RFK Jr. and MAHA Send Psychiatrists into a Panic Attack

Reining in psychiatric overprescription won’t come from targeting SSRIs alone, but from fixing insurance incentives that replaced therapy with 15-minute med checks.

https://amgreatness.com/2026/05/23/rfk-jr-and-maha-send-psychiatrists-into-a-panic-attack/

By Carole Lieberman

May 23, 2026

It is no secret that RFK Jr., Secretary of Health and Human Services, doesn’t like psychiatrists, and he has had good reason, based upon his personal life experiences. For example, his aunt, Rosemary Kennedy, was treated with a prefrontal lobotomy at age 23 in 1941, a dark chapter in the history of psychiatry that left her institutionalized for life. He credits his own recovery from addiction to abstinence-based 12-step programs, focusing on spiritual principles and peer support, rather than on psychiatrists or medication.

So, it is no surprise that he is drawn to curtailing psychiatrists’ powers. And he has begun to do so, with the recent MAHA Mental Health and Overmedicalization Summit. His first target for his “deprescribing” initiative is SSRI antidepressants. RFK Jr.’s heart is in the right place, but he has no idea of the hornet’s nest he’s walking into because he was not on the front lines of psychiatry for decades, as I have been. The American Psychiatric Association is already fighting back, and a look at the historical context explains why.

To understand this brewing conflict, one has to first look at what happened to psychiatrists to turn them into over-prescribers in the first place. As a psychiatrist often featured in the media, I, too, have taken every opportunity to rail at the current mental health establishment, and psychiatrists in particular, for overprescribing. So, I agree with RFK Jr.’s efforts to change the status quo. However, it is important to first understand the history of how the American mental health establishment became as dysfunctional as it is today.

RFK Jr. will soon realize that taking prescription pads out of the hands of psychiatrists is a lot tougher than taking COVID-19 vaccines out of the hands of Big Pharma. First of all, Big Pharma still has many vaccines, pills, and potions to make money off of, whereas psychiatrists separate themselves from other mental health professionals by the authority to write prescriptions that their MD license confers.

Once upon a time, I was very active in the American Psychiatric Association, including serving on the national Public Affairs Committee, so I remember well how the most urgent concern of the organization was stopping psychologists from getting the ability to prescribe medications. This war went on for years. No sooner had psychiatrists “won” than insurance companies drastically lowered the payments they made for psychiatrists to do 50-minute sessions of psychotherapy. In their never-ending quest to cut costs, it dawned on an insurance CEO one day that they could pay psychologists, social workers, marriage and family therapists, and counselors less money to do psychotherapy because they don’t have MD degrees.

This was very short-sighted because the years of medical school and psychiatry residency that psychiatrists complete give them much more intensive training and experience to assess and treat patients than other mental health professionals—not just the ability to prescribe medications. But this cutback on psychiatrists seeing patients for psychotherapy sent them into a tailspin. Suddenly, the bread and butter of their practice, the combination of psychotherapy and medication management (for those who also needed medication), disappeared.

But, instead of protest marches or any other attempt to fight back, psychiatrists surrendered to Big Insurance and figured out a workaround—one that cheated patients just as they, themselves, had been cheated by Big Insurance. A typical psychiatrist, working 8 hours a day seeing patients, at the rate of 50-minute therapy hours, can only see 8 patients a day, and at the lower fee schedule they were now being reimbursed by insurance, they wouldn’t be able to pay their mortgage or any other financial obligations they had. But if they only saw patients for 15-minute “med visits,” they could see four times as many patients and get sufficiently reimbursed by insurance.

However, what I learned as a psychiatric resident and then saw confirmed time and time again throughout my career is that medication alone cures no psychiatric disorder. Most of the psychiatrists who do “med visits” to survive know this as well. Most patients who go to psychiatrists for help today are met with brief visits where they discuss their symptoms, are handed a prescription, and told to return in a month or two or six. They are not given sufficient time to talk about their problems, and certainly no time to talk about their childhood—which is the root of whatever problem they currently have.

When the patient returns, with no improvement in their symptoms or their life, the psychiatrist simply hands them another prescription to add to the list. This is why people are walking around with prescriptions for 3-5 medications and feeling worse. Not only is this because each medication interacts with the others, but also because no one is really listening to their story and offering insight, compassion, and direction. Many of these patients suffer in silence until they either commit a crime or commit suicide. This is the main reason why mental health in America has deteriorated so badly.

But the answer isn’t simply to stop prescribing SSRIs. The answer entails changing the payment system that Big Insurance uses in order to properly subsidize 50-minute sessions of psychotherapy—not just med visits. It also entails better funding of psychiatry residency programs so they aren’t dependent upon Big Pharma. Residencies need to go back to spending more time teaching psychotherapy and supervising residents treating patients with psychotherapy, and less time teaching residents to prescribe the latest drugs that Big Pharma steers them towards.

It will be ever harder to get our head around the challenges of the future—from AI to aliens—and all the medications in the world won’t be enough to help us navigate these new frontiers. But a psychiatrist with a couch and a pad, who cares and knows how to help us put all the pieces of our life together, is still worth their weight in gold.

Carole Lieberman, MD, MPH is a Board Certified Beverly Hills psychiatrist, who was Chief Resident at NYU-Bellevue, and also trained with Anna Freud at her London Clinic. She is a bestselling/award-winning author, podcast host, and 3x Emmy-honored commentator on Newsmax, FOX News, and other media outlets.