In the days after a mass shooting roiled the nation, lawmakers seeking solutions often point to the need for mental health reform, even as others call for gun control. Last month, when a gunman who was being treated at a psychiatric hospital took the lives of 18 people in Lewiston, Maine, mental health again took center stage, especially during the 2024 campaign.
Candidates vying for the Republican nomination highlighted the tragedy, arguing that the next president must prioritize America’s mental health crisis.
This time, however, those calls were not exclusive to the issue of mass violence.
For months, presidential candidates have touted the need for mental health reform in response to a host of questions from voters in early primary states, from how to address the ongoing opioid epidemic to the well-being of children in the wake of the Covid-19 pandemic.
We have to treat this like the crisis it is, former South Carolina Gov. Nikki Haley told voters during a CNN rally in June. We must make mental health our number one priority.
Former President Donald Trump and several other hard-right candidates have focused on mental health as part of a plan to combat the rising rate of homelessness in the US, suggesting that institutionalizing some mentally ill patients could solve the crisis.
And Haley and North Dakota Gov. Doug Burgum have outlined multiple approaches to addressing mental health in various areas of American life, including advocating for more trained counselors in schools across the country.’
“Folks, this mental health crisis is something we have to face together as a country,” President Joe Biden said during a speech earlier this year.
Although the methods of addressing the issue differ, the very fact of the conversations and that they transcend the arena of gun violence give some advocates hope that mental health may soon emerge as an area of bipartisan consensus at a time when the federal government is beset by partisan politics.
A spreading crisis
Hannah Wesolowski, chief advocate at the National Alliance on Mental Illness, sees the growing importance of the issue as an inevitable result of record numbers of Americans dealing with conditions like depression and anxiety.
We know now, more than ever, that people need care, Vesolovski said. Conversations about good or bad show that there is an acknowledgment that we have to do something. We cannot sit and wait.
Nearly 30% of US adults have been diagnosed with depression at some point in their lives, according to a recent Gallup survey. That’s roughly 10 percent more than in 2015.
And the rates among adolescents are even more alarming.
Over 20% of children have experienced some form of mental health disorder in 2021, and more than one in five are seriously considering suicide. Between 2009 and 2019, suicidal behavior among high school students increased by 40%, according to the National Institute of Mental Health.
The presidential candidates are addressing the issue, Wesolowski said, because they know that if they don’t address it, we will face a tsunami of mental health consequences in the future.
Coping with the crisis
But it’s a long and winding road from the White House to a troubled household or affected community.
John Broderick, former Chief Justice of the New Hampshire Supreme Court, can put countless faces and names to America’s dire statistics. For the past seven years, Broderick has crisscrossed New England, speaking to packed school gymnasiums to children and teenagers dealing with mental health issues.
Broderick often leaves these speaking engagements with his jacket stained with tears. The children, he said, are happy to have someone to talk to. Almost all of them attribute their stress, anxiety and depression to one thing: overscheduling.
Between organized sports and the increasing pressure to take challenging courses, Broderick believes part of the mental health crisis stems from America’s loss of childhood.
It’s not necessarily something that can be solved at the federal level, he argued.
“The mistake we’re making is going straight to politics,” Broderick told USA TODAY. “‘What laws could we pass? What appropriations could we make? And then we will help solve the problem.’ Don’t get me wrong, some of it is necessary, but at the end of the day, it’s really a community problem.
When it comes to politics, he believes lawmakers often overcomplicate the issue.
“My question is, so what are you doing about it?” What did you do about it? We don’t have enough psychiatrists, psychologists, nurses. We don’t because we don’t pay them. We don’t compensate them. We don’t encourage them,” he said.
“It’s not rocket science.”
Mental health is the number 1 priority for candidates
For Burgum, the North Dakota governor who is in the single digits in the 2024 race, the effects of the mental health crisis have hit home. Burgum’s wife, Kathryn, has struggled with alcohol addiction for nearly three decades and, after finding sobriety 20 years ago, has become a vocal advocate for eliminating the stigma surrounding mental health issues.
With the right leadership, Burgum told USA TODAY, he believes a wave of bipartisan reform could be possible. The key to achieving that, he said, is to treat the problem in the same way as other major health conditions like cancer and chronic diseases.
Haley, who is fighting to become the Republican alternative to former President Donald Trump, similarly described the rising rate of mental illness as a cancer in America that no one was dealing with.
Both she and Burgum said if elected, they would iron out many of the hurdles in the mental health care system that advocates say must be addressed, from a lack of trained therapists and doctors to poor insurance coverage.
Each called for the addition of behavioral health specialists to every K-12 school in America and argued that mental health treatment is critical to reducing addiction in America.
But when it comes to concrete political plans, both candidates remained unclear.
The Bipartisan Vision of Congress
In Congress, where mental health has become a topic of increasing interest, concrete proposals are similarly rare.
Just last month, a group of ten senators formed the chamber’s first bipartisan mental health caucus, aimed at eliminating stigma and strengthening policy work on the issue.
The group, made up of five Democrats and five Republicans, has agreed on one thing so far: the need to share stories to raise awareness, raise the bar, Sen. Alex Padilla, D-Calif., a founding member of the caucus, told USA Today. TODAY.
“Before you even start talking about policy and funding and treatment and research and whatnot, it starts with overcoming the stigma and really normalizing the conversation,” Padilla said.
For him, that meant sharing the story of his mother-in-law’s struggles with manic-depressive disorder and schizoaffective disorder, along with his family’s ordeal leading up to her treatment from dealing with doctors to navigating the complex insurance system.
In terms of crafting policy, however, Padilla acknowledged that the young caucus has so far only agreed on issues that want to address labor shortages and patient cost challenges.
However, he is not worried about finding a consensus. And to anyone cynical about the recent bipartisan record of Congress, Padilla said he’d be happy to point to things like the 988 Suicide and Crisis Lifeline, which gives those in need of emergency mental health services a number to call. The crisis line was passed with help from Congress in 2020 and is far from the only mental health measure lawmakers have passed in recent years.
After 21 children were killed in the horrific shooting at Robb Elementary School in Uvalde, Texas last year, Congress passed sweeping legislation that appropriated $300 million in mental health funding, including $280 million in competitive grants for school mental health staff . Later that year, she allocated additional money to health care programs through the Restoring Hope in Mental Health and Wellness Act passed by 402 votes in the House.
Can some rhetoric jeopardize progress?
Still, as the conversation about mental health gains traction, Wesolowski expressed concern that growing calls to institutionalize the mentally ill by some candidates in the 2024 race could stall progress.
Trump, Florida Gov. Ron DeSantis and entrepreneur Vivek Ramaswamy have proposed re-establishing mental hospitals, many of which closed in the mid-20th century with the advent of psychiatric drugs, as a way to deal with the mental health crisis.
We were deinstitutionalized some 30-40 years ago. You know, I’m not sure that was the right thing to do, DeSantis said during a town hall in August, referring to President Ronald Reagan’s move to shift financial responsibility for mentally ill patients to states and local communities. I see all these homeless people in Los Angeles and San Francisco and some of these other liberal cities, they’re doing drugs or doing all these things, but their mental health is ultimately the root of this.
Ramaswamy, who shares similar views, told USA TODAY that he would consider redirecting federal dollars currently spent on the prison system or other areas of health care toward encouraging the reopening of mental health facilities that focus on faith-based care.
But Wesolowski expressed concern that institutionalization policies could further stigmatize those with mental health problems.
We can’t just focus on locking people up or talking about people as if they were some other population. They are friends, they are neighbors, they are our spouses, our children, she said, arguing that efforts to re-institutionalize people serve as a misinterpretation of what is needed.
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