Psychiatric Times January 17, 2020
Allen Frances, MD

Patients with severe mental illness (SMI) routinely have no access to adequate medication, psychological counseling, social support, and/or housing. The horrible result is that 600,000 patients are either prisoners or homeless—or rotate between the two. The past 50 years of neglect and criminalization have made the US one of the worst places in the world to have a mental illness.

Meanwhile, on the mild end of the psychiatric symptom spectrum, we have the opposite problem of massive over-treatment. About 20% of the general population regularly use psychotropic medications, most often prescribed unnecessarily and carelessly after brief visits with rushed primary care doctors eager to get the patient out of the office as quickly as possible.1 And, perhaps...

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