Fixing America's Broken Mental Health System : Introducing Shrink Speak
Publish Date: August 5, 2025
Author: Dr. Jeffrey A. Lieberman
Source: Shrink Speak substack
Speaking Truth About Psychiatry, Policy, and Public Health
It should not come as a surprise to learn that the quality of today’s mental health care is catastrophically poor.
But has it occurred to you that this historic neglect of and indifference toward a substantial segment of our population not only results in a health care disparity, but also constitutes a violation of an individual’s fundamental right to the pursuit of health and happiness? For this reason, mental health care is the Civil Rights Issue of our time.
Visit any major U.S. city and witness homeless persons with untreated mental illness on our streets. Examine the growing number of mentally ill inmates in our prisons and the persistence of suicide in our population despite treatment and prevention strategies that should have reduced rates dramatically. Contemplate the frightening frequency of mass violence perpetrated by persons with untreated mental illness, driven by their symptoms to commit their heinous acts. Consider the inability of people in need to gain access to competent and affordable mental health care.
The deeper tragedy of this state of affairs is that the solution to our mental health crisis lies within our grasp. After all, modern science has provided us with extensive knowledge of the brain as well as effective treatments for mental illnesses. Yet the vast majority of people who suffer from mental health conditions do not receive optimal care, and many do not even know that they need medical care, much less where to go to receive it.
The sad and shameful truth is that the American mental health system remains badly broken. In fact, the vast deficiencies in mental health care have only grown for the U.S. population as the modern age has progressed. At the same time, the field of medicine has made astounding progress in treating and curing previously deadly diseases of other organs. So why the disparity when it comes to mental health care?
We think of ourselves as a modern society and an enlightened people that have made tremendous social progress in overcoming the ignorance and prejudice that have historically resulted in discrimination against vulnerable segments of the population (women; religious, racial, and ethnic minorities; and those with same sex orientation). Yet despite our societal progress, mental illness remains stubbornly misunderstood, feared, and stigmatized, resulting in purposeful indifference and neglect of the mentally ill and their health care needs.
As a society, we should be addressing this situation appropriately. It is an egregious fault that we fail to provide those with mental illness the standard of health care that our scientific knowledge and effective treatments could afford, if we only chose to make it happen. To allow this situation to continue is a shameful affront to human values and the 70 million people worldwide who suffer from severe mental illnesses.
So, why this publication?
An important step in coming to terms with and making amends for the stigma around mental health care involves opening the doors for more honest conversation around its shortcomings. We need to better understand the root causes of these barriers to successful treatment as well as the steps needed to remove them. Moreover, to bring the mental health care system up to the requisite standard of care on a population-wide scale, we will require the cooperation of the federal government. Only once that conversation is out in the open, where it can no longer be buried, ignored, or downplayed, will we succeed in compelling the government to make improving mental health care a national priority.
But to start the discussion – to bring out of the shadows temporarily – is not enough. This issue must become a permanent fixture in the public arena and the media spotlight. No one, and particularly the stakeholder groups whose special interests perpetuate the status quo, can be allowed to avert their attention and avoid facing the painful reality.
This will be SHRINK SPEAK’S mission: to relentlessly speak truth to a society that must be roused from its ignorance and indifference. But fear not; the intent of SHRINK SPEAK is not to chastise and excoriate but to enlighten and inspire. The voice is one of guidance and support.
I have spent years now devoting myself to studying and treating mental illness, de-stigmatizing and educating people, and blending scientific rigor with compelling storytelling to reach as many concerned citizens as possible. SHRINK SPEAK is the latest iteration in this endeavor, allowing for a broader forum that stays abreast of current events and cutting-edge research while encouraging readers to engage and share compelling content.
Through SHRINK SPEAK, I will share evidence-based perspectives, personal reflections from my clinical practice, and updates on advocacy efforts to improve mental health care access and quality. Whether you’re a mental health professional, a patient, or simply curious about mental health care, this publication will provide clear, compassionate, and authoritative content to inform and inspire.
Seventy million people are denied mental health treatment that could be life-changing or life-saving. The time for change is now. Subscribe to SHRINK SPEAK today, and join me in exploring the stories, science, and solutions shaping the future of mental health.