How to make profit from psychiatry: Exploiting people in crisis

Dr Jess reports on the Acadia Healthcare scandal

I read a deeply disturbing investigation published by the New York Times in September, in which patients, employees, and police have worked together to report systemic abuses within Acadia Healthcare.

The allegations are chilling: psychiatric patients were hospitalised unnecessarily and detained for profit under the guise of medical care. These accounts paint a picture not of isolated misconduct, but of a system designed to exploit vulnerable people in crisis.

For those of my readers in the UK who might struggle to understand how this would work, members of staff and other professionals confirmed that Acadia ran a policy in which they sectioned/detained people on fake psychiatric disorders and then kept them there as long as they could, in order to get the individual’s medical insurance to pay out the highest amount possible.

The reports from patients and ex-staff confirm that they generally did this by claiming the person was psychotic or bipolar.

Acadia Healthcare, a £5.6 billion corporation with 54 psychiatric hospitals across 19 states, has built its empire on partnerships with non-profit health systems and emergency rooms. According to the investigation, Acadia deliberately manipulated involuntary commitment laws to trap patients in their facilities. The motivation? Profit, of course.

The corporation reportedly charges insurance companies £1,800 per day for inpatient stays, and many of its practices appear to be driven by this financial incentive.

Patients shared harrowing experiences of entering facilities seeking routine or voluntary care - only to find themselves stripped of autonomy, forcibly detained, and gaslit about their own health.

One woman seeking medication management for bipolar disorder she was already medicated for, was held for six days without medical necessity. Another, a hospital worker herself, was detained for seven days when she sought talking therapy, only to be released after her father took legal action to get her out!

Acadia’s strategy extended beyond its own walls, actively targeting vulnerable individuals in emergency services and A&E departments in the US.

The company employed people they called “assessors” who were embedded in local A&E departments, not to provide unbiased medical advice, but to funnel patients into their facilities. Former employees revealed that these assessors were under constant pressure to refer patients, regardless of their actual needs.

Think of it like a salesperson or referral generator on commission, because that’s basically what that is.

Acadia’s internal culture reportedly encouraged the manipulation of medical records to justify prolonged detentions and medications. Staff were trained to use language like ‘the patient is combative’ or to highlight minor behaviours - such as not finishing a meal - as evidence that a patient was unfit for discharge and needed to remain with them for weeks. These practices ensured that patients remained in the facility until their insurance coverage ran out, generating much higher profits for Acadia.

The legal and ethical failures

Involuntary commitment laws in the US, supposedly designed to protect individuals in extreme crisis, were clearly weaponised by Acadia to strip patients of their rights and to drain them of money.

Facilities like the North Tampa Behavioral Health Hospital filed thousands of court petitions to extend patients’ detentions, even though only a fraction were granted. Meanwhile, patients were held - and billed - for the days awaiting court decisions, which of course is brilliant news for Acadia.

But the harm extended far beyond the financial. Health inspections recently revealed patterns of physical and sexual abuse and neglect in Acadia facilities. Patients reported being denied essential medications, left without any evaluations, and being totally deprived of therapy. Living conditions were often described as filthy and dehumanising.

Even more appalling were the frequent reports of physical and sexual violence. At Lakeview Behavioral Health in Atlanta, police documented serious assaults, including three staff members attacking a patient. Children were not spared either; one child left the facility with visible bruises from being assaulted. In Utah, investigations into rapes and assaults at Highland Ridge Hospital resulted in its closure.

The trauma endured by patients in these facilities cannot be overstated. Instead of receiving care, they were financially exploited, pathologised, medicated and then subjected to harm and retraumatisation. Many survivors were left questioning their own experiences after being gaslit and disempowered by a system that claims to prioritise ‘mental health.’

Psychiatry’s silence

Perhaps most alarming is the lack of widespread outrage within the psychiatric and medical community (again).

The only article from The Psychiatric Times reduced this serious systemic abuse to an ‘isolated incident,’ comparing it dismissively to Rosenhan’s study from 50 years ago. Such responses are emblematic of a broader issue within psychiatry: a refusal to critically examine its own practices and power structures.

The public is often led to believe that psychiatric detention is inherently benevolent, that these facilities are places of healing and professional care. They believe you would only ever be detained for very good reason, using assessments based on science and medical evidence. But as this investigation reveals, the reality is far more sinister. When the profit motive drives care, harm becomes inevitable.

Time for action

The revelations about Acadia Healthcare should compel us to ask difficult questions about the very foundations of psychiatry and mental health care. Do the psychiatric assessments hold any scientific value at all? How can professionals detain and financial exploit people like this? Why are corporations allowed to make profit from detaining people in crisis? Why is corruption and coercion so deeply embedded into the mental health system? And why are survivors of psychiatric abuse so often disbelieved or dismissed?

To be trauma-informed and anti-pathology is to centre the voices and experiences of those harmed without the use of detention or labelling - or medication. In an anti-pathology service or system, none of this could have ever happened. No one would be able to profit from keeping someone detained, and no one could have forcibly medicated someone and lied about their ‘diagnosis’ either.

The stories from Acadia’s patients and employees are absolutely not ‘isolated incidents.’ They are evidence of systemic failings that demand accountability.

If we truly value ‘mental health’ care, we must dismantle the structures that enable this exploitation and harm. And if we are real about what structures they are, they are psychiatric diagnosis, detention, sectioning, forced treatment, and profit-driven pharma and healthcare.

The time for silence is over. It is time to listen to survivors and fight for a system that prioritises care, compassion, and autonomy over profit.

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