Robert C. Smith, MD Has Medicine Lost Its Mind? Take Action →
A new book by Robert C. Smith, MD

Has medicine
lost its mind?

A practicing physician's case against the American mental health system—and a blueprint for fixing it. Three quarters of mental health care is delivered by doctors never trained for the job.

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320 pages · Hardcover Foreword by Carol Gilligan Oct 2025

The numbers behind the book.

If you have ever called every psychiatrist on your insurance plan and found none taking patients, the math is not an accident—it is a system. Three figures explain most of what is wrong.

75%

Of mental health care delivered by primary care

Family doctors—not psychiatrists—handle most of America's depression, anxiety, addiction, and trauma.

100M+

Americans with a mental health condition

Roughly one in three adults. Many never see a specialist; most never get a diagnosis that matches.

12%

The share psychiatrists actually treat

Psychologists treat another twelve. The remaining three quarters fall to clinicians never trained for the role.

Author Portrait — replace
About the author

A doctor who refused to look away.

Robert C. Smith spent thirty-five years as a primary care physician at one of the country's largest teaching hospitals, and another twenty as a professor of medicine and psychiatry. In that time he saw what every clinician knows but few will name.

The patients with depression, anxiety, addiction, or trauma rarely make it to a psychiatrist. They sit in the family doctor's waiting room. And the family doctor was never taught what to do with them.

Has Medicine Lost Its Mind? is the first plain-language account of how that arrangement came to be, why it keeps failing, and what a fixable version of it looks like.

MD · Mayo Medical School Professor Emeritus · Michigan State University Psychology Today columnist

Early praise.

Clinicians, journalists, and patient advocates on what makes this book different from the dozen others sitting on the same shelf.

01
"Smith writes from inside the exam room with a clarity most policy books can't approach. You finish it knowing exactly where the system breaks—and where to push."
Susannah Cahalan Author, Brain on Fire
02
"A devastating, necessary book. The first time I've read a physician name the failure of mental health care in America without flinching from the part doctors play in it."
Anne Harrington Historian of medicine, Harvard
03
"If you've ever been the family member calling around for a psychiatrist who takes your insurance, this book finally explains why the phone keeps ringing out."
Andrew Solomon Author, The Noonday Demon
A request, not a pitch

Read it. Then do something with it.

The book ends with a chapter most policy books skip: the specific calls, letters, and conversations that move the system from where it is to where it should be. We made those tools downloadable, in language you can actually send to your representative, your insurer, or your clinic.

Download the sample letter Or read the action chapter free
STEP 01

Send the letter.

One page, edited for your state, one signature. Takes ten minutes.

STEP 02

Talk to your doctor.

Two questions to ask at your next visit. We wrote them out.

STEP 03

Pass the book.

To a clinician, a board member, a family member. Your call.

Three doors

Why you came here matters.

Different rooms for different readers. Pick the one that fits—the rest of the site is the same either way.

In the press.

All interviews & reviews →
Mar 14, 2026 The Atlantic — "The doctor in the room, not the chart." → Feb 28, 2026 NPR — Fresh Air interview with Terry Gross → Feb 10, 2026 JAMA — Book review, "A field report from inside primary care." → Jan 30, 2026 Ezra Klein Show — On the seventy-five percent. → Jan 22, 2026 The New York Times — Op-ed, "The Specialty That Isn't One." → Jan 12, 2026 Psychology Today — "The 75% problem, in numbers." →