Inside the world’s most expensive addiction clinic
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The indoor pool is too hot. It is summer and the room needs blinds. Despite being on the lowest level of the villa, the huge plate windows let in so much light from the manicured garden that the humid air, even with climate control, has become somewhat stifling.
From the floor above — all beautifully polished marble and modernist furniture — you can look out of the windows over the hedge surrounding the property. What you see is a sweeping panorama of Lake Zürich. The floor above that, reached by a grand staircase, is entirely occupied by the master suite.
Here, an enfilade of rooms stretches the length of the building, with the bedroom in its centre and a full complement of staff. Like a royal parade, everything is designed, Versailles-like, to turn around the life of its principal occupant.
Those who have stayed here are, of course, very, very rich. But they are also very unwell.
This villa is one of 12 that comprise the Kusnacht Practice, the world’s most expensive — and secretive — clinic for the treatment of serious addictions and mental health problems. For the past 15 years, alcoholics, drug-users, anorexics and sex-addicts have all come here. Royals, billionaires, celebrities and politicians.
In the past, it has generated controversy, in particular around a claim that it had, for a time, paid huge referral fees to therapists to send rich clients. The practice says it no longer pays anything for referrals and has not done so since 2018. It keeps a low profile. It has also, according to its management, helped dozens of individuals radically change their lives.
If Kendall Roy, the fictional addict son of media mogul Logan Roy in the streaming series Succession, had been real, he could have come here to get clean. Though, in reality, the lives of many Kusnacht clients are even more aberrant than the most creative scriptwriters could imagine. “We have something of a motto here,” says Eduardo Greghi, the practice’s chief executive. “Where everyone else gives up, we begin.”
We are sitting in his office in the practice’s main building, a low-rise block in the neighbouring suburb of Zollikon. There is very little to suggest that this, or any of the other rooms I am shown (stage-managed so I never glimpse a patient, just as they never see each other), has anything to do with the treatment of serious mental health problems.
Greghi, a Brazil-born 41-year-old, is the Kusnacht Practice’s driving force. He is not, by training, either a therapist or a clinician, but he exudes bonhomie. He talks about his clients, even those with serious problems, as if they were friends. From all that he describes — the regular phone calls, the knowledge of their idiosyncrasies and of their families — it sounds like many are.
“People often focus on the hospitality side of what we do here, about how we have these villas with these views, and so on,’’ he says ‘‘But most of my clients have much better at home — they have larger houses with better views. The reality is that the work we do here is hard, painful work.’’
Greghi won’t name any clients. Some might be celebrities with well-known peccadillos, but many more are struggling with secret addictions. Not every client is an addict. “People come here to be the best versions of themselves,” Greghi says. “They want better relationships, to sleep better, to eat better, to have a better libido or because they want to be people without drugs. Of course, we also look after people with severe mental illnesses — borderline personality disorders, depressions, anxiety and more serious substance abuse.”
Most arrive in Zürich by private jet, from which a waiting car whisks them to their villa. The villas themselves — the smallest being 250 square metres in size — are dotted in and around the town of Küsnacht. They are largely indistinguishable from most of the other houses on the “Gold Coast” of Lake Zürich, some of Europe’s most rarefied real estate.
“We try to learn everything about our clients before they come here,” says Greghi. They will find out their favourite flowers, or how firm they like their pillows.
The comforts that clients receive at the Kusnacht Practice, Greghi says, are not so much about luxury as making them feel safe — and normal. To anyone unaccustomed to such wealth, however, little of this seems normal.
Earlier, at the villa, I recall realising that a large room I was standing in — adjoining the sitting room of the master suite and probably bigger than most London apartments — was not an empty library, its walls lined with backlit wooden shelves, but a dressing room. A recent occupant had checked in and filled it with shoes, Greghi told me. Hundreds of pairs. Where did she think she was going to wear them, I wondered?
A week at the Küsnacht Practice starts at SFr103,000 ($105,000). Most patients are expected to stay at least six to eight weeks. Some stay for months. The clinic treats about 30 people a year. Which gets to a central question: does having so much money make you more prone to addictive behaviours, and does it make those behaviours harder to cure?
“Our clients are complex,” says Prof Georg Schulthess, chief medical officer at the Kusnacht Practice. “They come from an environment where things are not clear, where their lifestyle, their psychology, their work or their public profile complicates diagnosis and treatment. They have to be taken out of that situation.”
During their stay, clients must give up whatever substance or behaviour they are addicted to, or leave. Kusnacht will not take patients who are still going through the initial shock of withdrawal. But, if patients seek urgent help, they will secure a place in a top local hospital for treatment before being brought to a villa.
The Kusnacht treatment is all-encompassing. Dr Antoinette Sarasin Gianduzzo oversees the clinic’s nutrition programme, which micro-manages every meal (cooked by each villa’s live-in chef). Dr László Ürögi oversees a team of psychotherapists and psychiatrists (each villa also has a live-in counsellor). There are personal trainers, masseurs, nurses and specialists in alternative therapies.
“When they come to us, they are usually desperate for help, having tried almost everything else,” says Schulthess. Wealth has, if anything, been as much a cause of their unshakeable addictions and misery as it might be a ticket to curing them.
“Unlimited resources, unlimited options — that is not always supportive for a healthy mind or for a personal development,” says Ürögi. Among the clients, he notes, are children of the super-rich. Growing up with often-absent parents, in a world of staff and material plenty can obliterate a developing mind’s sense of self. Substances can become the only escape.
Sometimes, a client’s public standing complicates their ability to tackle addiction, because the problem must remain hidden. Schulthess recounts the case of a prominent politician: “They had reached a point of total exhaustion. From taking one pill one day to cope with the stress they were under, it had just got more and more in secret.”
One of the Kusnacht Practice’s more unusual approaches is that it offers “whole family” treatments. The roots of many addictions are in clients’ relationships with their families, notes Ürögi, and sometimes it is the family that needs to go through a therapeutic process too. “When families come here, they are not judged,” he says. Wealth and power can do strange things to family dynamics.
When clients leave Kusnacht, they can expect the clinic to stay in touch with them for months, or years, until they are better — or indeed, until they next check in. It is a “psychological concierge” service, says Greghi.
Are there contradictions in running a business that makes its money — presumably a lot of money — from addiction treatments?
In 2018, the UK’s Sunday Times newspaper said in an investigation that the Kusnacht Practice had, in the past, been paying psychiatrists and therapists in London tens of thousands of pounds for each client they referred.
According to Greghi, since he became chief executive in 2018, all such payments have stopped. He declines to comment on what happened before he was chief executive, when he was already a shareholder and a director. “I can guarantee that since I have been CEO, we do not pay commissions or referral fees or kickbacks or whatever you want to call it. People send us clients from all over the world because we are the best,” he says. “We perform miracles here.”
Greghi was born into a humble background in Brazil, but the Kusnacht Practice has made him wealthy. He owns seven horses in Zürich and is a regular on the city’s polo circuit. I ask him about how his made it to this point, but his answers are somewhat elliptical. The only prior entrepreneurial success he names is an Italian restaurant in Zürich, Ristorante Positano.
He began working for the Kusnacht Practice’s founder, Lowell Monkhouse, in about 2013, he says, and helped expand the business significantly. In 2015, he and a partner bought Monkhouse out. And in 2018, he in turn bought his partner out. He declines to discuss the shareholder structure, though he says he is now “the sole controlling owner” and that Swiss bank UBS had been a key lender for him.
He emphasises that the practice is not primarily about making money but helping people. “Money, power and possessions are like sand,” he says. “The minute you try to grasp them, they run out of your hands.”
Googling “luxury rehab” is quite an eye-opener: there are reviews that read almost like travel articles. The Kusnacht Practice, though the most expensive, is not unique. In Zürich alone, for example there is also the Paracelsus Clinic. Mallorca’s Balance clinic, meanwhile, offers a slightly sunnier locale for treatment.
Later, I speak with the London-based psychotherapist Nicholas Blackburn and ask what he makes of wealth and its peculiar effects on addiction. “It’s such an evocative scene,” he says, after I describe my trip to one of the Kusnacht villas. “Someone very rich, isolated there and perhaps hanging on to all the material things that reinforce their boredom and loneliness.” And all those shoes . . .
This article is part of FT Wealth, a section providing in-depth coverage of philanthropy, entrepreneurs, family offices, as well as alternative and impact investment