Less than a month before his assassination in 1963, President John F. Kennedy signed his last bill: one aimed at reforming America’s mental-health system. The year prior, Ken Kesey’s One Flew Over the Cuckoo’s Nest had brought attention to the crude treatments in mental institutions, and like the novel’s protagonist, the president’s sister Rosemary had received a lobotomy that left her profoundly disabled. Kennedy sought to end the “reliance on the cold mercy of custodial isolation,” he said in a statement to Congress.
Dedication to improving the country’s approach to mental health became a family project. In 1962, Eunice Kennedy Shriver started a sports camp for people with intellectual disabilities, which became the Special Olympics. In the 1970s, Senator Edward Kennedy tried to fix living conditions in mental institutions; in the ’90s, he helped establish the Substance Abuse and Mental Health Services Administration. Recently, his nephew Robert F. Kennedy Jr., the current secretary of Health and Human Services, subsumed that agency into a new one: the Administration for a Healthy America, which includes mental health as one of its focuses.
RFK Jr.’s policy plans have not yet taken form. So far, he has overseen deep cuts to HHS and begun reorganizing the agency internally. He has met once, reportedly, in private with the Make America Healthy Again Commission, created by the president to address chronic health issues; one of its stated goals is to assess the threat of prescription psychiatric drugs. (HHS did not respond to a request for comment.) When speaking publicly, Kennedy has repeatedly returned to the idea that American doctors overprescribe such drugs.
Kennedy is skilled at picking up on frustrations in the zeitgeist. The sentiment that doctors over-rely on psychiatric drugs, while neglecting side effects or difficulty tapering doses, has been receiving more public attention. Consistent and affordable access to therapists, or to economic and housing support, is hard to come by. Yet to the extent that RFK Jr. has revealed his own thinking on how to address those complaints, his suggestions remain isolated from robust debates about mental-health treatment. His clearest proposal, still, is his campaign promise to create wellness farms where Americans would reconnect with the soil and “learn the discipline of hard work.” That idea is little more than a retreat to well-trodden calls to address mental distress through seemingly natural means, and shows scant interest in the nuances of debate around psychiatric medication, or the ways in which separating people from society for such cures has failed.
Kennedy first brought up wellness farms during his presidential run, and when he painted a picture of pastoral meccas for treating addiction, he joined a tradition that dates back more than 200 years. Take the Retreat, founded in England at the end of the 18th century by a Quaker, William Tuke, who along with the French doctor Phillipe Pinel is considered a father of “moral treatment,” an effort to create humane hospitals. Instead of shackles and corporal punishment, the Retreat provided a stately country home, with acres of land to tend cows and grow food. The doctor Benjamin Rush—who signed the Declaration of Independence—was inspired by moral treatment, and wrote in 1812 that men who “assist in cutting wood, making fires, and digging in a garden, and the females who are employed in washing, ironing, and scrubbing floors, often recover,” whereas those who don’t do any manual labor do not.
Tuke and Pinel believed that farming was especially helpful, and many early asylums in the United States employed a “work as therapy” component, says Neil Gong, a sociologist at UC San Diego. At the time, these institutions were cutting-edge, and those running them believed that the “insane” didn’t have to be locked up in chains to improve. “Mental hospitals started out in the 19th century with very utopian expectations around them and their ability to cure,” says Andrew Scull, a sociologist and the author of Desperate Remedies: Psychiatry’s Turbulent Quest to Cure Mental Illness. By the end of the 19th century, every state had at least one government-funded institution.
But when moral treatment was generalized to larger populations, it fell apart. (The Retreat was designed to take on only 30 patients.) Over time, government-run asylums became overwhelmed with cases, and rampant with abuse. At scale, institutions “rapidly declined into warehouses where lots of unpleasant things happen to the patients, and where patients tended to get lost,” Scull told me.
Including farming didn’t protect against such issues, either. The Fort Worth Narcotic Farm, a federally funded project opened in 1938, promised to blend honest farmwork with recovery from drug addiction. Only 25 percent of patients, one study estimates, stuck to their treatment plan, and most people treated at federal narcotic farms, according to a 1957 study, used drugs after they left. The U.S. Narcotics Farm, which opened in 1935, was the temporary home of many famous jazz musicians, including Chet Baker. But once people left the farm, the majority—nearly 90 percent—relapsed. It closed in 1976 after a congressional inquiry led by Senator Ted Kennedy found that doctors were testing experimental drugs on the people living there, and sometimes giving patients drugs such as heroin and cocaine as a reward.
The idea of farm-based detox is appealing enough that today, plenty of private rehabilitation centers incorporate nature and farming; pastoral work as mental-health treatment has become a luxury good, Gong told me, but is often combined with a suite of other services, including psychiatric support. Still, there isn’t an overwhelming body of evidence that care farms have ever been effective at improving outcomes. One review from 2019 found no proof that “care farms improved people’s quality of life” and limited evidence for improved depression and anxiety. “To champion the wellness farm seems out of left field when other models like permanent supportive housing or supportive employment have a huge evidentiary base, including cost-effectiveness,” Ryan K. McBain, a health economist at the RAND Corporation, told me. If Kennedy wanted to, he might tap the Center for Medicare & Medicaid Innovation, which evaluates new programs, to assess how effective a state-run wellness farm could be. This month, however, the CMMI announced that it is cutting funding for several of its programs.
The most revealing aspect of Kennedy’s plan isn’t what people would do on these farms, but what they wouldn’t—take any sort of psychiatric drugs. In describing the farms, Kennedy painted a picture of them as detox centers where people would also taper off medications for depression and ADHD. In the moral-treatment times, drugs such as antidepressants and Ritalin didn’t exist; moral treatment was, nevertheless, seen as alternatives to barbaric interventions such as bloodletting and restraint. For Kennedy, the wellness farm is the same: a substitute for, not a complement to, other treatments.
The role that psychiatric drugs play in Americans’ mental-health treatment is a real and active debate. For many people, psychiatric medications can be a crucial part of their recovery. Yet contemporary psychiatrists have plenty of complaints about insurance companies that reimburse more for medication than for other treatments and a pharmaceutical industry riddled with conflicts of interest. In 2025, people working in this field recognize that the ways in which drugs have claimed to treat mental illness have oversimplified or overemphasized biology. Deliberations on the origin of and rightful reaction to mental distress are core to psychiatry: Michel Foucault thought that psychiatry could be a pernicious force to control society; the psychiatrist Thomas Szasz thought that mental illness was a myth altogether.
However, Kennedy hasn’t engaged with any of these topics substantially. Instead, he has muddied the water with false claims, including that antidepressants are associated with school shootings and are more addictive than heroin. In a podcast last year, he said that wellness farms free of psychiatric drugs would be especially helpful for Black children: “Every Black kid is now just standard put on Adderall, on SSRIs, benzos, which are known to induce violence, and those kids are going to have a chance to go somewhere and get re-parented.”
In this way, Kennedy’s wellness-farms proposal shows how his thinking about public health is defined almost entirely by his naturalness bias—that “natural” treatments are always better, and that manual labor and fresh air, or simply the right diet, could resolve complex and widespread health problems. (“They’re going to grow their own food, organic food, high-quality food, because a lot of the behavioral issues are food-related,” Kennedy said about the farms.) This is consistent with his ideas about vaccination—that natural exposure to disease might be desirable, and that dealing with diseases such as measles with diet and sanitation, as the country did in the first half of the 20th century, is preferable.
But we’ve learned plenty in the past 50, if not 200, years. Facilities that take people out of their community have limited capacity, on their own, to be an effective public-health measure. A more radical idea than wellness farms would be treating people in their community, with a mixture of care options that they can choose from. That idea is also closer to what John F. Kennedy had in mind when he signed the Community Mental Health Act in 1963. He didn’t simply want to close government-run mental centers; he aimed to create 1,500 community mental-health centers. This goal went unrealized. Community mental-health care gives a person access to an interdisciplinary case-management team of social workers, nurses, doctors, and psychologists, and to social services such as housing and employment support. Creating that at scale presents a more obvious and necessary challenge than sending people away to a farm to breathe fresh air and till the land.
