Q. I have an online content editor who says “mental health official” should be hyphenated: e.g., “he placed three county mental-health officials on administrative leave.” As a mental health professional, I say no. What say you?
A. In general, a compound modifier comprising an adjective plus a noun and preceding the word or words it modifies should be hyphenated:
first-floor record store
“Mental” is an adjective and “health” is a noun. Without the hyphen, the phrase “mental health official” could be misread as, to take one of several possible misreadings, a health official who is pretty mad or upset—as opposed to the intended meaning of an official of mental health. But that’s a rather ridiculous and unlikely, not to mention slang, misreading. There are a few compounds that, in addition to being ubiquitous as open compounds, always seem to go together and are completely unambiguous in any position without the hyphen. Aside from “mental health,” another example might be “physical therapy.” A “physical therapy expert” would tend not to be misread as a skilled psychiatrist who tends toward vigorous bodily movement. In sum, any compound modifier that is not traditionally hyphenated and would not be misread may be left unhyphenated in any position.