Mental Health Is in Crisis. What Is the Answer?


The US is still in a state of emergency for Covid-19 and monkeypox. However, the country has another longstanding and quickly worsening public health concern—mental health. According to, about 20 percent of American adults experienced a mental health issue in 2020. Nearly 1 in 20 Americans live with a severe mental illness. 

Perhaps the most severe and heartbreaking consequence of mental illness is a patient’s decision to end his or her own life. There were over twice as many suicides than homicides in 2020. Tragically, what motivates someone to commit suicide remains a mystery. Some choose to do so after enduring extreme hardship, trauma, or loss. In contrast, others commit the act while outwardly appearing to live happy and fulfilling lives. 

With suicide rates steadily increasing since the pandemic, many senators and health-related organizations recently sent a message of concern to President Biden urging him to provide more federal funds for mental health. He did. As part of the lavish Bipartisan Safer Communities Act, the Biden Administration provided nearly $300 million in support for certified community behavioral health clinics, with another $15 million to be distributed in 2023. 

Despite considerable funds and federal partnerships to reduce suicide rates, many professional organizations are still urging the President to declare a national public health emergency and take further steps. One possible and troublesome option could be to increase the amount of lithium in public drinking water. 

Why? Historically, lithium has been used to treat a variety of mental illnesses. Some studies find that higher amounts of lithium in the ground and drinking water are linked to lower rates of suicide and mental illness. Although most research examines how natural amounts of lithium in water affect mental health, some medical professionals propose standardizing higher amounts of lithium in public drinking water could be used to combat public mental health concerns. It’s been widely considered in Britain. This idea might also gain traction here, considering the already considerably high amounts of lithium in water across much of the US. 

Should it? Even with alarming mental health concerns across the country, there are two critical reasons to keep this option off the table. 

First, lithium’s use is not without controversy and side effects. Patients using lithium sometimes experience tremors, nausea, hypothyroidism, and potentially fatal renal complications. Like many other substances used to help treat mental illness, dosing lithium is highly sensitive. It can easily exacerbate severe conditions if not carefully monitored. These factors make lithium treatment a personal matter—not a preventative measure for public health concerns. 

Second, and more importantly, trusting the government to address any public health concern is extremely risky at best and deadly at worst. I’ve written before about the extensive failures of the federal government to address the Covid-19 pandemic and monkeypox outbreaks. My academic work argues that the US government has failed and done appalling harm to the mentally ill for over 100 years.

Beginning in the early 1800s, care for the poor, sick, and mentally ill was a local matter—often addressed through private charities or churches. Even before there were medical terms for many mental illnesses, medical almanacs identified hundreds of sources and treatments for “insanity.” However, by the 1820s, physicians began lobbying state governments to build and fund mental asylums promising better care. Instead, they received higher wages while involuntarily isolating patients from their loved ones and social systems.  

By the 1930s, physician and psychiatrist lobbying efforts built an extensive network of federal mental asylums and laws that easily allowed patients to be committed to them. Consequently, many federal asylums faced extreme overcrowding issues. The federal government began subsidizing lobotomies to provide a cheap way to make patients more docile and amenable to horrific living conditions. 

As I noted in my article published in Research Policy, lobotomies were widely understood to be ineffective and harmful for the patient, being dismissed by the American Medical Association after 13 surgeries. However, federal subsidies continued to fund the procedure well after at least 60,000 were performed across the country during the horrific “lobotomy boom” of the 1940s.

The state of mental health in the US is dire. But the first step toward fixing it is not letting it get worse. Given the US government’s track record of harming perhaps those who need our help the most, I think it would be foolish to trust them now.