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Maren Wiederhold

EMPIRE OF MADNESS

Khameer Kidia

Reimagining Western Mental Health Care for Everyone

An urgent rethinking of the Western approach to mental health, which treats the symptoms rather than the exploitative systems causing our distress - by a Rhodes Scholar and Harvard Medical School physician-anthropologist - offering lessons from the rest of the world.
In Empire of Madness, Dr. Khameer Kidia offers a re-evaluation of mental health in the Global North, where the answer to the structural causes of mental distress, like racism and economic inequality, has been to medicate the symptoms rather than revolutionize those causal structures. A clinician and researcher whose own mother suffers from the psychological harm of colonialism, Kidia reports from the front lines of mental health crises at home, in clinical practice and during fieldwork, highlighting the flaws in how we cope with global mental distress.

Western psychiatry, which emerged during nineteenth-century colonialism and expanded under neoliberalism, mollifies the effects - depression, anxiety, hunger, poverty - of oppressive structures rather than fixes them. "Burnout" is just one example of mental distress caused by economic and social conditions but disguised as a medical problem. Clear-eyed and open-hearted, Kidia asks the necessary questions that our current mental health system, pharmaceutically-driven and focused on one-size-fits-all solutions, doesn't address.

How do history, culture, and politics shape mental distress? Is hoarding a medical problem? Why are the outcomes of schizophrenia sometimes better in places without antipsychotics? Can a Zimbabwean grandmother sitting on a wooden "friendship bench" talk through someone's problems better than a Western-trained therapist? For those living in poverty, can cash replace pills?

Empire of Madness sharply intertwines discussions of the colonial origins of psychiatry, the long-lasting and psychological effects of oppression, and the overburdened health professionals striving to heal their patients in rigid, archaic systems to reimagine global mental health as a capacious, inclusive field where our wellbeing is mutual and everyone's voicepatients, caregivers, and health workers alikematters.

Dr. Khameer Kidia teaches at Harvard Medical School and the University of Zimbabwe. A 2023 New America Fellow, he's spent over a decade working at the intersection of mental health research, advocacy, and practice. His work has appeared in The New York Times, NEJM, The Lancet Psychiatry, Slate, Yale Review, and Los Angeles Review of Books. He splits his time between Harare and Washington, D.C.
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Published 2026-02-03 by Crown

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With searing insights rooted in scientific research and his personal experiences as a doctor, Khameer Kidia exposes the profoundly harmful impact of colonialism and capitalism on mental health. While the world's most powerful medical institutions target symptoms with endless cycles of prescription drugs, Empire of Madness calls for treating the structural causes of distress by addressing the economic inequalities wrought in the wake of imperial conquest. Boldly interrogating his own complicity in the system he critiques, Kidia brings a fresh, radical, and essential voice that reimagines the possibilities for global health care - and for a more compassionate world.

Deftly moving between incisive social and geopolitical analysis of what Western medicine calls "mental illness" and personal experience as a child of empire turned Western-educated physician, Kidia unfolds one brilliant revelation after another. Empire of Madness is required reading for anyone who seeks to improve health care - it offers solutions as much as it does critique - as well as anyone who wishes to better understand their own mental distress. If you read only one book on decolonizing mental health care, this should be it.

The Western view of mental illness as a purely neurochemical problem best treated with drugs is misguided and damaging, according to this bold debut treatise from physician Kidia.

Empire of Madness argues that the solution to our mental health crisis is not more psychiatry, but more justice. Khameer Kidia makes the powerful case that what we diagnose as individual illness is often a rational response to structural violence. This is an essential, paradigm-shifting book.

Blending vivid personal storytelling with history, anthropology, and medicine, Empire of Madness provocatively exposes the quicksand of a biomedical approach to mental health problems. Kidia highlights the importance of culture and context and prescribes the powerful antidotes of community action and social reform. A must read for everyone interested in a refreshing, even radical, perspective on mental health.

In Empire of Madness, Kham Kidia does something rare and necessary: traces the roots of Western psychiatry back through colonial violence and family memory. This book challenges readers to see how deeply empire shapes not just who receives care, but how we understand mental suffering itself. A vital intervention that asks whether the tools we've inherited can ever truly heal us.