How Our Blindness to Context Harms Patients and Breaks Practitioners: A Conversation With Kamaldeep Bhui

Alicia Ely Yamin is the Director of the Global Health and Rights Project and a lecturer at Harvard Law School. She's also an adjunct senior lecturer on health policy and management at the Harvard T.H. Chan School of Public Health and a Senior Advisor on Human Rights and Health Policy at Partners in Health. Alicia is known globally for her work on the right to health, economic and social rights, and reproductive justice. She has spent much of her professional life in Latin America and East Africa, including co-founding a health and human rights program with the Asociación Pro Derechos Humanos in Lima in 1999. She has served in major UN and global expert roles, including as one of 10 experts appointed by the UN Secretary-General to the Independent Accountability Panel from 2016 to 2021. Alicia has edited and authored over a dozen books and UN reports, and close to 200 articles. Her most recent book, When Misfortune Becomes Injustice: Evolving Human Rights Struggles for Health and Social Equality, was published in a revised and expanded second edition by Stanford University Press in 2023, with a Spanish edition forthcoming in 2026. Today, we're bringing her human rights lens to our international mental health systems, including what she's seeing in debates around accountability, consent, and institutional power. *** 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 2026. Produced by James Moore https://www.jmaudio.org

Susanne Paola Antonetta is an accomplished writer and poet, the author of numerous books, and in 2001 her book Body Toxic: An Environmental Memoir, won a prestigious American Book Award. Her latest book is The Devil's Castle, Nazi Eugenics, Euthanasia, and How Psychiatry's Troubled History Reverberates Today. *** 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 2026. Produced by James Moore https://www.jmaudio.org

Kamaldeep Bhui is Professor of Psychiatry at the University of Oxford and Honorary Professor at Queen Mary University of London. He is internationally recognized for his groundbreaking work on cultural psychiatry, ethnic inequalities in mental health, and the social determinants of distress. In recognition of his contributions to mental health research and policy, he was appointed Commander of the Order of the British Empire (CBE). He has written extensively on the grim reality of minorities facing higher rates of psychiatric detention and coercion. In an era of algorithmic checklists and time-pressured care, Bhui argues for reclaiming biographical listening and patients' own stories and understandings. Without cherishing lived experience, clinicians lose meaning in their work and patients lose agency, trust, and hope. In this interview, we will discuss how our contexts and culture reach deep within us to inform our experience of pain, and to indicate what is abnormal, why we feel distress, and what it means to heal. *** 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 2026. Produced by James Moore https://www.jmaudio.org

Elizabeth Cotton is Associate Professor of Responsible Business at the University of Leicester and the founder of Surviving Work, which carries out socially engaged research on mental health and work. She has worked with health teams and trade unions, practiced as a psychotherapist in the NHS, and now runs the Digital Therapy Project, a group of UK and US researchers studying the future of therapy from both sides of the relationship. In her new book, UberTherapy: The New Business of Mental Health, she explores the effects of reorganizing mental health care around the logic of the app store. Therapy is now something you can scroll through on your phone, match with in seconds, and rate like a ride share. Platforms promise frictionless access and personalized care. What is harder to see is how this new "mental health marketplace" is reshaping what therapy is, how it feels, and who it is really built to serve. UberTherapy is part political economy, part insider account of therapy work, part literary exploration of what it actually feels like to bring our most distressed selves to the mental health app ecosystem. In the second part of our conversation, Cotton traces how public austerity and platform capitalism have combined to turn mental health care into a set of digital products, governed by algorithms, data extraction, and dynamic pricing. In this world, qualified human therapists are slowly displaced by AI-driven "solutions," while those who remain are pushed into precarious, low-paid platform work. *** 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 2026. Produced by James Moore https://www.jmaudio.org

Elizabeth Cotton is Associate Professor of Responsible Business at the University of Leicester and the founder of Surviving Work, which carries out socially engaged research on mental health and work. She has worked with health teams and trade unions, practiced as a psychotherapist in the NHS, and now runs the Digital Therapy Project, a group of UK and US researchers studying the future of therapy from both sides of the relationship. In her new book, UberTherapy: The New Business of Mental Health, she explores the effects of reorganizing mental health care around the logic of the app store. Therapy is now something you can scroll through on your phone, match with in seconds, and rate like a ride share. Platforms promise frictionless access and personalized care. What is harder to see is how this new "mental health marketplace" is reshaping what therapy is, how it feels, and who it is really built to serve. UberTherapy is part political economy, part insider account of therapy work, part literary exploration of what it actually feels like to bring our most distressed selves to the mental health app ecosystem. In the first part of our conversation, we discuss how Cotton's path through psychoanalysis, labor organizing, and sociology shaped Uber Therapy, and how shame and anger get intensified when platforms frame therapy as an easy consumer service. *** 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 2026. Produced by James Moore https://www.jmaudio.org

This week, we are joined by Chris Masterjohn, PhD. Chris is a nutritional scientist, a former professor, and the founder of Mitome. With a PhD in nutritional science and years of research in mitochondrial biology, Chris's work focuses on translating peer-reviewed science into practical tools for human health. At Mitome, Dr. Masterjohn pioneered the first analysis designed to measure mitochondrial respiratory chain function directly, identifying individual energy bottlenecks and guiding personalized science-backed protocols to optimize the system responsible for over 90% of cellular energy production. His mission is to bring mitochondrial testing out of the rare disease space and into everyday health. In part 2, we discuss the biochemistry of our stress response and the potential benefits of balanced nutrition for those in psychiatric drug withdrawal. *** 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

This week, we are joined by Chris Masterjohn, PhD. Chris is a nutritional scientist, a former professor, and the founder of Mitome. With a PhD in nutritional science and years of research in mitochondrial biology, Chris's work focuses on translating peer-reviewed science into practical tools for human health. At Mitome, Dr. Masterjohn pioneered the first analysis designed to measure mitochondrial respiratory chain function directly, identifying individual energy bottlenecks and guiding personalized science-backed protocols to optimize the system responsible for over 90% of cellular energy production. His mission is to bring mitochondrial testing out of the rare disease space and into everyday health. In this interview, we discuss why so little is understood about the role serotonin plays in the body and how our mitochondria might play a part in the experince of antidepressant withdrawal. *** 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

Jan N. DeFehr is an associate professor in the Faculty of Education at the University of Winnipeg and an associate of The Taos Institute and a member of the Faculty for Palestine, Manitoba. She is also a member of the York University Mad Studies Hub. Before entering academia, she spent many years as a clinical social worker, working alongside people who were trying to make sense of their distress within, and often in spite of, the mental health system. Her teaching, research, and course development focus on building public access to critical analyses of that system, drawing on the work of clients and survivors of psychiatry, practitioners, and scholars. Her new book, A Critical Mental Health Primer: Towards Informed Choice in Social Services, Education, and Healthcare(Canadian Scholars, 2025), offers a clear and accessible map of critical mental health scholarship. The book examines scientific critiques of diagnosis, the potential harms of psychiatric labels, the lack of transparency and procedural justice in services, anti-colonial critiques of mental health premises and practices, and the evidence on psychiatric drugs and the DSM. It also gathers non-pathologizing ways of helping that center relational, dialogical, anti-oppressive, and anti-colonial approaches, along with concrete tools for informed choice and everyday support outside of the dominant medical model. In our conversation, we talk about how Jan came to adopt critical perspectives, why she sees access to critical mental health knowledge as a prerequisite for ethical practice, and what it looks like when organizations take informed choice seriously. We move through the key chapters of the book, explore its implications for social workers, educators, and health professionals, and look at how communities can build forms of care that do not depend on diagnosis or coercion. *** 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 2026. Produced by James Moore https://www.jmaudio.org

In our first podcast of 2026, Robert Whitaker joins us to answer questions submitted by Mad in America readers and listeners. We discuss the validity of ADHD diagnoses, withdrawal and sexual dysfunction risks of SSRI antidepressants, the harms of electro-convulsive therapy (ECT), the rise of AI-generated misinformation and much 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 2026. Produced by James Moore https://www.jmaudio.org  

Musician and artist Kev G Mor joins us to discuss his experience of psychosis, his daily support strategies, and the pros and cons of having a hundred-pound pit bull terrier for emotional support. Kev is a suicide survivor who grew up with early childhood trauma and has experienced homelessness as a teen, is a single father, and is now again in recovery. His work is about showing what staying well looks like on hard days and keeping it practical for people who live with psychosis. *** 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