Republicans have found religion on mental health. Or so it would seem, given their reactions to President Obama’s proposals to curb gun violence. Since December’s tragedy at Sandy Hook Elementary School, GOP lawmakers have routinely said they want to focus on the mental illnesses that cause violent behavior. They also are avoiding talking about new restrictions on gun ownership.
Cynics in the gun debate say Republicans are using the mental-health issue to deflect attention from gun control, a topic on which the slightest wavering can cost them reelection. Mental-health advocates say, bring it on. Republicans aren’t the only ones who have ignored the issue for 30 years. The federal law governing mental-health allocations to states hasn’t been reauthorized since 2000. Over the past three years, budget cuts have cost state mental-health systems $4.3 billion, according to the research institute connected with the National Association of State Mental Health Program Directors.
Sandy Hook offers an opportunity to address the mental-health components of violence. If the conversation is a sideshow to gun control, so be it.
Republicans zeroed in on mental health in response to Obama’s gun-violence plans, which call for better screening and treatment for potentially violent young people but which also include an assault-weapons ban and robust background checks for gun purchasers. Rep. Virginia Foxx, R-N.C., said, “New laws will do us no good if they burden responsible gun owners and small businesses but fail to stop sick people before they turn to evil.”
Rep. Larry Bucshon, R-Ind., insisted, “More emphasis should be placed on addressing mental-health issues.” And Rep. Tim Murphy, R-Pa., said he “wanted more” from the president on mental illness. He promised to be “relentless” in pursuing the causes and treatments for conditions that lead to violent behavior.
So what’s their plan? Some GOP ideas are scattershot. Rep. Trey Gowdy, R-S.C., says the definition of “adjudicated mental defective,” which legally bars a person from owning a gun, needs to be expanded. Former House Speaker Newt Gingrich thinks health privacy laws should be rolled back so that society can identify and monitor “dangerous people.”
The best ideas from Republicans involve information-gathering. They want to find out where the government resources on mental health are going and how to spur more research into the causes of violent behavior. “I don’t think we have a correct diagnosis of the challenges that are out there for individuals with mental illness who can potentially become a harm for a society,” said Rep. Tom Price, R-Ga., a physician.
Murphy, a psychologist, wants to begin the inquiries in the House Energy and Commerce Committee, where he chairs an oversight panel. “Our committee has jurisdiction over the key federal departments and agencies that play a role in mental-health research and care,” he said in an e-mail. “We have already commenced what will be a thorough overview of these programs to determine the current state of mental-health research and what role mental illness plays in outbreaks of violence.”
The GOP investigations on Capitol Hill are in line with the prescription from the conservative Heritage Foundation, which has urged a “careful diagnosis of the full scope of the problem” of violence and gun usage. John Malcolm, a senor legal fellow at Heritage, recommends lifting federal restrictions on state mental-health services, particularly when it comes to involuntary commitment to institutions. He cites a 2011 study finding from the University of California (Berkeley) that broader commitment criteria “appear to allow more rapid, timely, and targeted intervention.”
Of course, Democrats and mental-health advocates are pushing an opposite strategy. They want legislation to allow more federal involvement in community mental-health centers, creating nationwide standards for access and treatment. “It shouldn’t be an accident of where you’re born, because of what your state or county has decided to fund,” said Charles Ingoglia, senior vice president at the National Council for Community and Behavioral Healthcare.
Disagreements about the federal and state roles in mental-health treatment are unavoidably caught up in a fundamental dispute about the size of government. The debate even evokes two political icons of opposing philosophies: It was President Reagan’s massive government-slashing tax cut that handed most responsibility for mental-health services back to the states in 1981, undoing a federal program that was part of President Kennedy’s New Frontier in 1963.
But this underlying conflict may not derail all progress. One proposal that has bipartisan potential is Obama’s recommendation to offer training to non-physician teachers and counselors to identify mental-health problems in young people and to learn how to de-escalate crisis situations if necessary. An effective training program already exists, but it needs federal funding to be offered in schools.
Mental-health advocates view the attention from Republicans as a hugely positive development, in part because it expands the conversation in Washington beyond just a few diehard champions. “There have been some very strong voices in the U.S. Congress, historically,” Ingoglia said. “Most of that is fueled by personal connections. It’s a short list, but these are fairly passionate people. Like many illnesses, you pay attention to it because you have some experience that propels you.”
Republican advocates on mental health have included former Sen. Pete Domenici of New Mexico, whose daughter was diagnosed with schizophrenia, and recovering alcoholic Jim Ramstad, who was a representative from Minnesota. On the Democratic side, the late Sen. Edward Kennedy of Massachusetts and his son, former Rep. Patrick Kennedy of Rhode Island, advocated for mental-health funding, in part because Patrick has a bipolar disorder.
Unfortunately for the mental-health community, all of these voices are long gone from Capitol Hill. Perhaps now there is a chance to fill the void.
This article appears in the Jan. 26, 2013, edition of National Journal as A Worthy Diversion.