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Silver Lining: Would better mental health services help lessen gun violence?

This article first appeared in the St. Louis Beacon, Feb. 7, 2013 - WASHINGTON – While efforts to restrict assault weapons have grabbed the headlines, a quieter campaign is gaining support on Capitol Hill to try to curb gun violence by bolstering mental health services at the community level.

On Thursday, Oscar-nominated David O. Russell – director of “Silver Linings Playbook,” whose main character has bipolar disorder – appeared at a news conference with lawmakers including U.S. Sen. Roy Blunt to back a new effort to strengthen mental health care in medically underserved areas.

The bipartisan Excellence in Mental Health Act, whose main sponsors are U.S. Sen. Debbie Stabenow, D-Mich., and Blunt, R-Mo., aims to boost mental health centers to a more equal footing with other health centers, mainly by improving their quality standards and expanding access to people who need the care.

Would such improvements make much of a difference in the prevalence in gun violence? On one hand, studies indicate that people with a serious mental illness are more likely to be victims of violence than perpetrators.

On the other hand, some individuals suffering from first-break psychosis – unless diagnosed and treated quickly – have been shown to be at risk of committing acts of violence at a rate 15 times higher than fast-treated patients.

“In the wake of tragedies like Sandy Hook,” Blunt said, “we must work together to spend federal dollars more wisely when treating people who are mentally ill.”

Stabenow, noting that “most people living with mental illness are not a danger to themselves or anyone else,” warned that “the cost of inadequate treatment can be dire in some cases.”

Russell, an activist for better mental health care whose young son has suffered from mood disorders, applauded efforts to lessen the stigma of mental illness and “expand care for those living with mental illness who need it. We talk about diabetes, we talk about heart disease, so why can't we talk about mental illness in a regular way?”

The new bill would require the 2,000 “federally qualified community behavioral health centers” to cover a wider range of mental health services, including 24-hour crisis care, and integrate mental health services with other health services. Mental health centers that provide the new services would be enabled to bill Medicaid. The cost would be $1.4 billion over a decade.

“We have a moment that works and a model that works,” said Blunt, who opposes curbs on gun ownership. He said the bill would “help address our fragmented mental health system and ensure that more patients have access to the care they need.”

Blunt’s initiative appears to parallel the emphasis of Missouri Gov. Jay Nixon, who said at an event in Arnold on Wednesday that his $10 million proposal to expand the state’s mental-health services should be a component of any state effort to prevent school-shooting tragedies.

“Clearly we’re trying to get in a prevention mode here,” Nixon told reporters. Linking mental illness among youths to some violence, Nixon said, “prevention, when it comes to mental health, is very, very important.”

The Stabenow/Blunt federal bill would help pay for modernizing many community mental health centers – which now serve over 8 million people, including 2.2 million young people – and the establishment of new behavioral health centers.

Lawmakers said such expanded centers would be able to treat up to 1.5 million more people as a result of this legislation. And, with about a quarter of Iraq and Afghanistan vets reporting mental health issues, such health centers would be expected to serve about 200,000 veterans.

Stabenow said a third of the 4.8 million people suffering from mood disorders do not currently get treatment, and fewer than half of the people with severe mental disorders receive treatment of any kind in a given year. That lack of mental health care means that police often respond to psychiatric emergencies.

One cosponsor of the bill is Sen. Patrick Leahy, D-Vt., who chairs the Senate Judiciary Committee, which is developing gun-control legislation.

“Ensuring that those suffering from mental illness have access to the health care and support they need is important,” he said, in part to “help prevent debilitating mental and behavioral health problems, suicide, and violent acts like we saw at an elementary school in Connecticut.”

House Democrats outline proposals to deter gun violence

The renewed debate over gun violence was sparked by public reaction to the Dec. 21 mass shooting at Sandy Hook Elementary School in Newtown, Connecticut, where 20 first-graders and six adults were killed by a mentally disturbed young man who also took his own life.

Vice President Joe Biden, who led a White House effort to develop proposal to lessen gun violence, told House Democrats this week that “there's an overwhelming consensus about the need to act.”

On Thursday, President Barack Obama told House Democrats at their retreat in Virginia that “we've got to be mindful about steps we can take to end the cycle of gun violence in this country.”

At that Virginia meeting, two California Democrats -- House Minority Leader Nancy Pelosi and U.S. Rep. Mike Thompson, the chairman of the House Democratic Caucus's Gun Violence Prevention Task Force -- announced the group’s ideas, which include proposals to:

• Reinstate and strengthen a prospective federal ban on assault weapons.

• Reinstate a prospective federal ban on high-volume ammunition magazines.

• Require a background check for every gun sale, while respecting reasonable exceptions for cases such as gifts between family members and temporary loans for sporting purposes.

• Strengthen the National Instant Criminal Background Check System (NICS) database.

• Prosecute those prohibited buyers who attempt to purchase firearms and others who violate federal firearm laws.

• Pass legislation to crack down on illegal gun trafficking and straw-purchasing.

• Restore funding for public safety and law enforcement initiatives aimed at reducing gun violence.

• Close the holes in our mental-health system and make sure that care is available for those who need it

• Help communities get unwanted and illegal guns out of the hands of those who don’t want them or shouldn’t have them.

• Support responsible gun ownership.

• Address the “glorification of violence” seen and heard through movie screens, television shows, music and video games.