OK, Let’s Talk About Mental Health

It’s so predictable. And maddening. After each horrific mass shooting, Republicans pandering to the NRA insist that the problem isn’t guns–it’s mental health.

The most obvious response is equally predictable (albeit far more intellectually honest):  these attacks are vanishingly rare in countries where there are similar proportions of  mentally ill citizens but far fewer guns.

Mental health professionals will also point out that the great majority of people diagnosed with a mental health problem are not violent, so pointing to an undifferentiated “mental health” crisis is simply an effort to distract from the role played by virtually unrestricted gun ownership.

I personally agree with a New Republic headline:“The Main Mental Health Issue in This Country Is in the Republican Party.”

That said, I also agree that, overall, America does a very poor job of diagnosing and treating mental illness. So if we were to ignore the immense hypocrisy of the Republicans who only respond to these massacres by advocating an increase in resources devoted to mental health, we might welcome their sudden attention to that scarcity and their apparently heartfelt efforts to address it. (Snark alert: If you believe those efforts are really heartfelt, I have some swampland in Florida to sell you…)

The linked article from the New Republic looked at the existing patchwork of state funding for mental health diagnosis and treatment.

Before you click, just hazard a guess: Of the top 10 states, how many are red? Likewise, how many of the bottom 10 are red? And where do you imagine Texas ranks?

If you don’t feel like floating down that rabbit hole, I’ll save you the trouble. The top 10 states are: Maine, Pennsylvania, Arizona, New York, New Jersey, New Hampshire, Montana, Vermont, California, Maryland. One red state in the bunch (yes, Arizona is borderline, but it went Democratic in 2020). The bottom 10, from forty-first to fiftieth, are: Florida, Wyoming, North Dakota, Delaware, Louisiana, Oklahoma, Kentucky, Idaho, West Virginia, Arkansas. One blue state.

And Texas—where that lying death cultist of a governor vows to attack the scourge of mental illness with a zeal unmatched since Wayne LaPierre took his last trip to Zegna—just misses the bottom 10, in fortieth place. I doubt I even need to point out (although for the record I will) that Greg Abbott and the state’s Republicans have been cutting mental health funding, by more than $200 million over the last two years.

The article noted that there has been one –and only one–major expansion of mental health spending and insurance coverage in recent American history–and it was part of the Affordable Care Act., aka Obamacare. According to a Commonwealth Fund report, the ACA’s impact on the country’s mental health has been salutary, particularly in states that accepted Medicaid funding.

And we all know how the GOP has reacted to that particular expansion of access to healthcare, including mental healthcare.

The GOP then spent years trying to repeal and “replace” it. Trump also wanted it repealed. So the sole major expansion of mental health coverage in this century was contained in a bill whose passage every Republican in Washington opposed and on which most Republican governors have refused to participate in the state-level implementation. Come to think of it, probably the sole reason the red state of Montana ranks in the top 10 on mental health spending is that the state took the Medicaid expansion money under former Democratic Governor Steve Bullock.

Republicans are not going to expand mental health funding. Mental health care is for sissies and liberals. The only thing they’re going to expand is access to guns. We know this because recent history tells us so. Last week in Vox, Zack Beauchamp posted a shocking but not surprising report on academic studies of legislative responses at the state level to mass shootings. The finding? The norm in this country has been that mass shootings have been used by state legislatures and governors as an excuse to loosen gun laws, not tighten them. This is our country.

We have a mental health problem, all right– but it’s primarily among Republican legislators.

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