At first glance, Vivek Ramaswamy appears as a compelling presidential contender for libertarians. His rhetoric around limited government and personal responsibility resonates with those wary of state overreach. However, Ramaswamy’s recent proposal to reopen state psychiatric institutions armed with coercive power exposes a profound notion that should deeply alarm everyone who values constrained government power. This dangerous idea grants unchecked and coercive power to a system that has long served to oppress—not protect—the vulnerable.

As psychiatrists go, few were as influential and prolific as Dr Szasz. Dr. Thomas Szasz was a Professor of Psychiatry Emeritus at the State University of New York Health Science Center, Adjunct Scholar at the Cato Institute, and a Lifetime Fellow of the American Psychiatric Association. He remains the world’s leading social critic of the moral and scientific foundation of psychiatry, especially in its coercive nature. He’s authored more than 35 books on the subject, starting with The Myth of Mental Illness, a book still revered in libertarian and mental health circles.

For decades, he cogently warned against the abuses of psychiatric institutions and erosion of personal liberty. Szasz argued that “mental illnesses” lack a basis as real medical diseases. Rather, they serve as socially constructed justifications for the state and psychiatric institutions to control and modify behavior deemed undesirable or abnormal.

Committing people to asylums for these alleged “illnesses” deprives them of basic human rights and dignity.

Reopening state psychiatric institutions would constitute an unacceptable and hazardous expansion of government power, ripe for abuse. It risks resurrecting the field’s egregious history of pseudoscience, coercion, and outright torture masquerading as “treatment” mandated by the state;

• Until the 1970s, psychiatry diagnosed resistance to oppression as mental illness. “Drapetomania” referred to slaves who tried escaping captivity. “Sluggish schizophrenia” in the USSR was applied to political dissidents. Psychiatry has historically labeled non-conformity as an illness based on prevailing norms.
• Psychiatrist Walter Freeman, lacking any formal surgical training, carried out over 4,000 lobotomies on patients, including some as young as four years old. His methods resulted in fatal cerebral hemorrhages for over 100 of his patients as he endeavored to control behavior by destroying their frontal lobes. Meanwhile, Egas Moniz was awarded the Nobel Prize for pioneering the prefrontal leucotomy, which is the precursor to the lobotomy—both procedures are now banned and universally restricted due to their invasive nature. Such “treatments” stand as glaring violations of personal liberty.
• Psychiatrist Ewen Cameron conducted CIA-funded experiments at McGill University subjecting unwitting patients to electroshock, sensory deprivation, and paralytic drugs. This damaged patients’ memories and cognition in the name of “mind control” research.
• The Judge Rotenberg Center used electric shocks to punish children with disabilities. In 2020, the FDA finally banned these torture devices. However, the Center still uses them, exploiting legal loopholes.
• Psychiatrist Henry Cotton removed teeth, colons, and ovaries of asylum patients based on his discredited theory that infections cause mental illness. He justified these unnecessary surgeries as curative despite many resulting deaths.
• Psychiatric institutions have notoriously confined people involuntarily in abhorrent conditions. Patients were strapped to beds, beaten, and given insulin coma therapy. The Willowbrook State School experimented on children with disabilities and diseases.
• Today, the majority of U.S. states still allow forced electroshock treatment, psychosurgery, and involuntary psychiatric detention without due process for non-criminal matters. The UN Special Rapporteur denounced this as torture, especially when used punitively or for compliance.

Ramaswamy’s assertion that the resurgence of state-backed coercive psychiatric asylums is the cure-all for the surge in violent crimes is a well intended yet inherently simplistic perspective that doesn’t fully grasp the intricate nature of the issue. His argument hinges on the premise that the closure of these institutions has directly led to an increase in violent crimes, but the evidence suggests otherwise.

Firstly, the notion that deinstitutionalization had significantly contributed to violent crime and subsequent mass incarceration is misleading. The demographics of those historically confined in state psychiatric hospitals were predominantly white, older individuals, with a roughly even gender distribution. That is in stark contrast to violent crime offenders and the prison population today, which has been disproportionately composed of young men of color.

Furthermore, the historical context of institutionalization reveals that even at the height of the state mental hospital era, only about one-third of individuals diagnosed with mental illnesses were ever institutionalized. The majority lived in their communities, often without any significant issues. This fact underscores the reality that institutionalization was never a universal or even predominant solution for addressing mental health in society.

When Ramaswamy acomments on Big Pharma, he does so in an attempt to draw a direct line between the closure of psychiatric institutions and the industry’s influence. While there’s no denying that the pharmaceutical industry has an overarching influence on mental health care, it’s essential to delve deeper into the effects of psychopharma drugs themselves.

Numerous reports shed light on the violent side effects of these drugs. There have been numerous cases of individuals prescribed on these medications or withdrawing from them committing violent acts, including homicides and mass shootings. This raises a critical question: Is it the absence of institutional care or the adverse effects of these drugs that contribute more significantly to violent behaviors?

Additionally, a wealth of evidence demonstrates that coercive state psychiatric practices worsen outcomes rather than providing “care”;

• Loss of autonomy, dehumanizing conditions, and involuntary treatment methods induce trauma, deter help-seeking, and exacerbate distress for people with mental illness.
• The UN, WHO, and other agencies advocate voluntary, rights-respecting, community-based mental healthcare focused on consent over coercion.
• Proven alternatives like faith based approaches and Open Dialogue therapy eschew involuntary commitment and forced drugging, instead facilitating support through open communication and shared decision-making.
• Independent living, clubhouses, supported employment, and peer support offer many opportunities for connection outside coercive institutions. Compassion and empowerment, not control, foster recovery.

Of course, those struggling with mental health challenges deserve access to voluntary treatment and dignified care. But such care must not come at the cost of personal liberty and autonomy. As Szasz wrote, “Involuntary mental hospitalization is like slavery. Refining standards for commitment is like prettifying slave plantations.”

More psychiatric institutions overseen by an emboldened state are not the solution. The true answer lies in upholding the basic human rights and dignity of people with mental illness.

As libertarians, we must be deeply wary of expanding state authority, particularly regarding something as personal as mental health. We should harbor great suspicion of any institution empowered to impose highly subjective psychiatric “diagnoses” that serve its own interest over those of vulnerable individuals.

Vivek Ramaswamy’s libertarian outreach resonates with many who believe in the principles of individual liberty, personal responsibility, and minimal state intervention like me. His proposal to reconstruct state psychiatric institutions may intend to help. But in reality, it irresponsibly empowers a historically abusive and coercive state sanctioned-psychiatric system that risks grave consequences by letting the “fox guard the henhouse.”

Before granting the state more power to deprive liberty in the name of mental health, we must demand increased transparency and oversight, reduced coercion, and unwavering commitment to patient rights and autonomy.

The mentally vulnerable will be better served through voluntary community-based care, not controlled by a coercive state apparatus. It is long past time we heeded Szasz’s call to stop “ignoring the mentally ill person’s need for liberty, autonomy, and responsibility.”

The lesson is clear—unconstrained state power married to involuntary psychiatry is hazardous to freedom and human rights. We disregard that truth at our own great peril. The step away from oppression and towards a system worthy of public trust begins with ending forced institutionalization and treatment.

The goal should be care that prioritizes autonomy, equality, and basic human rights protections for those diagnosed with mental illness. Szasz and his libertarian principles light the path forward out of the darkness of psychiatric abuses run amok. The state should have no further ability to deprive liberty in the name of mental health treatment without the full consent and participation of the individual.