Good vs. Bad Psychiatry? (Venn Diagram)

While it’s courageous to ask for help, getting the wrong help may be harmful.

Derived from Greek psukhe soul and iatreia healing, psychiatry means soul healing.

Opening your soul to healing requires a therapeutic relationship with honesty and respect from both you and your psychiatrist (with no intrusive outside influences).

Have you ever sought mental health help and felt your experience was unhelpful—even harmful?

To understand if (and why) your care may have been less-than-ideal, reference the following self-assessment tools.

In the Psychiatry Venn Diagram overlapping circles illustrate the relationship between bad and good mental health care while the Psychiatry Pop Quiz will provide your numeric score.

Recall a specific mental health care experience. Where does your care fit on this diagram?

Psychiatry Venn Diagram

Psychiatry Pop Quiz

In each of these 10 questions, choose either (1) or (2). Then add your numeric score. Your total will be between 10 and 20.

1) Is your mental health care (1) state/job/insurance sanctioned/influenced or (2) your personal choice?

2) Did your psychiatrist or therapist come from (1) a “preferred” list or (2) could you choose anyone you desired?

3) Does your care feel (1) non-personalized or (2) personalized?

4) Does your care feel (1) punitive or (2) non-punitive?

5) Do you feel you are receiving (1) illegitimate excessive testing or (2) legitimate selective testing?

6) Are medical decisions (1) made for you or (2) do you make your own choices through shared decision-making?

7) Does your care feel (1) discriminatory or (2) non-discriminatory?

8) Is your mental health care (1) non-confidential (visit details may be shared with others without your non-coerced consent) or (2) confidential?

9) Is your mental health care (1) involuntary, coerced, forced or (2) 100% voluntary?

10) At any point in your mental health care have you experienced (1) gaslighting/bullying or (2) has your care always been respectful?

Add up your answers.

Score  Interpretation

10        You are receiving bad mental health care
11-13    You are likely receiving bad mental health care
14-16    You are receiving a blend of bad/good mental health care
17-19    You are likely receiving good mental health care
20         You are receiving good soul-healing mental health care


Bad Psychiatry Defined

Want to steer clear of harmful mental health interventions? Here are situations that place you at high risk of bad care (with examples from doctors who were patients in physician health programs).

State/job-sanctioned psychiatry – Rather than choosing to receive mental health care, you are sent by your state, job, licensing authority, or other organization for psychiatric care.

Physician whistleblowers have been forced into psych evals following anonymous, unsubstantiated tips (often retaliatory) with no avenue to explore or appeal allegations of disability or impairment.

“Preferred” psychiatrist list – Instead of choosing your own psychiatrist, you must choose a “preferred” psychiatrist from your insurance plan, job, licensing authority, or state “health” program.

“My Florida license was delayed by a month. I was required to have a psych evaluation by an ‘approved’ doctor due to my history of depression which was treated and well-managed. It fell under the ‘impaired physician’ program and definitely was stigmatizing. To this day I don’t answer those questions honestly anymore and am hesitant to seek treatment as needed.”

“After standing up for patient safety at my hospital, to renew my contract I had to submit to a four-day neuropsychiatric eval (and 90-day admission) at a facility on their approved list.” [Note: this physician then lost his job and died by suicide].

Non-personalized psychiatry – Instead of a personal relationship with your psychiatrist, you feel captive on a one-size-fits-all program predetermined before you entered the relationship.

Physicians with no history of drug/alcohol use have been automatically enrolled in costly out-of-state inpatient faith-based abstinence programs—followed by five years of drug monitoring and AA attendance.

Punitive psychiatry – Instead of feeling cared for, you are punished for your mental health issues.

“Overwhelmed with abuse I was facing in anesthesia residency, I begged my program director with tears running down my face for emergency mental health care. I spent the next few days isolated, confused, exhausted on my couch. I saw a counselor. I started an antidepressant for the first time in my 30 years of existence. By the weekend I felt refreshed with a glimmer of hope. When my program asked to meet with me on Monday, I was sure it was to see if I was okay, to ensure I had no thoughts of self-harm or suicide. I was wrong. The meeting was to let me know I was placed on 6 months probation for being unprofessional. I was flabbergasted, my mouth literally fell open. I couldn’t believe I was sitting in front of the people I trusted with my education and they were able to look at me in my greatest time of need and anguish knowing I was now in counseling and on medication and respond only with punishment.”

Illegitimate excessive psychiatric testing – Rather than selective tests for your condition, you receive many tests of questionable legitimacy and accuracy (often at your own expense).

“My polygraph was one of the most humiliating experiences in my life. I have no access to my results and had threats of license revocation if I didn’t cooperate.”

Physician “health” programs have made unfounded diagnoses of substance misuse via non-FDA-approved drug tests known for false positive results.

Psychiatric decisions made for you – Your psychiatrist tells you what you must do and you have no ability to advocate for yourself.

“My own psychiatrist and psychotherapist have stated I don’t have bipolar disorder, yet my state-sanctioned counselor concluded the mere act of disputing their diagnosis proves I have it.”

Discriminatory psychiatry – Your psychiatric issues are used to discriminate against you.

Competent physicians who cannot afford to pay thousands of dollars to for-profit “preferred” rehabs get reported to their board as “noncompliant,” usually resulting in license revocation with automatic entry into National Practitioner Data Bank, rendering the physician unemployable.

Non-confidential psychiatry – Your deepest thoughts, feelings, and life experiences that you thought were protected are shared with others outside of your “confidential” session.

Medical boards publicly disclose physicians’ disability-related license revocation, perceived HIPAA-protected health information (detailing unsupported, yet unchallengeable misdiagnoses)—all published on the World Wide Web in perpetuity.

“Do you know what really hurts? The fact that anyone can look me up on the Internet and read my dirty laundry. I’m publicly shamed [by my medical board], punished for being ill. I will only know peace when I am gone.”

Involuntary psychiatry – Rather than choose to see a psychiatrist, you are told you must—or you will forfeit your job, career, or livelihood.

To keep their license, doctors must “voluntarily” agree to travel out-of-state to physician “health” program “preferred” facilities where they may be interrogated via polygraph during a 4-day multidisciplinary evaluation for up to $10,000 cash (no insurance accepted).

“My forced out-of-state 90-day ‘treatment’ for alleged disability without impairment feels like involuntary civil commitment and extortion under threat of career destruction.”

“The running joke was they wouldn’t discuss a discharge date until the person’s money was running out. I knew some kept for more than 20 weeks, after being told (as we all were) before admission that it was a 6-week program.”

Psychiatric gaslighting and bullying – Rather than being treated with respect, you are bullied, belittled, and psychologically manipulated causing you to question your own sanity.

“My brilliant physician friend was sent to an out-of-state health program. When he asked to call his psychiatrist mother, his counselor replied, ‘Oh, you need to call your mommy?’”

To share your good or bad psychiatric experiences, please add your comments below.


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13 comments on “Good vs. Bad Psychiatry? (Venn Diagram)
  1. Leo says:

    Fuck them all; PDs, and attendings are just bastards

    • Pamela Wible MD says:

      I do know some really good ones who are so invested in helping their residents. Also know others who are rather naive about what a PHP referral can do to the career of a vulnerable doc. I feel your anger and do share more (even confidentially) if you would like support or help.

      • Psychiatrist says:

        I would suggest that she record the session with the psychiatrist. If he refuses to allow that then she should retain an attorney who can force that to happen.

  2. Pamela Wible MD says:

    Just off the phone with a friend who is being referred by her employer to a physician “health” program psychiatrist. She fears she is facing psychiatric retaliation and punishment for standing up for patient safety at her corporate job. Sent her the above article.

  3. Ann Pianetta says:

    Thanks for the information about forced help. You should’ve also added that people need to get a good lawyer. There’s nothing better than to put the fear of God into people when you get a lawyer to help defend you.
    Keep up the good work!

  4. JH says:

    That’s why the system is falling alart. Docs are retiring or working less. The problem is our own colleagues play again us so as to get more business favor with hospitals.

  5. MilitaryDoc says:

    Hi Pamela,

    Don’t forget to mention the military services. HIPAA does not apply to military service members, in that military commanders have access to any medical or mental health records for any service member, and military members can easily be forced into having non-independent, in-house mental health evaluations by their commanders. Military psychologists and psychiatrists have been weaponized by the military command structure as a means of getting rid of any service member, including doctors, who might not tow the party line or otherwise question or resist authority. These mental health professionals know that when they see a service member for a command-directed mental health evaluation, their own careers depend upon reaching the conclusions that the military command structure wants to see. If the military command wants to see a service member gone, this is done by ordering a mental health evaluation and having the service member labeled with a personality disorder. Once labeled with a personality disorder, the service member is administratively separated from the service. Since the separation is considered administrative (and not “medical”) in nature, the separated member is not entitled to any military retirement benefits, etc… (VA benefits may still apply, though, if the nature of the service is otherwise considered honorable). This is the way the military uses mental health as a weapon to get rid of any service members who are not well-liked or in disfavor by the command structure, even if the member has not performed their job poorly and has not done anything illegal or unethical.

    By the way, what is the status of the congressional action (based on ADA, I believe) to limit state medical boards from inappropriately using mental health issues as a weapon against potential or current licensees?

  6. Acumen Anon says:

    Oh. My. God. Just had a PTSD moment – that was me – but I was naive and trusting, so went along with the “Wellness” committee and the Acumen evaluation thinking I was open to growth and feedback that way. Acumen found nothing (much to the system chagrin in retrospect) – and I was instructed to “ask permission” before I spelled my name…

    She needs a lawyer. Now.

    Thanks for doing what you do, Pamela

  7. PA says:

    Thank you for taking the scab off this authoritarian move by Hospital Administrators- usually made through a lackey chief of staff. In the active duty military, this is a real method of retaliation. They remove many rights of physicians on active duty. I have had a similar threat made against me years ago. I responded that I would like a letter sent to my lawyer- and the threat went away.

    Keep swinging, Pam!

  8. AJC says:

    I applaud your efforts, Pamela.
    I know how this “forced treatment “ can go.
    It’s not real psychiatric treatment when confidentiality is compromised. They insist on patients signing off in agreement with the process, under duress, of course. If the doctor wants to stay licensed, they must agree. Not really a voluntary treatment agreement.
    I have encountered excellent psychiatrists who do this work- usually through their own experiences on the other side of the couch, so to speak. But it can be a roll of the dice for a physician seeking help during a likely low point in their personal and professional lives. Making difficult choices when feeling “shell-shocked” and actively under fire from different directions, is extremely hard. They may feel that they must surrender to the process, hoping the controllers are acting in good faith, with their best interests in mind. Licensing representatives have other masters to serve, the public, for one, as they frequently proclaim. Unfortunately, many times, their actions do the public a serious disservice. When a physician is taken out of circulation, limited in their options, tarnished by the processes of rehabilitation, etc., the potential service that doctor can provide to the community will suffer. It can , with certainty, be forever reduced, constrained, diminished, or altered in a negative fashion.
    I know this to be a fact.
    In addition, the real potential for corruption and abuse in “ Wellness “ programs (experienced first hand) furthers one’s sense of distrust about the good faith intentions of a healing approach being offered.
    I can say in California, the medical board will always post “probation completed” on the physician’s license status, on their website. They will never state simply “license in good standing “ despite many years passing since probation was finished and all conditions met.
    That seems discriminatory to me.
    I know of no other profession in which an individual is permanently singled out as a “lesser than equal” for a misdeed that was resolved completely with dues being paid and all conditions met. There’s no second chance to return to practice on an equal footing with one’s colleagues. It’s not just for appearances that this matters. The public, potential future employers, insurance companies, etc. can see this online. It can have significant detrimental effects on the physician’s livelihood, professional standing, contracting opportunities- the list can be long.
    I could go on, but I trust my message has been delivered.
    Continue with your very helpful, positive efforts to improve the lives of physicians who only seek to help others in a profession under attack from so many sides.
    AJC MD

    • Pamela Wible MD says:

      Oh yes, your message is heard loud & clear. The psychiatric witch hunt on doctors (good, competent, qualified docs) is exacerbating our physician shortages and leading to a real fear of help-seeking among those who really, really need confidential help for what we witness on a “good day” in medicine.

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