My Brother's Keeper

The Untold Stories Behind the Business of Mental Health—and How to Stop the Abandonment of the Mentally Ill

Nicholas Rosenlicht

A leading psychiatrist seeks to transform our understanding of mental health care and how it fits into larger social and economic forces—and proposes an effective and compassionate new framework for healing.

Mental health care in America has become nothing short of atrocious. Supposed developments in treatment methods and medication remain inaccessible to those who need them most. Countless people seeking treatment are routinely funneled into homelessness and prison while a mental health epidemic ravages younger generations. It seems obvious that the system is broken, but the tragic truth is that it is actually functioning exactly as intended, providing reliably enormous profits for the corporate entities who now manage mental healthcare.

It is easy to turn a blind eye. Most of us are more comfortable ducking our own fears about mental health and placing our faith in the rugged American individual and the free market, rather than confronting our own prejudices and misguided beliefs. Why did we choose to build such a disastrous system when every other industrialized nation has developed far better models? After decades of work in psychiatry, Dr. Nicholas Rosenlicht reveals how and why we arrived at this abysmal reality—and more importantly, how we can find our way out of it.

Timely and unflinching, and written with commanding prose and the deep knowledge of a mental health care veteran who categorically rejects corporate interests, Dr. Rosenlicht makes plain the disastrous outcomes of the for-profit mental health care model. Patients are “clients” and doctors are “providers,” stripping away the human element and emboldening shifty ethical and legal practices. Perhaps most insidious, the business model paints the mentally ill as the “other,” as people who just don’t want help, rather than someone who can’t afford care or even realize they need help as a consequence of their illness. But a path forward does exist. Mental illness is something that will touch all of us in some way, if not directly through those we know and love. Those who have already helped care for a loved one know that those who suffer from it have hopes, desires, and aspirations. A healthy solution means a healthier society. In the tradition of Andrew Solomon or Bessel van der Kolk's The Body Keeps the Score, My Brother's Keeper is a paradigm-shifting book that can help us find our way to real and lasting solutions.

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Endorsements & Reviews

“Rosenlicht offers glimpses of hope, reminding readers that people continue to fight for a better system in America that encompasses all citizens, with emphasis on care, not profit. My Brother’s Keeper is a scathing look at a crisis that can no longer be ignored and a heartfelt call to demand change.” Kirkus Reviews

“Dr. Rosenlicht, a leading thinker in psychiatry, has written a masterful and moving narrative that provides insight into the very human struggles of mental health care and pulls back the curtain on the vast and complex factors that has led to the crisis of care for so many people. My Brother’s Keeper fiercely demonstrates the societal forces that drive us to embrace business goals, and how we must reverse this process that dehumanizes both clinicians and their patients. This deeply important book is a must-read.” Jodi Halpern, M.D., PhD, Chancellor’s Chair, University of California, Berkeley

“By turns infuriating, insightful, educational and, ultimately hopeful, My Brother's Keeper isn't merely an indictment of a crazy and broken system. Nicholas Rosenlicht walks us through how we got to this terrible place, and offers real—and plausible—solutions for caring for the seriously mentally ill in the U.S. A truly compelling must-read for anyone who knows anyone affected by mental illness." Katie Hafner, author of The Boys

“This is a brave book, an important book, a hard-hitting indictment of a mental health care system that neglects and exploits the most vulnerable. For a half a century, Dr. Rosenlicht has witnessed first-hand the evolution of health care to a business model geared to profit. Today’s mental health crisis is doubly tragic since treatments exist, solutions are at hand, if only resources were justly allocated. Calm and compassionate as Rosenlicht’s account is, My Brother’s Keeper is also a long-overdue call to arms.” Gayle Greene, Professor Emerita, Scripps College, author of Immeasurable Outcomes