A look at health provisions in the new law

Posted on July 10, 2022 at 12:00 am

Victoria Night

Kaiser Health News

The gun safety law, created through a tense bipartisan parley in the Senate last month, was foretold as the first federal law in 30 years to counter the rise in gun violence. But often below radar are new laws focused on improving mental health services.

News coverage is primarily focused on legislative provisions that strengthen background checks for young buyers and encourage states to implement their own “danger signal laws” and close “boyfriend loopholes.” Little attention is paid to mental health programs, which are allocated most of the estimated $ 13 billion.

“It’s like a gun safety bill wrapped in a mental health bill,” said Jeffrey Swanson, a professor of psychiatry at Duke University School of Medicine who is studying the crossroads of gun violence and mental illness. increase.

The combination of these initiatives in a law led by a small group of senators after the May 24 mass shootings in Yuvalde, Texas, is a spirit of gun reform efforts, even if Democrats deny the relationship. It was the result of the Republican claim that health should also be dealt with. Between two concerns.

“I don’t think we can solve the epidemic of American gun violence through the mental health prism, but add billions of dollars to mental health treatment, especially for vulnerable communities between the Democrats and the Republicans. If there is an agreement to spend on it, take the opportunity, “said Senator Chris Murphy (D-Conn.), A key negotiator, on the framework of the bill at a press conference on June 13.

Mental health advocates are pleased that Congress is approving new funding for their purposes, but research shows that this is not the case for people with mental health disorders. He also expressed concern about perpetuating the idea that is the main cause of gun violence. Only 3% to 5% of individuals with serious mental illness, such as schizophrenia, bipolar disorder, and major depression, commit violence. People living with mental illness are more likely to be victims of violence than the general public.

Hannah Wesrowski, Chief Advocacy Officer of the National Federation of Mental Illness Families, said: “We need to invest in mental health, but we know that mental health is not the direct cause of human violence.”

The central question about this increased level of investment is whether it can make a difference in the national struggle to fight gun violence. Let’s take a look at the important mental health aspects of the new law.

What is in the law

The Parliamentary Budget Department estimates the total cost of the new law at $ 13 billion, most of which will be used to increase funding to expand existing mental health and school safety service programs. School mental health counselor.

Other assignments are:

• $ 80 million over four years on a pediatric mental health care access program that enables pediatricians to provide mental health services via telemedicine. An additional $ 60 million is devoted to training primary care clinicians to provide mental health services to young people over a four-year period.
• In four years to increase community mental health service block grants to the state to fill the void in the state’s mental health system, including creating care programs for adults and children with serious mental illness and mental illness 250 million dollars.
• $ 240 million will be added to Project AWARE over four years. This project will subsidize mental health and behavioral health organizations, community groups, and schools to raise student awareness and connect with schools’ mental health services.
• $ 150 million for the new 988 National Suicide Prevention Lifeline, launched in mid-July this year.

The new law will also provide up to $ 8.6 billion in funding over a decade to support the construction of accredited community behavioral health clinics in all states of the United States. These types of clinics already exist in 10 states as part of the Pilot Medicaid Program. , Regardless of insurance coverage, you need to meet people and treat mental health and substance use issues. The state must apply for participation in the program, which will begin in 2024.

An annual report submitted to Congress about the pilot program shows that behavioral health outcomes vary from state to state, but other data show clinics save money and give patients antidepressants. It shows that they scored high on measures such as compliance and engagement in the treatment of alcoholism. However, according to a 2021 Government Accountability Office report, the data from these clinics were incomplete and it was difficult to assess their effectiveness in improving behavioral health.

How useful are these mental health programs and when will they start?

Marisa Domino, economist and director of the Center for Health Information Research at Arizona State University, said that not all programs with additional funding are valued, so how much new spending can help improve mental health. He said it was difficult to know the target. Can be validated or evaluated.

“There are many small opportunities for this bill, but it’s hard to say overall,” Domino said.

Part of the funding will start this year and last for 4-5 years. Other spending streams may not start until 2024. This is common because government funding needs to be planned a few years in advance. However, it raises the question of how quickly mental health programs can be strengthened.

Still, supporters and researchers emphasized that more money is likely to be beneficial for mental health because the program is severely underfunded throughout the United States.

Does it 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 this law could help reduce these deaths.

The new law will also fund states that can be used to implement the Hazard Signals Act, which has been shown to reduce suicide rates. These types of laws are currently in books in 19 states and the District of Columbia, where family members, police, or doctors risk injuring themselves or others in court.

For example, Swanson led a research project to analyze how the red flag policy works in Connecticut. His team estimated that for every 10 to 20 guns removed, one suicide would be prevented.

However, experts are spending on mental health to thwart mass shootings such as Yuvalde during the July 4 parade in Buffalo, NY in May and Highland. Admits that may not be very effective. Illinois Park.

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