The Necessary
Revolution

Foreword: A Note on Urgency

Why this book is written with urgency proportional to the crisis, not diplomatic hedging.

The Collapse — Mental Health in America

The scale of the catastrophe: 57.8 million affected, the geography of despair, ERs as default psychiatrists, and the biology of how untreated mental illness damages the brain.

Chapters 1–5

The Broken Machine — Why Therapy Can't Deliver

Modest outcomes, a structural therapist shortage that math cannot solve, and the devastating 73% problem: patients don't tell their therapists the truth.

Chapters 6–8

The Skeptic's Case — Talk Therapy on Trial

The Dodo Bird Verdict, inflated evidence, the replication crisis, and an uncomfortable history of what the profession has gotten catastrophically wrong.

Chapters 9–11

The Chemical Gamble — Medication and Its Limits

Where psychiatric medication works, where it fails, the serotonin myth, polypharmacy, and the opioid lesson about trusting confident prescribing.

Chapters 12–15

The Honest Picture — Why Even Money Can't Fix This

The funding fallacy, the stepped care mirage, lessons from the UK's NHS Talking Therapies, Australia, and the WHO — every system hits the same ceiling.

Chapters 16–19

The Drift — Why People Are Already Going to AI

The largest shift in health-seeking behavior in history. Tens of millions already using AI for mental health support — and why they stay.

Chapters 20–21

The Trap — AI Dependency and the Unprepared Mind

How RLHF creates sycophancy, the six-stage AI Dependency Trap, parasocial relationships, Digital Munchausen, and why the most vulnerable are most at risk.

Chapters 22–24

The Reckoning — What Happens to Psychology Now

Five predictions for the profession, why resistance is a losing strategy, and the case for clinical leadership in the AI therapy revolution.

Chapters 25–27

The Necessary Component — Building the AI That Can Actually Heal

The blueprint: clinical foundations, safety architecture, anti-sycophancy design, outcome measurement, accessibility, the cost of delay, stakeholder mandates, and the call to build.

Chapters 28–32

Appendices

Research gaps and proposed studies, recommended reading, and the full reviewer panel critiques with revision history.