Lower than a month earlier than his assassination in 1963, President John F. Kennedy signed his final invoice: one aimed toward reforming America’s mental-health system. The 12 months prior, Ken Kesey’s One Flew Over the Cuckoo’s Nest had introduced consideration to the crude therapies in psychological establishments, and just like the novel’s protagonist, the president’s sister Rosemary had acquired a lobotomy that left her profoundly disabled. Kennedy sought to finish the “reliance on the chilly mercy of custodial isolation,” he stated in an announcement to Congress.
Dedication to bettering the nation’s method to psychological well being grew to become a household venture. In 1962, Eunice Kennedy Shriver began a sports activities camp for folks with mental disabilities, which grew to become the Particular Olympics. Within the Seventies, Senator Edward Kennedy tried to repair residing situations in psychological establishments; within the ’90s, he helped set up the Substance Abuse and Psychological Well being Providers Administration. Not too long ago, his nephew Robert F. Kennedy Jr., the present secretary of Well being and Human Providers, subsumed that company into a brand new one: the Administration for a Wholesome America, which incorporates psychological well being as one in every of its focuses.
RFK Jr.’s coverage plans haven’t but taken kind. To date, he has overseen deep cuts to HHS and begun reorganizing the company internally. He has met as soon as, reportedly, in personal with the Make America Wholesome Once more Fee, created by the president to deal with power well being points; one in every of its acknowledged objectives is to evaluate the specter of prescription psychiatric medicine. (HHS didn’t reply to a request for remark.) When talking publicly, Kennedy has repeatedly returned to the concept American docs overprescribe such medicine.
Kennedy is expert at choosing up on frustrations within the zeitgeist. The sentiment that docs over-rely on psychiatric medicine, whereas neglecting negative effects or issue tapering doses, has been receiving extra public consideration. Constant and inexpensive entry to therapists, or to financial and housing assist, is tough to come back by. But to the extent that RFK Jr. has revealed his personal pondering on the right way to deal with these complaints, his options stay remoted from sturdy debates about mental-health therapy. His clearest proposal, nonetheless, is his marketing campaign promise to create wellness farms the place People would reconnect with the soil and “study the self-discipline of laborious work.” That concept is little greater than a retreat to well-trodden calls to deal with psychological misery via seemingly pure means, and exhibits scant curiosity within the nuances of debate round psychiatric treatment, or the methods wherein separating folks from society for such cures has failed.
Kennedy first introduced up wellness farms throughout his presidential run, and when he painted an image of pastoral meccas for treating habit, he joined a convention that dates again greater than 200 years. Take the Retreat, based in England on the finish of the 18th century by a Quaker, William Tuke, who together with the French physician Phillipe Pinel is taken into account a father of “ethical therapy,” an effort to create humane hospitals. As a substitute of shackles and corporal punishment, the Retreat offered a stately nation dwelling, with acres of land to have a tendency cows and develop meals. The physician Benjamin Rush—who signed the Declaration of Independence—was impressed by ethical therapy, and wrote in 1812 that males who “help in chopping wooden, making fires, and digging in a backyard, and the females who’re employed in washing, ironing, and scrubbing flooring, usually get well,” whereas those that don’t do any guide labor don’t.
Tuke and Pinel believed that farming was particularly useful, and lots of early asylums in america employed a “work as remedy” element, says Neil Gong, a sociologist at UC San Diego. On the time, these establishments have been cutting-edge, and people operating them believed that the “insane” didn’t must be locked up in chains to enhance. “Psychological hospitals began out within the nineteenth century with very utopian expectations round them and their skill to treatment,” says Andrew Scull, a sociologist and the writer of Determined Cures: Psychiatry’s Turbulent Quest to Treatment Psychological Sickness. By the top of the nineteenth century, each state had no less than one government-funded establishment.
However when ethical therapy was generalized to bigger populations, it fell aside. (The Retreat was designed to tackle solely 30 sufferers.) Over time, government-run asylums grew to become overwhelmed with instances, and rampant with abuse. At scale, establishments “quickly declined into warehouses the place plenty of disagreeable issues occur to the sufferers, and the place sufferers tended to get misplaced,” Scull instructed me.
Together with farming didn’t defend towards such points, both. The Fort Price Narcotic Farm, a federally funded venture opened in 1938, promised to mix sincere farmwork with restoration from drug habit. Solely 25 % of sufferers, one examine estimates, caught to their therapy plan, and most of the people handled at federal narcotic farms, in response to a 1957 examine, used medicine after they left. The U.S. Narcotics Farm, which opened in 1935, was the non permanent dwelling of many well-known jazz musicians, together with Chet Baker. However as soon as folks left the farm, the bulk—almost 90 %—relapsed. It closed in 1976 after a congressional inquiry led by Senator Ted Kennedy discovered that docs have been testing experimental medicine on the folks residing there, and typically giving sufferers medicine resembling heroin and cocaine as a reward.
The concept of farm-based detox is interesting sufficient that at this time, loads of personal rehabilitation facilities incorporate nature and farming; pastoral work as mental-health therapy has grow to be a luxurious good, Gong instructed me, however is commonly mixed with a collection of different providers, together with psychiatric assist. Nonetheless, there isn’t an amazing physique of proof that care farms have ever been efficient at bettering outcomes. One overview from 2019 discovered no proof that “care farms improved folks’s high quality of life” and restricted proof for improved melancholy and nervousness. “To champion the wellness farm appears out of left subject when different fashions like everlasting supportive housing or supportive employment have an enormous evidentiary base, together with cost-effectiveness,” Ryan Okay. McBain, a well being economist on the RAND Company, instructed me. If Kennedy wished to, he may faucet the Heart for Medicare & Medicaid Innovation, which evaluates new packages, to evaluate how efficient a state-run wellness farm might be. This month, nonetheless, the CMMI introduced that it’s chopping funding for a number of of its packages.
Probably the most revealing side of Kennedy’s plan isn’t what folks would do on these farms, however what they wouldn’t—take any kind of psychiatric medicine. In describing the farms, Kennedy painted an image of them as detox facilities the place folks would additionally taper off drugs for melancholy and ADHD. Within the moral-treatment instances, medicine resembling antidepressants and Ritalin didn’t exist; ethical therapy was, however, seen as options to barbaric interventions resembling bloodletting and restraint. For Kennedy, the wellness farm is similar: an alternative to, not a complement to, different therapies.
The function that psychiatric medicine play in People’ mental-health therapy is an actual and lively debate. For many individuals, psychiatric drugs is usually a essential a part of their restoration. But modern psychiatrists have loads of complaints about insurance coverage firms that reimburse extra for treatment than for different therapies and a pharmaceutical trade riddled with conflicts of curiosity. In 2025, folks working on this subject acknowledge that the methods wherein medicine have claimed to deal with psychological sickness have oversimplified or overemphasized biology. Deliberations on the origin of and rightful response to psychological misery are core to psychiatry: Michel Foucault thought that psychiatry might be a pernicious power to manage society; the psychiatrist Thomas Szasz thought that psychological sickness was a delusion altogether.
Nonetheless, Kennedy hasn’t engaged with any of those matters considerably. As a substitute, he has muddied the water with false claims, together with that antidepressants are related to college shootings and are extra addictive than heroin. In a podcast final 12 months, he stated that wellness farms freed from psychiatric medicine could be particularly useful for Black youngsters: “Each Black child is now simply normal placed on Adderall, on SSRIs, benzos, that are recognized to induce violence, and people children are going to have an opportunity to go someplace and get re-parented.”
On this manner, Kennedy’s wellness-farms proposal exhibits how his fascinated by public well being is outlined nearly solely by his naturalness bias—that “pure” therapies are all the time higher, and that guide labor and contemporary air, or just the correct weight loss plan, might resolve complicated and widespread well being issues. (“They’re going to develop their very own meals, natural meals, high-quality meals, as a result of a whole lot of the behavioral points are food-related,” Kennedy stated concerning the farms.) That is constant along with his concepts about vaccination—that pure publicity to illness may be fascinating, and that coping with ailments resembling measles with weight loss plan and sanitation, because the nation did within the first half of the twentieth century, is preferable.
However we’ve discovered loads up to now 50, if not 200, years. Amenities that take folks out of their neighborhood have restricted capability, on their very own, to be an efficient public-health measure. A extra radical thought than wellness farms could be treating folks of their neighborhood, with a mix of care choices that they’ll select from. That concept can be nearer to what John F. Kennedy had in thoughts when he signed the Neighborhood Psychological Well being Act in 1963. He didn’t merely wish to shut government-run psychological facilities; he aimed to create 1,500 neighborhood mental-health facilities. This purpose went unrealized. Neighborhood mental-health care provides an individual entry to an interdisciplinary case-management group of social employees, nurses, docs, and psychologists, and to social providers resembling housing and employment assist. Creating that at scale presents a extra apparent and mandatory problem than sending folks away to a farm to breathe contemporary air and until the land.