Healing

Our Path from Mental Illness to Mental Health

By: Thomas Insel

Narrated by: Thomas Insel

Length: 9 hrs and 11 mins

Publisher's summary

A bold, expert, and actionable map for the reinvention of America’s broken mental health care system.

As director of the National Institute of Mental Health, Dr. Thomas Insel was giving a presentation when the father of a boy with schizophrenia yelled from the back of the room, “Our house is on fire and you’re telling me about the chemistry of the paint! What are you doing to put out the fire?” Dr. Insel knew in his heart that the answer was not nearly enough. The gargantuan American mental health industry was not healing millions who were desperately in need. He left his position atop the mental health research world to investigate all that was broken - and what a better path to mental health might look like.

In the United States, we have treatments that work, but our system fails at every stage to deliver care well. Even before COVID, mental illness was claiming a life every 11 minutes by suicide. Quality of care varies widely, and much of the field lacks accountability. We focus on drug therapies for symptom reduction rather than on plans for long-term recovery. Care is often unaffordable and unavailable, particularly for those who need it most and are homeless or incarcerated. Where was the justice for the millions of Americans suffering from mental illness? Who was helping their families?

But Dr. Insel also found that we do have approaches that work, both in the US and globally. Mental illnesses are medical problems, but he discovers that the cures for the crisis are not just medical, but social. This path to healing, built upon what he calls the three Ps (people, place, and purpose), is more straightforward than we might imagine. Dr. Insel offers a comprehensive plan for our failing system and for families trying to discern the way forward.

The fruit of a lifetime of expertise and a global quest for answers, Healing is a hopeful, actionable account and achievable vision for us all in this time of mental health crisis.

This audiobook includes a downloadable PDF that contains charts and graphs. 

PLEASE NOTE: When you purchase this title, the accompanying PDF will be available in your Audible Library along with the audio.

©2022 Thomas Insel (P)2022 Penguin Audio

Critic reviews

“The outcomes for people treated for serious mental illness are often poor.... Why? A psychiatrist and neuroscientist who headed the National Institute of Mental Health in 2002-15 and has since returned to the private sector, Dr. Insel is well-positioned to answer the question...traveling widely to identify the crisis of care and look for solutions. Healing is the product of this odyssey—and a compelling summary of all that he learned along the way.”—Sally Satel, The Wall Street Journal

“[Insel’s] recollections give depth and provide a human face to the problems he articulates and offer hints at possible solutions.... Like a good doctor, Insel identifies symptoms and prescribes solutions to the problems that plague the country’s mental health infrastructure...our country’s soul is in a decidedly bad place. Healing suggests a path toward a better one.”—Benjamin F. Miller, Science 

“Insel’s reflective and heartfelt book is an important contribution to the ongoing debate about how to address the current crisis that prevents so many Americans saddled with a serious mental illness from rebuilding their lives.”—Joshua C. Kendall, Undark

What is the Point Doubting Thomas?

I do not recommend this book on systemic problems in the American mental health system. Thomas Ensel does not deal with the causes, conditions, and consequences of mental health at the systemic level. This book also does NOT serve individuals who might be looking for insight to further their good life’s progress. This book does not look at the effects created by the mental health system.

Its kind of a weird book. It points out the fact that there are no known biomarkers for mental illness but symptoms can be treated with psychopharmacology. Ethical justifications for using drugs on human beings experiencing psychological suffering are not discussed. Thomas Insel says that the mental health system has been better for pharmaceutical companies than for individuals suffering in the conditions that cause mental illness.

The book gives case studies about long term effects of mental illness on individuals, and the need for community(s) to support effected individual(s) but does not look at the social constructions of emotion. In the very end, the book says mental health SYSTEMS might benefit people more if the mental health SYSTEM dealt with suffering the way social justice communities do.

The book is about doubting Thomas Insel’s long career and his personal power to live in ideas. The most heart felt concepts come when he uses his daughter’s story. Her story is used to illustrate how an non-professional person in an office for social work in a big city can learn to knit by watching YouTube videos. Then his Smith graduate daughter teaches what she learned by offering group knitting lessons as a circle for catharsis and connection. The products of the knitting circle lead to having resources sold in a small business benefitting the makers.

This uplifting story of bringing (distressed) women together to talk and produce an item that fortifies economic existence is told much better by Sarah Chayes in her book, “Corruption in America and What Is at Stake.”

Women have gathered to talk and make craft or art objects to be used for their own purposes occurs in many many cultures. Sarah Chayes participated in helping a community of Afghan women whose lives were precarious due to war, religion, and other cultural nullifications of their human capacity. Sarah Chayes tells the story of corruption by adopting a metaphor to communicate the simultaneous ongoing regeneration and morphing of oppressive qualities. The metaphor she uses is the Medusa.

The Medusa names the ugly disempowerment that reinvents itself. The Medusa is a symbol for systemic corruption which can be corrected but only momentarily. Once one good practice is in place, along comes another head of the Medusa as some group who corrupts the good process for their own benefit.

The story of corruption Sarah Cheyes tells is about interconnected interdependence of people who get power by manipulating ethics under the guise of community leadership. Relief from oppression comes when people choose to educate their selves together. This is a sharp contrast to Thomas Insel’s story that does not address to the fact that individuals get better by learning truth together.

Thomas Insel’s whole intellectual project depends on “TREATING” the mentally ill and/or developing mental health by adding resources to get better. His systemic approach has been challenged by many, most notably by Robert Whitaker and Lisa Cosgrove in their book called, “Psychiatry Under the Influence.” The criticism is noted by Thomas Insel. He tells readers that Robert Whitaker’s work is a conspiracy theory. Robert Whitaker and Lisa Cosgrove ask questions that Thomas Insel does not.

In “Psychiatry Under the Influence,” simple questions are discussed: What research validates the diagnoses used in the mental health system(s)? Are mental diagnoses valid? If so, what scientific data determines the validity of the diagnostic categories? Is the difference between psychiatry and psychology significant for the person wanting to learn about their life? If psychological symptoms are the cause of many mental health distresses, and there are no biomarkers for mental illness, and the diagnostic scheme for classifying symptoms Might Not be validated by scientific data, is it ethical to use the psychiatric (biological) intervention of medication? and so on.

The Thomas Insel “Healing” book does not address many helpful questions. He wrote a book about his career interests in the style of a psychological rhetorician of the late 1960’s. That was an age when a few people had access to making theory. They mixed ideas with anecdotal case studies to move the story toward meaning. There is little discovery or scientific inquiry in Insel’s book on “Healing.” There is no call out to the sociologists and community organizers who are actually doing the work to address the causes of mental illness.

Gee wiz! This Thomas Insel book is pathetic! For goodness sake, when Insel discusses the social problem of jails serving as mental asylums, he does not even address how the justice system creates mental illness. You want to look at that story? Read, “When They Call You a Terrorist” by Patrisse Kahn-Cullers and Asha Bandele. It is an excellent account of the causes and conditions that create mental illness. It also tells the story of the person who started #blacklivesmatter.

There is also a book called “Enforcing Freedom” by Kerwin Kaye. Ultimately, the author of this book taught me to have an open mind to discovering good in a good ways. He reported his research found at the intersection of drug courts and treatment programs. For me, the biggest surprise about drug ordered treatment programs was the fact that if a person could get a job, they were considered a success and survived drug court.

Thomas Insel, I do not know who your friends are, but you seem to need more friends to tell you the truth. Then write a better book. Make one that does not betray inherent wisdom that is in reality. Join your daughter’s knitting group for God’s sake. Thank you.

Wide Ranging Insights from a Psychiatric Pioneer

This illuminating book by the former Director of NIMH is a superb overview of what “ails” the American mental healthcare system - hardly a “system”, because it is so fragmented - and a set of “prescriptions” for improving it. Dr Insel shares his vast fund of knowledge and experience, weaving together the history of mental healthcare policies, the history of major psychiatric and psychological theories and practice patterns, numerous stories of individual patients, and examples of best practices that deserve close attention from health system leaders and government officials; yet all the while he maintains a humble tone, demonstrating a consistent willingness to update his thinking and set aside his own past convictions. It is clear that Dr Insel has had a lifelong interest to raise mental health care standards and accountability to be comparable to medical conditions such as heart disease or pediatric cancer. The book further benefits from his sharing about being California’s mental health czar for a year. During that time he learned from the homeless, skid row psychiatrists, law enforcement, and many others. Dr Insel’s many faceted background in psychoanalysis, clinical research, the neurobiology of attachment, administration, technology, being a parent of two children with mental health challenges, all combined with a keen eye and the warmth of a caring clinician, make this book a gem and must-read for anyone who cares about advancing the future of mental health. Make sure to listen or read through to the end; I personally found the FutureProof program for youth mental health promotion in Australia to be particularly inspiring. Thank you Dr Insel!

Insightful, thoughtful, and actionable

I work in mental health housing and often wondered why the mental health system seems so unsystematic. This book provided helpful historical context as well as great ideas for a way forward. I'm going to re-read it immediately.

Forward-looking. Hopeful. Helpful.

For families of loved ones in the throes of mental illnesses, Dr Inslee is a credible prophet of hope. For other fellow citizens, please don't wait till mental illness breaks your heart. Join the fight to support practical changes that can save and change lives.

Absolutely beautiful, HOPE

Dr. Insel’s book is not only informative and insightful, he offers actual solutions to bring about hope and healing. I have used his teachings in my Practice. I am grateful for this book and highly encourage anyone who wants to be a part of the social change on mental illness/health to listen carefully to the insights of his teachings.

Eye-opening for the late person

For quite some time, it has been plainly obvious to anyone in the United States, that there is a serious mental health problem. But for us who are not in the mental health profession, we know little about the cause of this growing problem and even less about the solution. This book examines the issue from numerous important perspectives and helps the reader understand there are solutions. In this book there is also a strong notion that every one of us can do something to help the mental health crisis in our communities. This book is laden with a hopeful tone. The ideas in this book can be the genesis of a movement that will greatly help our struggling family members and neighbors.

For everyone (mental health experience or none at all)

This book makes sense of many things that felt hopeless otherwise. I will be recommending to everyone I know. It changed my outlook on healthcare and our potential.

Couldn’t put the book down

Outstanding! The book should be a requirement of all mental health programs. I’ll reread it!

PMHNP -Enjoyed it

I’m a psych mental health nurse practitioner. Selected this book on whim and thoroughly enjoyed it.

Mental health care in the US

An eloquent analysis of the current mental healthcare system in the United States with tangible thoughts and constructs for improving care and outcomes.