We talk with Nick Rosenlicht about what's gone wrong in the mental health care system.

Welcome to the Carlet Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chris Aiken, the editor-in-chief of the Carlat Psychiatry Report.

And I'm Kelly Newsom, a psychiatric MP and a dedicated reader of every issue.

As we were finishing off the final edits of this podcast, we received the news that the

CEO of United Healthcare, Brian Thompson, was fatally shot not far from where we're recording

in Midtown Manhattan.

The words encased on the bullets made clear the shooter's intent, deny, defend, depose.

A reference to a book from 2020 called, delay, deny, defend, why insurance Companies Don't Pay Claims and What You Can Do About It.

Well, there's a lot you can do about it, and we're going to get into that in this podcast,

and murder is not counted among them. But this podcast is not a reaction or a response to the

events of the shooting. It's a reaction to a crisis to the events of the shooting.

It's a reaction to a crisis that has been long-standing.

Nicholas Rosenlicht, MD, has worked as a psychiatrist, teacher, and researcher for over four decades.

It's a career that has seen major advances, Clozapine, Persac, TMS, and dialectical behavioral

therapy. But he's also witnessed a degradation in how we care for people with mental

illness. And that is the subject of his latest book, My Brother's

Keeper. Today, he talks with us about insurance denials, private equity takeovers, and how to reduce

burnout in the age of healthcare productivity. Stay tuned to the end for an important

Clauseapine update. You argue that health care has become a business where patients are called clients and doctors

or providers.

So what's wrong with all that?

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