Harvard’s newest Health and Human Rights issue features a special section dedicated to institutional corruption and human rights in mental health. The editorial introducing the special section, written by Alicia Ely Yamin (of Harvard University), Camila Gianella Malca (of the Pontifical Catholic University of Perú), and Daniela Cepeda Cuadrado (of the Christian Michelsen Institute), asks an important question: why has progress on paper towards human rights based treatment in mental health not translated to meaningful change in the way mental healthcare systems actually treat people?

The authors argue that question can be answered in part through the concept of institutional corruption. While ordinary corruption typically involves an illegal act such as bribery or fraud, institutional corruption involves systemic, often invisible forces that divert an institution from its stated goals and undermines its trustworthiness.

Institutional corruption in mental healthcare has many forms, including forced psychiatric detention, which the U.N. has compared to torture, and narrow medical models that fail to address people’s real needs, especially in low- and middle-income countries. This concept does not describe a broken system, but one that harms people when it operates exactly as intended.

The Road to Institutional Corruption

The authors point to the Global South as an example of how institutional corruption can fester in mental healthcare systems. Tax fraud and illicit financial practices cost the region $1.7 trillion per year and drive countries into immense debt. The debt has grown so large that 54 countries spend more money managing their debt than they do on healthcare. This enormous debt leads to calls for privatization and cost-cutting measures in systems such as healthcare. Mental healthcare, often a low priority already, is especially vulnerable to these types of cuts.

As public money is diverted away from mental healthcare, private money and foreign interests fill the gap. As governments grow to rely more on private providers, pharmaceutical companies, and donor-driven programs, decisions about mental health care may be guided more by profit, efficiency, or international agendas than by local needs or human rights principles.

Many of the articles included in the special section are also critical of the dominant biomedical model of mental health. This approach tends to medicalize mental health issues, locate them within individuals, and treat them with stigma inducing diagnoses and dangerous psychiatric drugs.

While medical care may be appropriate for some service users, many of the authors argue that overreliance on this model can detract from systemic and social causes of poor mental health such as poverty, discrimination, trauma, lack of access to suitable housing, employment issues, and lack of community support, while leaving mental healthcare systems “trapped in colonialist dynamics and mentalities.” When combined with industry interests and international agendas, this narrow focus may reinforce systems that prioritize profit and Western ways of thinking and being rather than humane and effective treatment.

Featured Papers

The first paper in the special section, authored by Alicia Ely Yamin and Camila Gianella Malca, argues that the initial step in adopting approaches to mental healthcare that are truly rights-based is to go beyond calling for equity of access and to interrogate the power structures that often harm service users. The authors call for upending the dominance of the biomedical model of mental health, confronting institutional corruption, exploring how institutional corruption leads to bad policy, and questioning the prioritization of favorable metrics that prop up harmful practices and existing presumptions.

Lisa Cosgrove’s contribution to the special section explores the marketing of postpartum distress as a “silent health crisis” and the expensive, dangerous, likely ineffective drug (zuranolone) approved by the FDA to treat it. The author argues that the medicalization of distress after childbirth is essentially an advertisement for zuranolone, made possible by the completely legal influence of industry money and power over regulatory agencies and professional associations. To combat this kind of institutional corruption, Cosgrove calls for a “moral renaissance” in mental health narratives; a monumental shift away from medicalized models towards human rights-based frameworks.

Robert Whitaker’s piece explores the global export of the biomedical model of mental health and the institutional corruption that made this model possible in the first place. The author explains that the American Psychiatric Association (APA) pushed the chemical imbalance hypothesis of “mental illness” as an extraordinary medical breakthrough in order to gain prestige. The pharmaceutical industry saw this “breakthrough” as an opportunity to sell more of its products and showered the APA and its members with funding. Ultimately, this partnership established the chemical imbalance hypothesis as a fact in popular discourse.

However, research could not validate the chemical imbalance hypothesis, long-term studies of industry drugs showed no benefits, and this model led to poor public health outcomes. Despite these facts, the chemical imbalance myth and the biomedical model of mental health have been exported across the globe. Whitaker argues that this model and its global export were only possible due to psychiatric professionals abandoning their obligation of informed consent and refusing to be reliable narrators of their own research.

Alberto Vásquez Encalada writes about how lack of investment in mental health and weak regulations have paved the way for private pharmacy chains to commodify mental health in Peru. Lack of access to mental health resources and trained professionals leads many people in Peru to seek mental health services through pharmacies. These private pharmacies exploit regulatory loopholes and engage in ethically suspect practices such as price fixing, sales without prescriptions, collusion against competition, blatant conflicts of interest in recommending their own expensive drugs over generics, and using their considerable resources to influence laws and regulations.

The result of this institutional corruption is a mental health system that prioritizes private profits at the expense of service user health. The author recommends both short-term solutions to make drugs more accessible through public systems that may not be as influenced by profit, as well as a longer-term move away from medication-centric models of mental health.

Other papers in the special section provide case studies of institutional corruption in South Africa, Serbia, Eastern Europe, treatment of adolescents in Peru, and the global marketing of weight-loss drugs.

Conclusion

Collectively, the authors featured in this special section call for a more honest and politically informed approach to mental health reform. Human rights must be paramount both in individual treatment decisions and at the level of institutions, funding structures, professional cultures, and global health governance. This requires mental health professionals, service users, and the general public to question dominant models, call out conflicts of interest, and center the voices of people with lived experience.

The authors argue that transforming mental health systems requires more than good intentions or new laws. It requires confronting the deeper institutional forces that quietly shape how care is delivered, and how human rights are violated. Only by reckoning with these forces can mental health systems truly serve the people they are meant to support.

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Yamin, A. E., Malca, C. G., & Cuadrado, D. C. (2025). Examining Institutional Corruption in Mental Health: A Key to Transformative Human Rights Approaches. Health and Human Rights, 27(2). (Link)