The number of people who try suicide has risen steadily in the U.S. But despite gains in health coverage, nearly half are not getting mental health treatment.Suicide attempts in the United States showed a “substantial and alarming increase” over the last decade, but one number remained the same, a new study has found: Year in and year out, about 40 percent of people who had recently tried suicide said they were not receiving mental health services.The study, published in JAMA Psychiatry on Wednesday, traces a rise in the incidence of suicide attempts, defined as “self-reported attempts to kill one’s self in the last 12 months,” from 2008 to 2019. During that period, the incidence rose to 564 in every 100,000 adults from 481.The researchers drew on data from 484,732 responses to the federal government’s annual National Survey on Drug Use and Health, which includes people who lack insurance and have little contact with the health care system. Because the data is self-reported, it could reflect faulty or inexact recollections.They found the largest increase in suicide attempts among women; young adults between 18 and 25; unmarried people; people with less education; and people who regularly use substances like alcohol or cannabis. Only one group, adults 50 to 64 years old, saw a significant decrease in suicide attempts during that time.Among the major findings was that there was no significant change in the use of mental health services by people who had tried suicide, despite the passage of the Affordable Care Act in 2010 and receding stigma around mental health care.Over the 11-year period, a steady rate of about 40 percent of people who tried suicide in the previous year said they were not receiving mental health care, said Greg Rhee, an assistant professor of psychiatry at the Yale School of Medicine and one of the authors of the study.The Affordable Care Act, which took effect fully in 2014, required all health plans to cover mental health and substance abuse services, and also sharply reduced the number of uninsured people in the U.S. In 2008, 43.8 million Americans, or 14.7 percent of the population, were uninsured, according to the Centers for Disease Control and Prevention. By 2020, the total uninsured had fallen to 28 million, or 8.6 percent of the population, the Census Bureau reported.Still, many respondents to the survey in the new report said the cost of mental health care was prohibitive; others said they were uncertain where to go for treatment or had no transportation.“It is a huge public health problem,” Dr. Rhee said. “We know that mental health care in the U.S. is really fragmented and complicated, and we also know not everybody has equal access to mental health care. So, it’s somewhat not surprising.”Since people who try suicide have a higher likelihood of making another attempt in the next six months compared with the general population, the barriers to treatment are particularly troubling, he said.“That is our idea of hope,” he said. “That is the goal of the medical structure. We want to provide health care to people who attempt suicidal behavior.”Suicide is one of the top 10 leading causes of death in the United States, with a yearly death toll that has risen 60 percent in recent decades, to 48,344 in 2018 from 29,180 in 1999. During that period, the rate of suicide in the population increased by 35 percent, dipping for the first time, by 2 percent, in 2019, according to the C.D.C.This has happened despite significant advances in brain science and the development of promising interventions using cognitive behavioral therapy, attachment-based family therapy and dialectical behavioral therapy, said Dr. Christine Moutier, the chief medical officer for the American Foundation for Suicide Prevention.“One would argue, why haven’t the rates been going down?” she said. “Until 2018, it’s very clear that those have yet to be made accessible to the general population.”The study suggests that overall, people who attempt suicide face especially high barriers to access, since the U.S. population as a whole is using mental health services at a higher level than ever before, with recent research suggesting that one in four Americans was receiving some care, Dr. Moutier said.“This is not a new finding, from that standpoint, but it is terribly concerning,” said Dr. Moutier, who was not involved in the study.The population of people who have tried suicide is distinct, demographically, from those who have died by suicide: While women make up a majority of suicide attempts, more than three-quarters of those who die by suicide are men, the data shows, among other reasons because men are more likely to use guns.People who survive a suicide attempt often do well afterward, said Dr. Paul Nestadt, an assistant professor of psychology at Johns Hopkins who has researched the epidemiology of suicide.He cited a 1978 study of 515 people who had tried suicide at the Golden Gate Bridge in San Francisco; after following up with the survivors for 26 years, researchers found 94 percent of them were alive or had died of natural causes, and only 4.9 percent had died by suicide subsequently.Dr. Nestadt, who was not involved in the study, said the new data points, once again, to the scarcity of psychiatric beds or mental health professionals who take insurance, factors that have prevented medical science from bringing down the country’s suicide rates.“The bottom line is, our treatments really work, that’s one of the things that always surprises medical students doing psychiatry rotations,” he said. “But people have to be able to access care. When they can’t, they’re left with less choices.”

A jury found Harvard chemist Charles Lieber guilty of lying to the federal government about his participation in China’s Thousand Talents recruitment program.BOSTON — Charles Lieber, one of the country’s top research chemists, sat miserably in a chair at the Harvard Police Department, trying to explain to two F.B.I. agents why he had agreed to partner with a lesser-known Chinese university in a relationship that had soured and landed him in trouble with the U.S. government.The university had money to spend — “that’s one of the things China uses to try to seduce people,” Dr. Lieber said in the interrogation, clips of which were shown in court. But money wasn’t the reason, he said. By training young scientists in the use of technology he had pioneered, he hoped to burnish his credentials with the committee that decides the ultimate scientific honor.“This is embarrassing,” he said. “Every scientist wants to win a Nobel Prize.”On Tuesday, after deliberating for two hours and 45 minutes, a federal jury found Dr. Lieber guilty of two counts of making false statements to the U.S. government about whether he participated in Thousand Talents Plan, a program designed by the Chinese government to attract foreign-educated scientists to China. They also found him guilty of failing to declare income earned in China and failing to report a Chinese bank account. Though it is not illegal to participate in Chinese recruitment programs, scientists are required to disclose their participation to the U.S. government, which also funds their research and may view it as a conflict of interest. Dr. Lieber’s conviction is a victory for the China Initiative, an effort launched in 2018, under the Trump administration, to root out scientists suspected of sharing sensitive information with China. Of several dozen cases opened against academic researchers, most, like the case against Dr. Lieber, do not allege espionage or intellectual property theft, but failure to disclose Chinese funding, and the effort has been criticized for prosecutorial overreach. It suffered a series of setbacks over the summer, with half a dozen cases dismissed and the first case to reach the trial stage, against the researcher Anming Hu, ending in acquittal. Dr. Lieber’s trial was watched closely in scientific circles, as an indicator of whether the Justice Department will proceed with prosecutions of other researchers. Peter Zeidenberg, a Washington, D.C. lawyer who represents around a dozen researchers who are under investigation, said Dr. Lieber’s case stands out because he was specifically asked about his participation in the Chinese program, and denied it.“The reason people like Lieber lie is because they are afraid,” he said. “It’s really sad. They are afraid to answer truthfully, ‘Are you a member of the talent program?’ I’m sure in the Red Scare, people said they were not a member of the Communist Party. ”The department of chemistry and chemical biology at Harvard, where Dr. Lieber was chair. He is on leave from the university.Katherine Taylor/ReutersIn closing arguments on Tuesday, Dr. Lieber’s lawyer, Marc Mukasey, said the government had inadequate proof of wrongdoing and risked silencing a pioneering researcher. “Isn’t it troubling that nobody in this courtroom has explained what the Thousand Talents Plan is and who is in it?” he said. “Isn’t it troubling that Dr. Lieber’s work was all public, was for the benefit of the world, yet he is facing criminal charges for it?”He added, “No villains, no victims, no one got robbed, no one got rich, but over a few seconds of conversation — Special Agent Mousseau called it a blip on the radar — the world’s greatest nonscientist is facing multiple felonies.”Among the researchers prosecuted as part of the China Initiative, Dr. Lieber is by far the most prominent, chosen as chairman of Harvard’s chemistry and chemical biology department and seen by some as a potential Nobel Prize winner. Since 2008, prosecutors said, his laboratory at Harvard had received research grants totaling $18 million from the Department of Defense and the National Institutes of Health.At issue in this case was a joint venture that Dr. Lieber launched in 2011 with the Wuhan University of Technology, where one of his former students had taken a post. Outside employment is standard for high-level researchers, who often contract with private sector firms or universities overseas for part of the academic year. A three-year contract emailed to Dr. Lieber in 2012, and displayed to the jury by prosecutors, identified him as a “One Thousand Talent High Level Foreign Expert,” entitling him to $50,000 a month, plus about $150,000 in living expenses and more than $1.5 million for a laboratory, which they called the WUT-Harvard Joint Nano Key Laboratory.In 2018, as the China Initiative got underway, investigators from the Department of Defense and the National Institutes of Health approached Dr. Lieber to ask if he had taken part in the Thousand Talents programs. Over the week-long trial, jurors heard from a series of witnesses who said that in both instances, Dr. Lieber had denied participating. They also watched video clips from an F.B.I. interrogation, conducted on Jan. 28, 2020, the morning Dr. Lieber was arrested at 6:30 a.m. at his office at Harvard. After initially asking for a lawyer, Dr. Lieber went on to answer the agents’ questions for about three hours, acknowledging at several points that he had misled investigators.At first, he denied receiving income from the Wuhan university or participating in the Chinese recruitment program. Then the agents produced a series of documents, including contracts from 2011 and 2012, and Dr. Lieber examined them, remarking at one point, “I should pay more attention to what I’m signing.”“That’s pretty damning,” he said. “Now that you bring it up, yes, I do remember.”He went on to offer detail about his financial arrangements with the Wuhan university: A portion of his salary was deposited in a Chinese bank account and the remainder — an amount he estimated as between $50,000 and $100,000 — was paid in $100 bills, which he carried home in his luggage.“They would give me a package, a brown thing with some Chinese characters on it, I would throw it in my bag,” he said. After returning home, he said, “I didn’t declare it, and that’s illegal.”He acknowledged, as well, that he “wasn’t completely transparent by any stretch of the imagination” when approached by investigators from the Department of Defense in 2018, and that he was aware he might face charges.“I was scared of being arrested, like I am now,” he added.As the jury prepared to deliberate, Jason Casey, an assistant U.S. attorney, reminded jurors of Dr. Lieber’s demeanor in the F.B.I. interview and urged them to “use your common sense.” “It’s not that the defendant has no memory of events prior to 2015,” he said. “It’s that he does not want to remember. He does not want to remember that he participated in the Thousand Talents program. He does not want to remember that he took bags of cash on an airplane and never reported them to the I.R.S.”‘Scaring the scientific community’Dr. Lieber in 2002. He studies nanotechnologies and has pursued commercial nanotechnology projects outside of his work at Harvard. He was considered a contender for a Nobel Prize in chemistry.Volker Steger/Science SourceDr. Lieber’s arrest was one of the first signals that federal authorities were investigating scientists who had received funding from Chinese sources, and it sent shock waves through academic circles. It was followed, in January of 2021, by the arrest of Gang Chen, a professor of mechanical engineering at the Massachusetts Institute of Technology, on suspicion of hiding affiliations with Chinese government institutions in order to secure $19 million in U.S. federal grants.Brian Timko, who worked under Dr. Lieber as a graduate student and now heads his own laboratory at Tufts University, said he believed China Initiative had strayed from its original focus on espionage toward disclosure violations that, a few years ago, “would have been handled at the university level.” “I think these cases are about scaring the scientific community,” he said. Dr. Timko, who attended stretches of the week-long trial, said he was troubled by the way Dr. Lieber’s work had been “twisted” by prosecutors. He said Dr. Lieber had invented electronic chips so small and flexible that they could be injected into parts of the human body, like the brain or the retina. Eventually, he said, the technology could lead to breakthroughs in bioelectronic medicine, like restoring sight to blind people or movement to paralyzed limbs.“Charlie spent his whole career trying to help the world, and a handful of individuals who don’t even understand how science works tore the whole thing down,” he said. “And that is just not fair.”This year, the Justice Department has dropped cases against five researchers accused of hiding ties to the Chinese military, and one case, which reached the trial stage, ended in acquittal.Stefani Reynolds for The New York TimesWitnesses over the last week painted Dr. Lieber as a demanding, sometimes impatient academic star, who struggled to manage his relationship with his partners in Wuhan, and complained that Harvard was not acting vigorously to defend him. “I definitely do not have a good taste” about “many ‘friends’ in China,” Dr. Lieber wrote in an email to a Chinese colleague at another institution. “These people want to use me, so we will not let that happen, versus me using them. But we’ll be ever so polite in the mean time.”He expressed alarm, in 2018, when investigators Department of Defense and the National Institutes of Health began asking about his participation in the Thousand Talents plan. “They are threatening not only to end my funding (which supports much of my research) but also force me to pay back the last three plus years they supported much of my work,” he wrote to a Chinese colleague, adding, “perhaps someone (Chinese) who does not like me brought this to attention of N.I.H.?”In his conversation with the F.B.I. agents on the day of his arrest, Dr. Lieber was reflective about the role of international funding in the lives of researchers, saying that relationships with foreign partners were never as straightforward as they seemed at first.“Early on, if someone said, ‘We’ll give you this title and we’ll pay your travel to and from,’ you don’t think anything about it,” he explained, “but partners “always want something from you.”“A lot of countries, money is what they have in excess,” he said. He added, “that’s one of the things China uses to seduce people.”He tried to impress on the two special agents that a different motive, the desire for acclaim, had brought him to partner with Wuhan and train scientists there. “I was younger and stupid,” he said. “I want to be recognized for what I’ve done. Everyone wants to be recognized.” He offered a comparison he had given his son, a high school wrestler. The Nobel Prize is “kind of like an Olympic gold medal — it’s very, very rare,” he said.A prize he had won recently was more like a bronze medal, he said with a self-deprecating laugh. “That probably is the underlying reason I did this,” he said.

The trial of Charles Lieber offers a peek inside the world of big-money, big-prestige science as the U.S. cracked down on Chinese funding.BOSTON — Charles Lieber, one of the country’s top research chemists, sat at the Harvard Police Department, trying to explain to two F.B.I. agents why he had agreed to partner with a lesser-known Chinese university in a relationship that had soured and landed him in trouble with the U.S. government.The university had money to spend — “that’s one of the things China uses to try to seduce people,” Dr. Lieber said in the interrogation, clips of which were shown in court. He described returning from several visits to China carrying tens of thousands of dollars in cash, wrapped in “a package, a brown thing with some Chinese characters on it.”But money wasn’t why he had become involved, he said. By training young scientists in the use of technology he had pioneered, he hoped to burnish his credentials with the committee that decides the ultimate scientific honor.“This is embarrassing,” he said. “Every scientist wants to win a Nobel Prize.”The trial of Dr. Lieber, which is expected to conclude this week, has offered a glimpse inside the big-money, big-prestige world of elite science as the U.S. government began the China Initiative, an effort to root out scientists suspected of sharing sensitive information with China.Like many of the government’s cases against researchers, the one against Dr. Lieber does not bring charges of espionage or intellectual property theft but something narrower: a failure to disclose Chinese funding that could be viewed as a conflict of interest by the U.S. government, which also funds their research.Dr. Lieber is accused of lying to the government on two occasions about whether he participated in China’s Thousand Talents Plan, an effort to attract foreign-educated scientists to China; of failing to declare income earned in China on his tax returns; and of failing to declare a Chinese bank account. Though participating in the Chinese recruitment program is not a crime, making false statements to government agencies about it is.The trial comes as the China Initiative, which began under the Trump administration in 2018, has experienced a series of setbacks. In July, the Justice Department dropped cases against five researchers accused of hiding ties to the Chinese military, and in September, the one against a researcher, Anming Hu, the first prosecution to reach the trial stage, ended in an acquittal.The verdict in Dr. Lieber’s case is being watched in scientific circles as an indicator of whether the Justice Department will proceed with the prosecutions of other researchers.The department of chemistry and chemical biology at Harvard, where Dr. Lieber was chair. He is on leave from the university.Katherine Taylor/ReutersDr. Lieber’s lawyer, Marc Mukasey, argued in court that the government could not prove the false statements charges because the two interviews in question, in 2018 and 2019, were neither taped nor precisely transcribed.“That day almost two years ago when the F.B.I. raided Charlie’s home and office, they turned off one of the leading lights in the world of science,” he said in an opening statement, referring to Dr. Lieber’s 2020 arrest.A guilty verdict requires “proof beyond a reasonable doubt, and the government simply doesn’t have it,” he added. “If there was a Nobel Prize for inventing something out of nothing, the government’s case would win.”Conviction on a false statement charge could bring a sentence of up to five years in prison.Among the researchers under federal prosecution as part of the China Initiative, Dr. Lieber is by far the most prominent. Celebrated in the world of chemistry, he served as chair of Harvard’s department of chemistry and chemical biology and was seen by many in the field as a potential Nobel winner.Every morning, a handful of Dr. Lieber’s colleagues have filed into the gallery in Boston’s federal courthouse to listen to testimony.Adam Cohen, a professor of chemistry, chemical biology and physics, who attended last week, called him “one of the best and most impactful chemists alive.”Brian Timko, who worked under Dr. Lieber as a graduate student and now heads his own laboratory at Tufts University, said Dr. Leiber had invented electronic chips so small and flexible that they could be injected into parts of the human body, like the brain or the retina.Eventually, he said, the technology could lead to breakthroughs in bioelectronic medicine, like restoring sight to blind people or movement to paralyzed limbs.“I was especially devastated this week just by the way all of Charlie’s accomplishments, his altruistic accomplishments, were twisted,” Dr. Timko said. “Charlie spent his whole career trying to help the world, and a handful of individuals who don’t even understand how science works tore the whole thing down. And that is just not fair.”Mr. Mukasey, Dr. Lieber’s lawyer, tried during the trial to shift the focus toward the importance of Dr. Lieber’s work, asking one government witness to read aloud the paragraph of his curriculum vitae that lists 23 prizes he has won, among them the Welch Award in Chemistry, the John Gamble Kirkwood Award and the Von Hippel Award.‘These people want to use me’Dr. Lieber in 2002. He studies nanotechnologies and has pursued commercial nanotechnology projects outside of his work at Harvard. He was considered a contender for a Nobel Prize in chemistry.Volker Steger/Science SourceIt is standard for high-level academic researchers to enter into contracts with outside employers, either consulting with private-sector firms or maintaining affiliations at universities in other countries.In 2011, Dr. Lieber started a joint venture with Wuhan University, where one of his former students had taken a post.A three-year contract emailed to Dr. Lieber in 2012, and displayed to the jury by prosecutors, made him a “One Thousand Talent High Level Foreign Expert,” entitling him to $50,000 a month, plus about $150,000 in living expenses and more than $1.5 million for a laboratory, which they called the WUT-Harvard Joint Nano Key Laboratory.Mr. Mukasey has argued that the document proves nothing about payments or Dr. Lieber’s status, comparing it to a congratulatory letter from Publishers Clearing House.Dr. Lieber, who has been on paid administrative leave from Harvard since his arrest in 2020, told the F.B.I. that he received a smaller amount, with between $50,000 and $100,000 paid in cash and another portion deposited into a bank account in China, which at one time contained about $200,000, but which he said he had never touched.Emails read at trial trace the deterioration of Dr. Lieber’s relationship with his colleagues in Wuhan. In one email, Dr. Lieber complained to a colleague that his partners there were pressuring him to credit their grants in his published work.He was also upset when Wuhan University nominated him as a member the Chinese Academy of Sciences, but he was not elected, an outcome he described in an email as “an insult to me and all that I’ve done for Chinese scientists.” (He was elected later, in 2015.)“I definitely do not have a good taste” about “many ‘friends’ in China,” Dr. Lieber wrote in an email to a Chinese colleague at another institution. “These people want to use me, so we will not let that happen, versus me using them. But we’ll be ever so polite in the mean time.”To make things worse, Harvard administrators had discovered that the Wuhan institution was using the Harvard’s name on its nanotechnology laboratory without permission.By 2018, the Wuhan arrangement had become a serious problem for Dr. Lieber. Investigators from the Department of Defense and the National Institutes of Health approached Dr. Lieber to ask if he had participated in the Thousand Talents program.“They are threatening not only to end my funding (which supports much of my research) but also force me to pay back the last three plus years they supported much of my work,” he wrote to a Chinese colleague, adding, “perhaps someone (Chinese) who does not like me brought this to attention of N.I.H.?”Since 2008, Dr. Lieber’s lab had received research grants totaling $18 million from the Department of Defense and the National Institutes of Health, court documents show.This year, the Justice Department has dropped cases against five researchers accused of hiding ties to the Chinese military, and one case, which reached the trial stage, ended in acquittal.Stefani Reynolds for The New York TimesDr. Lieber had said little to investigators until 6:30 a.m. on Jan. 28, 2020, when two F.B.I. agents arrested and handcuffed him at his office in Cambridge.After initially asking for a lawyer, he went on to answer the agents’ questions for about three hours.At first, according to a video clip shown in court, he suggested the charges may have been based on a mix-up, because he had written a paper with a former student who “had Thousand Talents funding, which is a big no-no.”He also told them he had never received payment from Wuhan University aside from travel expenses and had not qualified for the Thousand Talents grant because it required spending extended time in China.Then the agents produced a series of documents, including contracts from 2011 and 2012, and Dr. Lieber examined them, remarking at one point, “I should pay more attention to what I’m signing.”“That’s pretty damning,” he said. “Now that you bring it up, yes, I do remember.”He went on to offer detail about his financial arrangements with Wuhan University: A portion of his salary was deposited in a Chinese bank account and the remainder was paid in $100 bills, which he carried home in his luggage.He said his involvement with the university had ended by 2016 but acknowledged he had not been forthcoming when approached by the Defense Department two years later.“I was scared of being arrested, like I am now,” he said.At moments in the interview, Dr. Lieber was reflective about the role of international funding in the lives of researchers, saying that relationships with foreign partners were never as straightforward as they seemed at first.“Early on, if someone said, ‘We’ll give you this title and we’ll pay your travel to and from,’ you don’t think anything about it,” he explained, “but partners “always want something from you.”“A lot of countries, money is what they have in excess,” he said.He tried to impress on the two special agents that a different motive, the desire for acclaim, had brought him to partner with Wuhan and train scientists there. “I was younger and stupid,” he said. “I want to be recognized for what I’ve done. Everyone wants to be recognized.” He offered a comparison he had given his son, a high school wrestler. The Nobel Prize is “kind of like an Olympic gold medal — it’s very, very rare,” he said.A prize he had won recently was more like a bronze medal, he said with a self-deprecating laugh. “That probably is the underlying reason I did this,” he said.