Schizophrenia Gets Better in Countries That Don’t Drug People Into Oblivion — And We Refuse to Talk About It

Here’s a truth the U.S. mental health system does not want you to sit with for more than five seconds:

People diagnosed with schizophrenia do better in countries that don’t over-drug them.

Not “a little better. ”Not “in some cases. ”Substantially better. More recovery. Back to work. back into relationships. Back into actual, enjoyable lives.

And this isn’t some fringe, anti-science rant. This comes from their own data — data that has been quietly minimized, buried, or explained away for decades because it threatens an entire treatment economy.

Let’s get clear.

In the United States and other Western, medication-dominant systems, schizophrenia is framed as a chronic, deteriorating brain disease that requires lifelong antipsychotics, escalating doses, and permanent patienthood. Once you’re in, you’re in. Compliance is worshipped. Questioning is labeled “lack of insight.” Side effects are shrugged off as the cost of doing business.

But in other parts of the world — places with less aggressive drugging, stronger social containment, and more tolerance for altered states — the story looks very different.

The World Health Organization ran long-term, cross-cultural studies starting in the 1960s — including the International Pilot Study of Schizophrenia and later the Determinants of Outcome studies. Their conclusion was uncomfortable and undeniable:

Patients in “developing” countries had significantly better long-term outcomes than patients in the U.S. and Europe.

More complete recovery. Less chronic disability. Higher rates of returning to work and family life.

Let that sink in.

The countries with fewer psychiatrists, fewer hospital beds, and far fewer drugs had better outcomes than the countries with the most “advanced” biomedical systems on earth.

So what did we do with that information?

We ignored it. We pathologized it. We said things like “cultural differences,” “underreporting,” or “they don’t really have schizophrenia like we do.”

Anything except the obvious question:

What if our treatment model is making people worse?

Fast-forward to modern examples.

In Finland, the Open Dialogue approach treats psychosis with immediate social support, minimal medication, family involvement, and time. Antipsychotics are used cautiously — sometimes not at all — especially in first episodes.

The results?

Lower relapse rates. Higher employment. Less long-term disability. Far fewer people are sentenced to a lifetime diagnosis.

In other words, people actually get better.

Contrast that with the U.S., where someone can have one psychotic break during trauma, grief, or extreme stress and end up:

• Rapidly tranquilized

• Diagnosed in days

• Medicated heavily

• Told they have a permanent brain disease

• And placed on a conveyor belt of compliance for life

We don’t even try to see who the person is without the drugs. We just stack prescriptions until the behavior is manageable and call it care.

And let’s not pretend this is just about “following the science.”

This system is held together by:

• Pharmaceutical profit

• Risk-averse institutions

• Disability pipelines

• And a culture terrified of emotional and psychological intensity

  
  

If schizophrenia were widely understood as something that can resolve, remit, or transform under the right conditions, entire power structures would crack.

So instead, we double down on the story that people are broken forever — because that story is profitable, controllable, and safe for the system.

Here’s the part that makes people uncomfortable:

Many people diagnosed with schizophrenia don’t need more drugs. They need less fear, less coercion, more meaning, more patience, and more human connection.

Yes, some people benefit from medication — temporarily, carefully, contextually. But over-drugging is not treatment. It’s sedation masquerading as care.

Other countries prove this every day.

We are not failing because schizophrenia is “too severe. ”We are failing because we refuse to imagine recovery that doesn’t flow through a pill bottle.

And until we confront that — honestly, angrily, and without pharmaceutical talking points — we will keep calling lifelong disability a success story.

I’m done pretending this isn’t happening.

If other countries can help people recover without chemically erasing them, then the problem isn’t schizophrenia.

It’s us.

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References

Harrow, M., & Jobe, T. H. (2007). Factors involved in outcome and recovery in schizophrenia patients not on antipsychotic medications: A 15-year multifollow-up study. Journal of Nervous and Mental Disease, 195(5), 406–414. https://doi.org/10.1097/01.nmd.0000253788.32338.6e

Hopper, K., Harrison, G., Janca, A., & Sartorius, N. (2007). Recovery from schizophrenia: An international perspective. Oxford University Press.

Jääskeläinen, E., Juola, P., Hirvonen, N., McGrath, J. J., Saha, S., Isohanni, M., Veijola, J., & Miettunen, J. (2013). A systematic review and meta-analysis of recovery in schizophrenia. Schizophrenia Bulletin, 39(6), 1296–1306. https://doi.org/10.1093/schbul/sbs130

Lehtinen, V., Aaltonen, J., Koffert, T., Räkköläinen, V., & Syvälahti, E. (2000). Two-year outcome in first-episode psychosis treated according to an integrated model: Is immediate neuroleptisation always needed? European Psychiatry, 15(5), 312–320. https://doi.org/10.1016/S0924-9338(00)00322-3

Sartorius, N., Jablensky, A., Korten, A., Ernberg, G., Anker, M., Cooper, J. E., & Day, R. (1986). Early manifestations and first-contact incidence of schizophrenia in different cultures. Psychological Medicine, 16(4), 909–928. https://doi.org/10.1017/S0033291700011910

Seikkula, J., Alakare, B., & Aaltonen, J. (2001). Open dialogue in psychosis I: An introduction and case illustration. Journal of Constructivist Psychology, 14(4), 247–265. https://doi.org/10.1080/10720530125965

Seikkula, J., & Olson, M. E. (2003). The open dialogue approach to acute psychosis: Its poetics and micropolitics. Family Process, 42(3), 403–418. https://doi.org/10.1111/j.1545-5300.2003.00403.x

World Health Organization. (1979). Schizophrenia: An international follow-up study. Wiley.

World Health Organization. (1992). The International Pilot Study of Schizophrenia (Vols. 1–5). WHO.

World Health Organization. (2001). Mental health: New understanding, new hope. WHO.