Trump and the global rise of fascist anti-psychiatry
Trump’s new executive order uses psychiatry to dismantle social care, expand policing and imprisonment, and exploit public disillusionment. We have seen this before, and we know the consequences.
US Secretary of Health and Human Services Robert F Kennedy Jr and US President Donald Trump participate in an event on ‘Making Health Technology Great Again,’ in the East Room of the White House in Washington, DC, on July 30, 2025 [Jim Watson/AFP]
Despite spending more on psychiatric services and prescribing psychiatric medications at a higher rate than almost any other nation, mental health in the United States over the last two decades has only been getting worse.
Rates of depression, anxiety, suicide, overdose, chronic disability due to mental health conditions, and loneliness have all been rapidly increasing. No quantity of psychiatric drugs or hospitalisations appears adequate to reverse these trends.
Despite this, the US medical and psychiatric establishment has persistently refused to use its substantial political power to demand the transformation of care by expanding non-medical support systems to address the root social causes of mental illness, such as poverty, childhood trauma and incarceration, rather than focusing on reactive treatment via lucrative medication-centric norms. This failing status quo has created an opening for President Donald Trump and Secretary of Health Robert F Kennedy Jr’s emerging plans to remake the nation’s approach to mental health, with disastrous consequences now coming into focus.
Trump and Kennedy have hijacked legitimate anger at a broken system to justify destroying public care infrastructure, including Medicaid, food and housing assistance, harm-reduction and overdose prevention programmes, and suicide-prevention hotlines for LGBTQ youth, while promoting wellness scams and expanding the police state. They focus on the “threat” supposedly posed by psychiatric medications and call to reopen the asylums that once confined approximately 560,000 people, or one in 295 US residents, in horrific conditions, until protests against their cruelty led to their closure beginning in the 1950s.
Trump invokes false claims about mental illness to demonise immigrants, whom he is now hunting via a mass arrest and incarceration campaign. Last month, he signed an executive order that allows police to arrest and forcibly institutionalise poor Americans who are unhoused, deemed mentally ill, or struggling with addiction, effectively incarcerating them for indefinite periods.
Trump’s order, which also defunds housing-first programmes and harm-reduction services, while criminalising homelessness and encampments, contains no provisions to protect people from abuse or from the political misuse of psychiatric labels and institutionalisation to target his opponents. This raises concerns about risks to LGBTQ youth and other vulnerable groups. It also threatens groups upon which the administration has shown a eugenicist fixation: transgender people, people with autism, and others with disabilities that RFK Jr and Trump have characterised as a threat or burden on society.
The order appears to grant the government the power to deem anyone mentally ill or abusing substances, and to confine them indefinitely in any designated treatment facility, without due process. In a context where there is already a profound shortage of psychiatric beds even for short-term treatment, there are no provisions for new funding or regulatory systems to ensure that facilities are therapeutic or humane, rather than violent, coercive warehouses like American asylums of decades past.
Trump’s allies, including some medical professionals aligned with ideologies of social control and state coercion, may dismiss this as overly pessimistic. But that requires ignoring the fact that Trump’s executive order follows Kennedy’s proposal for federally funded “wellness farms”, where people, particularly Black youth taking SSRIs (selective serotonin reuptake inhibitors primarily used to treat anxiety and depression) and stimulants, would be subjected to forced labour and “re‑parenting” to overcome supposed drug dependence.
These proposals revive the legacy of coercive institutions built on forced labour and racialised interventions.Kennedy has also promoted the conspiracy theory that anti-depressants like SSRIs cause school shootings, comparing their risks with heroin, despite a total lack of scientific support for such claims. In his early tenure as health and human services secretary, he has already gutted key federal mental health research and services, including at the Substance Abuse and Mental Health Services Administration (SAMHSA), Centers for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH).
Given this, it is unclear what kind of “treatment”, other than confinement and cruelty, Trump and RFK Jr plan to deliver in their new asylums.
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Trump and Kennedy’s lies about mental health, cuts to public care and vision for expanding the incarceration of immigrants, homeless people, and anyone they label as mentally ill, worsen mental health while creating more opportunities to profit from preventable suffering, disability and death. These tactics are not new, and their harmful consequences and political motivations are well established.
From Hungary to the Philippines, right-wing politicians have deployed similar rhetoric for comparable purposes. In a precedent that likely informs Trump’s plan, Brazil’s former president, Jair Bolsonaro, attacked psychiatric reformsas leftist indoctrination and defunded successful community mental health services, replacing them with coercive asylum and profit-based models, while advocating pseudoscience linked to evangelical movements. Bolsonaro claimed to defend family values and national identity against globalist medical ideologies, while sacrificing countless Brazilian lives via policies later characterised by the Senate as crimes against humanity.
Bolsonaro’s record is instructive for anticipating Trump’s plans. Trump has made no secret of his admiration for Brazil’s disgraced former president and their shared political ideologies. Bolsonaro’s reversal of Brazil’s internationally recognised psychiatric reform movement, which emphasised deinstitutionalisation, community-based psychosocial care and autonomy, inflicted profound harm. Under his rule, institutionalisation in coercive “therapeutic communities”, often operated by evangelical organisations, with little oversight, and similar to RFK Jr’s proposed “wellness farms”, skyrocketed.
Investigations revealed widespread abuses in these communities, including forced confinement, unpaid labour, religious indoctrination, denial of medication, and physical and psychological violence. Bolsonaro’s government poured large sums into expanding these dystopian asylums while defunding community mental health centres, leaving people with severe mental illness and substance use disorders abandoned to punitive care or the streets.
This needless suffering pushed more people into Brazil’s overcrowded prisons, where psychiatric care is absent, abuse rampant and systemic racism overwhelming, with Black people accounting for more than 68 percent of the incarcerated population. Bolsonaro’s psychiatric agenda enhanced carceral control under the guise of care, reproducing racist and eugenicist hierarchies of social worth under an anti-psychiatry banner of neo-fascist nationalism.
Trump and Bolsonaro’s reactionary approaches underline a crucial truth: Both psychiatry and critiques of it can serve very different ends, depending on the politics to which they are attached. Far-right politicians often use anti-psychiatry to justify privatisation, eugenics and incarceration. They draw on ideas from the libertarian psychiatrist Thomas Szasz, who argued in the 1960s that mental illness was a “myth”, and called for the abolition of psychiatric institutions.
In the US today, these political actors distort Szasz’s ideas, ignoring his opposition to coercion, by gutting public mental health services under the guise of “healthcare freedom”. This leaves vulnerable populations to suffer in isolation, at the hands of police or fellow citizens who feel increasingly empowered to publicly abuse, or even, as seen in the killing of Jordan Neely in New York City, execute them on subways, in prisons, or on the streets.
By contrast, critics of psychiatry on the left demand rights to non-medical care, economic security and democratic participation. Thinkers such as Michel Foucault, Frantz Fanon, RD Laing and Ivan Illich advocated for deinstitutionalisation not to abandon people, but to replace coercion with community-led social care that supports rights to individual difference. Their critiques targeted not psychiatry itself, but its use by exploitative, homogenising political systems.
To oppose reactionary anti-psychiatry, mental health professionals and politicians cannot simply defend the status quo of over-medicalisation, profit-driven care and the pathologisation of poverty. Millions justifiably feel betrayed by current psychiatric norms that offer little more than labels and pills while ignoring the political causes of their suffering. If the left does not harness this anger towards constructive change, the right will continue to exploit it.
The solution is not to shield America’s mental health systems from critique, but to insist on an expansive political vision of care that affirms the need for psychiatric support while refusing to treat it as a substitute for the political struggle for social services. This means investing in public housing, guaranteed income, peer-led community care worker programmes, non-police crisis teams and strong social safety nets that address the root causes of distress, addiction and disease.
Mental health is fundamentally a political issue. It cannot be resolved with medications alone, nor, as Trump and RFK Jr are doing, by dismantling psychiatric services and replacing them with psychiatric coercion.
The fight over mental health policy is a fight over the meaning of society and the survival of democratic ideals in an era where oligarchic power and fascist regimes are attempting to strangle them. Will we respond to suffering with solidarity, or with abandonment and punishment? Will we recognise the collective causes of distress and invest in systems of care, or allow political opportunists to exploit public disillusionment for authoritarian ends?
These are the questions at stake, not just in the United States, but globally. If the psychiatric establishment refuses to support progressive transformation of mental health systems, we may soon lose them altogether as thinly disguised prisons rise in their place.
If you or someone you know is at risk of suicide, these organisations may be able to help.
The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial stance.
Eric ReinhartPolitical anthropologist, psychiatrist, and psychoanalytic clinicianEric Reinhart is a political anthropologist, psychiatrist, and psychoanalytic clinician based in Chicago. He works with individuals and collectives around the world via remote connections.
Roy Cohn taught Donald Trump the six rules of managing and dominating situations and people. These are those rules and you can see them being utilized to this very day by the man to brutal ends (this is excerpted from the book, The Last American President):
1. Never apologize or admit wrongdoing, ever. Cohn viewed contrition as weakness and would rather die (literally, as it turned out) than acknowledge error or fault. As journalist Ken Auletta, who covered Cohn extensively, noted, “The idea that you can admit a mistake is not part of Roy’s genetic code.” This principle would become so fundamental to Trump’s approach that even faced with irrefutable evidence—a recorded confession of sexual assault on the Access Hollywood tape, for instance—he would deny, deflect, and attack rather than offer the slightest acknowledgment of impropriety.
2. Always counter-attack, and always with greater force than you received. When criticized or accused, Cohn’s response was invariably to hit back harder, to escalate, to make the accuser regret ever mentioning his name. As Cohn himself explained to a reporter: “I bring out the worst in my enemies, and that’s how I get them to defeat themselves.” This tactic became Trump’s signature move, whether attacking Gold Star parents who criticized him, mocking a disabled reporter who questioned his claims, or threatening critics with lawsuits and retribution.
3. Use the legal system as a weapon, not a recourse for justice.Cohn taught Trump that lawsuits were instruments of intimidation, not vehicles for dispute resolution.He filed cases not to win—though winning was nice—but to punish, to harass, and to silence. The expense and stress of litigation was the point, not the legal outcome. Trump would eventually be involved in over 3,500 lawsuits—an unprecedented number for any American businessperson or politician—using the courts not to seek justice but to exhaust opponents with fewer resources.
4. Manipulate the media ruthlessly. Cohn was a master at planting stories, cultivating journalists, and creating controversy to serve his ends. He understood that perception trumped reality, that bold claims often went unchallenged, and that most people would remember the accusation but not the retraction. Trump elevated this approach to an art form, calling reporters using pseudonyms like “John Barron” to plant favorable stories about himself, staging pseudo-events to attract coverage, and later, using Twitter to bypass media filters entirely and inject his unfiltered messages directly into the public consciousness.
5. Use fear as both shield and sword.Cohn understood that people who are afraid—of communists, of crime, of social change, of the “other”—are easier to manipulate and more willing to accept authoritarian solutions. He helped McCarthy weaponize the Red Scare, stoking paranoia about secret communists undermining America from within. Trump would adapt this tactic to the 21st century, stoking fears about immigrants, Muslims, “inner city” crime, and later, a “deep state” conspiracy, always positioning himself as the only solution to these terrifying threats.
6. Build a fortress of loyalty around yourself. Cohn demanded absolute devotion from his clients and associates, and he repaid it in kind, at least until they were no longer useful. He created a network of mutual obligation and fear that served as both sword and shield in his battles. Trump’s infamous demand for loyalty—from James Comey, from his cabinet members, from Republican legislators—and his swift punishment of perceived disloyalty, all echo Cohn’s approach to power.
Robert Mueller speaks about the Russia investigation in 2019. Photo: Doug Mills/The New York Times
Robert Mueller, the former FBI director who as special counsel probed President Trump and Russian interference in the 2016 election, died at 81 on Friday night. His family said last year he was battling Parkinson’s disease.
Mueller’s probe resulted in a series of criminal cases against people in Trump’s orbit and earned him the president’s lasting ire, Axios’ Ben Berkowitz and Avery Lotz write.
At the FBI, Mueller set about almost immediately overhauling the bureau’s mission to meet the law enforcement needs of the 21st century, beginning his 12-year tenure just one week before the Sept. 11 attacks and serving presidents of both parties.
He was the second-longest-serving director in FBI history, behind only J. Edgar Hoover. (AP)Screenshot: Truth Social
Former President George W. Bush said: “Bob dedicated his life to public service. As a Marine in Vietnam, he proved he was ready for tough assignments. He earned a Bronze Star and a Purple Heart before returning home to pursue law.In 2001, only one week into the job as the 6th Director of the F.B.I., Bob transitioned the agency mission to protecting the homeland after September 11. He led it effectively, helping prevent another terrorist attack on U.S. soil.
“Former President Obama wrote: “Bob Mueller was one of the finest directors in the history of the FBI, transforming the bureau after 9/11 and saving countless lives. But it was his relentless commitment to the rule of law and his unwavering belief in our bedrock values that made him one of the most respected public servants of our time.”N.Y. Times obit by Tim Weiner (gift link)
Larry Johnson discusses Trump and Netanyahu seeking an exit ramp to end the war against Iran. If Trump is serious about ending the war and leaving the Strait of Hormuz under Iranian control, the consequence will likely be the US being evicted from the Middle East. Johnson is a former CIA intelligence analyst who also worked at the U.S. State Department’s Office of Counterterrorism. Read Larry Johnson’s Sonar21: https://sonar21.com/
🚨John Mearsheimer: This war was a colossal mistake, and it's hard to believe that President Trump did this. not simply because he had promised that he would not start any more wars.
🚨Lindsey Graham coached Netanyahu to manipulate Trump
Recorded for the ASPIRE Conference on 11th February 2026 at Stanford University, California — just weeks before the outbreak of war with Iran. “An aircraft carrier group of the United States is in position in the Persian Gulf and further air strikes against Iran seem quite likely.” Sir Niall Ferguson argues that the world has already entered a Second Cold War, the warning signs have been visible for years, and the West has been dangerously slow to act as it begins to warm. Ferguson makes the case that Australia is unprepared for what comes next in the Middle East, Ukraine, and Taiwan. — @AspireConference Subscribe to our channel to watch conference sessions and new ASPIRE content. — Sir Niall Ferguson is a Senior Fellow at the Hoover Institution, Stanford University, and one of the world’s leading historians. He is the author of more than fifteen books including The Ascent of Money and Civilisation, and writes regularly for Bloomberg and The Free Press.
Robert Mueller speaks about the Russia investigation in 2019. Photo: Doug Mills/The New York Times
Screenshot: Truth Social
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