Mad in America: Rethinking Mental Health

On July 21st 2025, the FDA convened a hearing on maternal use of antidepressants during pregnancy and the impact this use has on fetal development. Around 400,000 children in the United States are born each year whose mothers took antidepressants while pregnant, and so it's easy to see the societal importance of this topic. What are the risks to the fetus, the newborn, and the long-term development of that child? Adam Urato and Joanna Moncrieff were members of that FDA panel, and so too were several others well-known to MIA readers, including David Healy and Joseph Witt-Doerring. The purpose of the panel was to assess whether the FDA needed to put a warning on antidepressants related to their use in pregnancy, and most on the panel spoke of research that told of the need to do so. However, after the panel concluded, the American Psychiatric Association and other medical associations, most notably the American College of Obstetricians and Gynecologists, responded with what can only be described as howls of outrage, issuing press releases and telling the public that the panel was biased and that the real risk during pregnancy was untreated mental illness. These medical organizations asserted that the increased risk of adverse outcomes for children born to depressed mothers is due to the illness and not the drug, and that there was plenty of evidence that antidepressants were a helpful and even life-saving treatment for maternal depression. Here is where we are today. That FDA hearing put two narratives on public display, and most media reports embraced the narrative put forth by the medical organizations. What we will do today is review the evidence that exists on this topic and the response by the medical guilds to a public airing of that evidence. Dr. Adam Urato is Chief of Maternal and Fetal Medicine at the Metro West Medical Center in Framingham, Massachusetts, and he has been speaking and writing about the risk of medications used during pregnancy for years. Dr. Joanna Moncrieff is a UK psychiatrist and researcher who was a co-founder of the Critical Psychiatry Network and is well known for her research on the safety and efficacy of psychiatric drugs. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2025. Produced by James Moore https://www.jmaudio.org

Frank Gruba-McCallister is a clinical psychologist, educator, and scholar whose career spans more than three decades of teaching and academic leadership.  He served as Vice President of Academic Affairs at Adler University, where he helped to reorient the institution’s mission toward training socially responsible practitioners. His leadership and curricular reforms contributed to Adler’s doctoral program receiving the American Psychological Association’s Board of Educational Affairs Award for Innovative Practices in Graduate Education in 2007. He has also taught at the Illinois School of Professional Psychology and The Chicago School of Professional Psychology, and worked as a clinician in both medical settings and private practice. Throughout his career, Dr. Gruba-McCallister has been a steady voice at the intersection of critical psychology, humanistic and existential thought, and spiritual inquiry. He is the author of Embracing Disillusionment: Achieving Liberation Through the Demystification of Suffering, a book that examines how internalized oppression and ideological mystification compound human suffering and how healing demands a deep and sometimes painful confrontation with illusions. His newest book, Radical Healing: No Wellness Without Justice, published by University Professors Press, draws from liberation theology, critical theory, existential psychology, and transpersonal thought to explore the structural and spiritual roots of suffering. At its core is a call to restore moral responsibility, to reclaim compassion and justice as central to any meaningful model of care, and to invite those who seek to heal others to do so with humility, courage, and radical honesty. In our conversation, we discuss the origins of this work, the crises that shape our current moment, and what it might mean to envision psychotherapy as both a spiritual and political act. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2025. Produced by James Moore https://www.jmaudio.org    

John Ioannidis is a Stanford professor, a physician, and one of the most eminent scholars in the world in the field of evidence-based medicine. Ioannidis has spent his career exposing the weak foundations of much of modern medicine. His 2005 paper, "Why Most Published Research Findings Are False," became the most-viewed article in the history of PLOS Medicine and helped spark a global reckoning with reproducibility. He has since warned about how evidence-based medicine can be hijackedby industry influence, how biased reward systems in academia favor quantity over quality, and how even systematic reviews can recycle flawed data. His critiques extend to psychiatry, where pharma-funded trials often tilt toward positive results, guidelines are shaped by insiders, and neuroscience findings are more fragile than they appear. He is a tenured professor at Stanford and has an extensive background in medicine, epidemiology, population health, and data sciences. As much as he is a champion of good science, Ioannidis is also a lover of the arts and humanities. He's a novelist, teaches poetry, loves operas, and has written libretti for four operas himself. In this interview, he discusses the extensive bias that pervades scientific research, the problematic practices and pressures that enable flawed science, and the significant issues with antidepressant research. At the same time, he reminds us why good science is a gift to humanity and something we must protect for our well-being and dignity. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2025. Produced by James Moore https://www.jmaudio.org

Talia Weiner, a psychological anthropologist and assistant professor, dives deep into the interconnectedness of social forces and mental health care. She discusses the unrealistic self-management expectations placed on individuals with bipolar disorder and the impact of political structures on mental health practices. Weiner contrasts community mental health with private psychoanalysis, advocating for integration of community support. She also highlights the necessity of structural competency in therapy and explores the role of AI in enhancing therapeutic practices.

On the Mad in America podcast this week, we explore the importance of raising awareness of psychological approaches that challenge mainstream perspectives. Joining us today are three people who are practising clinical psychologists and who have written for Mad in America. Zenobia Morrill is a critical-liberation psychologist and psychology professor who received her doctorate from the University of Massachusetts, Boston. Her research interests include critical and liberation psychology, the psychotherapy process, and wider conceptual and ethical issues in psychology and psychiatry. José Giovanni Luiggi-Hernández is a clinical psychologist in private practice, a qualitative researcher at the University of Pittsburgh, a writer for Mad in America and part of the recently launched Mad in Puerto Rico website. His interests include understanding the lived experiences of colonized people using phenomenological, psychoanalytic, and decolonial frameworks, LGBTQ issues and psychotherapy for physical health concerns. Also joining us is Mad in America’s lead research news editor, Justin Karter. A graduate in both psychology and journalism, Justin’s research and writing span topics in the philosophy of psychology, critical psychology, MAD studies, cross-cultural psychology, qualitative methods, and theories of counselling and psychotherapy. In this conversation, we discuss the possibilities opened up by adopting a critical mindset, identify some of the barriers to working in such a way, and share some key resources to help aspiring psychologists explore alternative approaches. Find a full transcript of this interview here: https://www.madinamerica.com/2025/08/how-to-be-a-critical-psychologist-without-losing-your-soul/  *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2025. Produced by James Moore https://www.jmaudio.org

Welcome to MIA Radio. Today, we are pleased to have as our guest Jaakko Seikkula. Jaakko is a psychologist who helped develop the Open Dialogue practice at Keropudas Hospital in Tornio, Finland, in the 1990s, and he is the person who  has conducted the research that told of remarkable longer-term outcomes with this form of care. For the past 15 years, he has developed and led training programs that have seen Open Dialogue practices adopted in 40 countries. He recently published a book titled, Why Dialogue Does Cure. In this interview, we discuss how Open Dialogue came to be, the research that shows its positive outcomes, how psychiatry has failed to learn from Open Dialogue practice and more. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2025. Produced by James Moore https://www.jmaudio.org

Jørgen Kjønø, whose stage name is Dex Carrington, is a Norwegian-American stand-up comedian based in Oslo, Norway. He is also an actor, host of the Truth Train podcast, and former travel show host who gained international recognition as the host of Dexpedition, which aired on MTV in over 30 countries. He joins us on the Mad In America podcast to talk about his experience with Lyrica and Zyprexa, including a five-and-a-half-year taper after 10 years on the drugs. *** Find a full transcript of the interview here: https://www.madinamerica.com/2025/07/horror-psychiatric-drug-withdrawal-dex-carrington/  Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2025. Produced by James Moore https://www.jmaudio.org

Stijn Vanheule is a clinical psychologist, psychoanalyst, and professor of psychology at Ghent University. Trained in the Lacanian tradition, he has written widely on the structure of psychosis, the limits of psychiatric diagnosis, and the importance of attending to the subjective logic of mental distress. His books include The Subject of Psychosis: A Lacanian Perspective, Diagnosis and the DSM: A Critical Review, and most recently, Why Psychosis is Not So Crazy, which offers a reorientation of how clinicians, families, and broader society might understand and engage with psychotic experience. Drawing on psychoanalytic theory, case studies, and contemporary cultural examples, Vanheule treats hallucinations and delusions not as meaningless symptoms but as creative responses to existential disruptions. He emphasizes the importance of listening—clinically and socially—not for coherence imposed from the outside, but for the structure and logic within a person’s seemingly incoherent world. His approach challenges dominant psychiatric models that prioritize symptom suppression, calling instead for a therapeutic attitude grounded in humility and collaboration. In this interview, Vanheule discusses the role of hallucinations in restoring a shattered sense of meaning, the necessity of admitting one’s limitations as a clinician, and the importance of everyday practices—gardening, conversation, shared meals—in building connections that can anchor recovery. Using a depathologizing lens, he discusses that to overwhelming existential challenges that make us all vulnerable, psychosis might not be a crazy reaction after all. *** Find a full transcript of the interview here: https://www.madinamerica.com/2025/06/why-psychosis-is-not-so-crazy-a-conversation-with-stijn-vanheule/  Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2025. Produced by James Moore https://www.jmaudio.org

Nelson Lee is a therapist and mental skills coach with a master's degree in clinical mental health counseling and an MBA. In 2024, he attempted to get off antidepressants that he'd been on for 15 years. This led to significant long-term medication withdrawal that Nelson is still navigating at the time of this interview. As a therapist, Nelson specializes in helping clients transform their relationships with themselves and others and overcome anxiety and OCD. He loves helping people rise above their challenges and proactively maintain long-term healing and growth. He believes it's never too late or too early to improve your mental health. *** Find a full transcript of the interview here: https://www.madinamerica.com/2025/06/a-therapist-navigating-antidepressant-withdrawal-nelson-lee/  Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2025. Produced by James Moore https://www.jmaudio.org

Paulo del Vecchio is a person in long-term recovery from mental health and addictions, who has been a leader in the peer recovery movement for 40 years. He recently completed a 30-year career at the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, where he served in multiple roles including the director of the Center for Mental Health Services and the founding director of the Office of Recovery. Paolo is now an independent advocate, working to advance recovery-oriented policies and practices on national and international levels. In this interview, he speaks with Mad in America’s Leah Harris about his roots as a housing justice activist to his decades of public service at SAMHSA, what worries him most about mental health in today’s America, and where he sees hope in the recovery movement that he helped create. *** A full transcript of this interview can be found here: https://www.madinamerica.com/2025/06/progress-only-occurs-when-people-make-demands-paolo-del-vecchio/  Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2025. Produced by James Moore https://www.jmaudio.org