The gun safety legislation, the result of tense bipartisan negotiations in the Senate last month, was announced as the first federal law in 30 years to combat rising gun violence. But what often flies under the radar is the new law’s emphasis on improving mental health services.
News coverage has largely focused on the law’s provisions to improve background checks for young buyers, encouraging states to implement their own “red flag laws“, and close”the gap guy.” Less attention has been paid to mental health programs, which receive most of the estimated $13 billion.
“It’s kind of a gun safety bill wrapped up in a mental health bill,” he said Geoffrey Swansona professor of psychiatry at Duke University School of Medicine who studies the relationship between gun violence and mental illness.
The combination of these initiatives in legislation initiated by a small group of senators after the May 24 school shooting in Uvalde, Texas, was the result of Republicans insisting that any gun reform must also address mental health, even as Democrats rejected the connection between the two issues.
“We don’t think you can solve America’s gun violence epidemic through the lens of mental health. But if we have an agreement between Democrats and Republicans to spend billions of dollars on mental health care, especially for vulnerable populations, let’s take advantage of that opportunity,” said Sen. Chris Murphy (D-Conn.), a key negotiator. creating the basis of the bill at a press conference on June 13.
While mental health advocates are happy that Congress is providing new funding for their cause, they also expressed concern that the idea that people with mental disorders are largely responsible for gun violence will continue to be perpetuated, even though studies show that this is not the case. Only 3% to 5% of violent acts are committed by individuals with serious mental illnesses such as schizophrenia, bipolar disorder, or major depression. People living with mental illness are more likely to be victims of violence than the general population.
“We have very mixed emotions when we think about bringing them together,” he said. Hanna Vesalovsky, chief advocacy officer at the National Alliance on Mental Illness. “We need investment in mental health, but we know that mental health is not the direct cause of human violence.”
The main question about this increased level of investment is whether it will affect the country’s fight against gun violence. Here’s an overview of the key aspects of mental health in the new law.
What is in the legislation
Congressional Budget Office estimated the total cost of the new law $13 billion, much of which will be used to increase funding to expand existing school mental health and safety services programs, including $1 billion over five years for two programs to increase the number of mental health counselors in schools.
Other allocations include:
- $80 million over four years for a child mental health care access program, which allows pediatricians to provide mental health services through telehealth. An additional $60 million over four years is dedicated to training primary care clinicians to provide mental health services to young people.
- $250 million over four years to expand community mental health services block grants states to help fill gaps in the state’s mental health system, such as creating programs to care for adults and children with serious mental illness or emotional disturbances.
- To this will be added $240 million over four years Project AWAREwhich provides grants to mental and behavioral health organizations, community groups and schools to increase student awareness and connect them to mental health services in schools.
- $150 million this year for a new one National Suicide Prevention Lifeline 988which starts in mid-July.
The new law also provides up to $8.6 billion in funding over 10 years to support the creation of certified community behavioral health clinics in every US state. These types of clinics, which already exist in 10 states as part of a Medicaid pilot program, are required to visit people regardless of their insurance coverage and treat them for mental health or substance use problems. States will need to apply for the program, which will begin in 2024.
For now annual reports submitted to Congress about the pilot program show that behavioral health outcomes vary by state, other data show that clinics saved money and scored well on measures such as getting patients to stick to antidepressants or participate in alcohol addiction treatment. However, a 2021 State Accountability Office The report found that data on these clinics was incomplete, making it difficult to assess their effectiveness in improving behavioral health.
How useful are these mental health programs and when will they start?
It’s hard to say how effective new spending on mental health will be Marissa Dominoeconomist and director of the Center for Health Information and Research at Arizona State University, because not all programs that receive supplemental funding have been evaluated for effectiveness or can be evaluated.
“There are a lot of small opportunities in this bill, but overall it’s hard to say whether it will be good for improving mental health,” Domino said.
Some of the funding will begin this year and continue for four to five years. Other spending streams may not begin until 2024. This is typical as government funding must be planned years in advance. But that raises questions about how quickly mental health programs can be scaled up.
Still, advocates and researchers have stressed that more money directed toward mental health is likely to be beneficial because programs in the U.S. are severely underfunded.
Will it stop gun violence?
It depends on how you define gun violence, Swanson said.
More than half of the deaths are from firearms suicides are on the rise in the US, and perhaps this law will help reduce the number of such deaths.
The new law also provides funding for states that can be used to enforce red flag laws that have been shown to reduce suicide rates. Such laws, now in place in 19 states and the District of Columbia, allow family members, police or doctors to petition a court to temporarily confiscate guns for up to a year from people they fear may be at risk of harm yourself or others.
For example, Swanson led a research project analyzing how red flag politics worked in Connecticut, where his team estimated that for every 10-20 guns removed, one suicide was prevented.
But experts acknowledge that spending on mental health may not do much to stem the gun violence seen in mass shootings such as the one in Uwald, a supermarket in Buffalo, N.Y., in May and during a Fourth of July parade in Highland Park, Illinois.
“The vast majority of people with mental illness are not violent,” Swanson said.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Along with policy analysis and surveying, KHN is one of the three main operating programs in the KFF (Kaiser Family Foundation). KFF is a non-profit organization that provides health information to the nation.