Gun safety ‘wrapped in a mental health bill’: An overview of the health provisions of the new law

The gun safety law forged following tense bipartisan discussions in the Senate last month was announced as the first federal legislation in 30 years to address rising gun violence. But what often falls under the radar is the new law’s focus on improving mental health services.

Media coverage has largely focused on the law’s provisions to improve background checks on young buyers, encourage states to implement their own “red flag laws” and close the “small friend “. Less attention has been given to mental health programs for which most of the $13 billion is intended.

“It’s kind of a gun safety bill wrapped up in a mental health bill,” said Jeffrey Swanson, a professor of psychiatry at Duke University School of Medicine who studies the intersection of gun violence and mental illness.

The pairing of these initiatives in legislation led by a small group of senators after the May 24 school shooting in Uvalde, Texas, was the result of Republicans’ insistence that any gun reform effort to fire must also address mental health, even though Democrats have disavowed a link between the two concerns.

“We don’t think you can solve America’s gun violence epidemic through a mental health lens. But if we have a deal between Democrats and Republicans to spend billions more on mental health treatment , especially for vulnerable communities, let’s take advantage of this opportunity,” said Sen. Chris Murphy (D-Conn.), a key negotiator, while laying out the framework for the bill during a press conference on 13 June.

While mental health advocates are pleased that Congress is authorizing new funding for their cause, they have also expressed concern that it continues to perpetuate the idea that people with mental disorders are largely responsible for violence. army, although research shows that is not the case. Only 3% to 5% of acts of violence are committed by people with serious mental illness, such as schizophrenia, bipolar disorder or major depression. People living with mental illness are more likely to be victims of violence than members of the general population.

“It is with very mixed emotions that we think about bringing these together,” said Hannah Wesolowski, advocacy manager at the National Alliance on Mental Illness. “We need investments in mental health, but we know that mental health is not the direct cause of a person’s violence.”

A central question regarding this increased level of investment is whether it can make a difference in the national fight against gun violence. Here is an overview of the main aspects of mental health in the new law.

What is in the legislation?

The Congressional Budget Office has estimated the total cost of the new law at $13 billion, much of which will be used to increase funding to expand existing mental health and school safety service programs, including 1 billion over five years for two programs to increase the number of mental health counselors in schools.

Other attributions include:

  • $80 million over four years for a Pediatric Mental Health Care Access Program, which enables 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 increase Community Mental Health Services Block Grants to states to help fill gaps in a state’s mental health system, such as creating care programs for adults and children with serious mental illnesses or emotional disorders.
  • $240 million over four years would be added to Project AWARE, which provides grants to mental and behavioral health organizations, community groups and schools to educate students and connect them to mental health services in schools.
  • $150 million is being allocated this year for the new 988 National Suicide Prevention Lifeline, which will launch in mid-July.

The new law also provides up to $8.6 billion in funding over 10 years to support the construction of certified community behavioral health clinics in every state in the United States. These types of clinics, which already exist in 10 states as part of a Medicaid pilot program, are required to see people regardless of their insurance coverage and treat them for mental health or addiction issues. States would have to apply to participate in the program, which would begin in 2024.

While annual reports submitted to Congress on the pilot program show that behavioral health outcomes vary by state, other data shows that clinics have saved money and performed well on metrics like as patient adherence to antidepressants or commitment to alcoholic treatment. However, a 2021 Government Accountability Office report found that data on these clinics was incomplete, making it difficult to assess their effectiveness in improving behavioral health.

What is the purpose of these mental health programs and when will they start?

It’s hard to know how effective new spending will be in improving mental health, said Marisa Domino, an economist and director of the Center for Health Information and Research at Arizona State University, because all programs receiving funding supplemental have not been evaluated for efficacy or can be evaluated.

“There are a lot of small opportunities in this bill, but it’s hard to say overall ‘whether it will help improve mental health,’ Domino said.

Some of the funding will start this year and continue for four or five years. Other spending streams may not begin until 2024. This is typical since government funding must be planned years in advance. But it raises questions about how quickly mental health programs can be scaled up.

Still, advocates and researchers have pointed out that more money spent on mental health would likely be beneficial, as programs are severely underfunded in the United States.

Will he stop gun violence?

It depends on how you define gun violence, Swanson said.

More than half of gun deaths in the United States are suicides, and it is possible that this legislation will help reduce those deaths.

The new law also provides funding for states that can be used to implement red flag laws, which have been shown to reduce suicide rates. These types of laws, now in effect in 19 states and the District of Columbia, allow family members, police or doctors to ask a court to temporarily remove firearms for a year from people whose they fear being at risk of hurting themselves or others.

For example, Swanson led a research project analyzing how a red flag policy worked in Connecticut, where his team estimated that for every 10 to 20 firearms removed, one suicide was averted.

But experts acknowledge that spending on mental health may not do as much to stop the gun violence that manifests in mass shootings, such as in Uvalde, at a supermarket in Buffalo, New York, in May, and during a 4th of July Parade in Highland Park, Illinois.

“The vast majority of people with mental illness are not violent,” Swanson said.

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