Shootings may spur mental illness funding

Both sides in the gun control debate focus on the need to help the mentally ill.

January 25, 2013 

There’s not much President Obama and the National Rifle Association agree on when it comes to a response to mass shootings, but there is a vague consensus about the need to pay more attention to mental health.

It’s a consensus fraught with problems. NRA CEO Wayne LaPierre has dealt in the basest stereotypes by talking about the need to identify the tiny fraction of people who are “deranged” and “monsters.” Obama is focused on expanding access to mental health care for all who need it, a goal his health care law will serve.

Obama has said, "We are going to need to work on making access to mental health care as easy as access to a gun.”

It would be a good thing if both ends of the political spectrum could meet on an issue too often overlooked. It’s far from a broad agreement, but there is a shared sense that more should be done to help people in acute mental distress.

Shrinking funding

Liberals have always advocated better mental health care, but much of their energy has gone into moving the mentally ill out of hospitals and into the community. That approach benefits almost all people with mental illness, but it has undercut support for hospital beds for those few who need to be removed from the community for temporary and sometimes long-term treatment.

Conservatives have tended to see spending on the mentally ill as part of an overextended network of social services. When the struggling economy tightened state budgets, mental health wasn’t spared. About 30 states have reduced mental health spending since 2008, according to the National Alliance on Mental Illness. In a third of those states, the cuts surpassed 10 percent.

In FY 2011-2012, North Carolina’s mental health budget had the fourth-biggest drop in the nation, falling 7.3 percent from $656 million to $608 million. Meanwhile, the supply of psychiatric beds has continued to drop precipitously in North Carolina and around the nation as funding shrinks and mental hospitals close.

Rethinking cuts

But the Associated Press reported this week that mass shootings have even the most cost-conscious states wondering whether they should spend more on mental health, or at least stop cutting. Pennsylvania and Utah are backing away from plans to reduce their mental health programs. Kansas, which cut its mental health spending 12 percent from 2008 to 2011, now plans to spend $10 million on a program to identify mental health dangers.

Kansas Gov. Sam Brownback, a Republican who has seen plenty of room for cuts in social programs, said programs directed at serious mental illness need more money. He told The AP: “I don’t think we’re well set as a state at all to be able to deal with these intensive cases.”

The AP quoted Jon Thompson, spokesman for the Republican Governors Association, as saying many budget-cutting governors are having second thoughts, including whether to reform mental health policies “to further invest in the safety of their citizens.”

Brian Stettin, policy director for the Treatment Advocacy Center, a national proponent of more care for the mentally ill, said it’s encouraging “that the states seem to be waking up to the need to fund mental health services.” But he said the response will miss the most urgent needs if stepped-up funding goes into community-based programs rather than into restoring in-patient psychiatric beds.

In that case, he said, it won’t help “the many folks who refuse treatment because they can’t see that they are ill.”

States are now seeing that mental illness is not cured by being ignored. And when it’s neglected, it can endanger others. On the right and left, there are calls to do more. Now is the time to do it.

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