on this episode of Thank you, American Thought Leaders. I'm your host, Janja Kellick.