Why Mental Health Is Now a National Security Issue

By Kenneth Dekleva

Dr. Kenneth Dekleva is a former physician-diplomat with the U.S. State Dept. and Professor of Psychiatry and Director, Psychiatry-Medicine Integration, UT Southwestern Medical Center and senior Fellow, George HW Bush Foundation for US-China Relations.  He is the author of two novels, The Negotiator's Cross and The Last ViolinistThe views expressed are his own and do not represent the views of the U.S. Government, State Dept., or UT Southwestern Medical Center.

OPINION — I recently had the privilege of attending the first annual “REAL Summit: The Intersection of Finance and Mental Health,” a 2-day conference in New York City organized by the well-known impact investor Shawn Lesser. The gathering brought together leading mental health advocates, practitioners, startup founders, and investors — representing family offices, high-net-worth individuals, venture capitalists, and private equity.  

One of the exciting takeaways was that in the world of impact investing, mental health has become the new ‘S’ in ESG (environmental, social and governance) investing, and that this space is going to accelerate in the next decade, with a potential worldwide market size that may reach as high as $500 billion. Such awareness has been accelerated by the social, medical, psychological, and economic changes accelerated by the COVID-19 pandemic.  

The summit looked at novel technologies – such as telemedicine, mental health apps, facial recognition software, neurostimulation, novel mechanisms of drug delivery, augmented and virtual reality, genomics, wearables, nanotechnology, miniaturization, and the availability of scalable, at-home treatments – the list is long. And it’s clear that the investment market for technology allowing for improved access, diagnosis, prevention, and treatment of mental illnesses will continue to accelerate and grow. 


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Along with the opportunities – a security risk 

However, what the REAL summit didn’t highlight is that most of the above involve potentially “dual-use” technologies, with possible national security implications for America and its allies. Mental health apps are already in wide use, but as with other applications, it is essential that China and other U.S. adversaries do not gain a foothold in their production, given the implications for the theft of private information. The same concern is relevant for the other technologies in development to help in mental health care; they all have enormous potential for good, along with the danger that others will enter the market with the aim of collecting data on vulnerable Americans.  

These are questions that have been raised in many other areas – and they should be raised in the mental health sphere: Who will develop and own the various technologies? Who will control the supply chains? And which countries will own and control the intimate, personal medical data generated by such technology? China is already in this space. For me, a key precept is that mental health is not merely a human rights issue – impacting 10-20% of the world’s population and accounting for a huge proportion of disability worldwide – but that these new hi-tech treatment options carry with them that “dual-use” risk. What this means is that our government, investors, and private-sector partnerships will need to align strategically in the coming decade. 


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Low-tech issues, too 

There exist other issues in mental health which impact our nation’s national security. The opioid epidemic, with its 110,000 overdose deaths annually from Fentanyl – illegally imported from China via Mexico – is not merely a national tragedy, but a disgrace and stain upon our nation’s leaders, who have failed to stop the deaths, and treat this abomination as an act of war.  

I also worry about captagon, a dangerous stimulant, endemic in the Middle East – many of the Hamas terrorists who committed atrocities against Israel on October 7, 2023, were reportedly high on captagon. Were Syria (the leading producer of captagon, controlling a multi-billion-dollar drug trade) to decide to partner with Mexican cartels to produce and ship the drug to the US, we could face a terrible equation: Fentanyl and captagon = a calamity. 

While the intelligence community has paid closer attention in recent years to the mental health of its workforce – kudos to CIA Director William Burns for highlighting and championing this and similar initiatives – the development of possible “neuroweapons” by our ruthless adversaries has also shown that neurotechnology can have “dual use” as well, with devastating health impacts for our nation’s diplomats, intelligence officers, military officers, and law enforcement personnel, many of whom may have been targeted in cases of the so-called “Havana Syndrome.” This too, is a huge and complex national security challenge, and one that requires more research and more answers. 

Thankfully, in the mental health space and in similar areas of impact investing, hope exists.  Just as The Cipher Brief’s founders Suzanne Kelly and Brad Christian, along with thought leaders and venture capitalists (such as Gilman Louie, Hamlet Yousef, Jeremy Hitchcock, and others) have pioneered building bridges between the U.S. government and the private sector to address national security challenges and “dual-use” technologies such as drones, AI, cyber, robotics, and quantum computing, similar approaches can and should occur in areas of biomedicine and mental health. This happened in recent years under the rubric of DARPA’s Defense Science Office, which in the late 2000s funded Moderna, a subsequent developer of the COVID vaccine. And with the recent creation of ARPA-H [Health], more innovative research and government-private partnerships have become possible. 

Many observers would suggest that in the case of “dual use” technologies in biomedicine and mental health, we need not worry or become alarmed, and that such technologies are in the earliest stages of the investment cycle. Such complacency ignores the fact that our most formidable adversaries such as China and Russia are already in this space. There is little time to delay. The national security community and private sector must partner, allied with our government leaders, to accelerate investments and research in the mental health space. We must act now.

The Cipher Brief is committed to publishing a range of perspectives on national security issues submitted by deeply experienced national security professionals. 

Opinions expressed are those of the author and do not represent the views or opinions of The Cipher Brief.

Have a perspective to share based on your experience in the national security field?  Send it to [email protected] for publication consideration.

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