So now we’re being treated to the charming spectacle of Republicans, or a few of them anyway, purporting to care about mental-health treatment in the wake of the Washington Navy Yard shooting. How touching. This doesn’t mean, of course, that they care about mental health. They’re just coming up with something to say in the wake of the tragedy that sounds to the willfully credulous like action and that won’t offend the National Rifle Association. Meanwhile, they have devastated mental-health funding since you-know-who became president. And more important than that, they voted against, and are now preparing to vote en bloc to defund or delay, the law that will do more to address mental health and give society at least a chance that future Aaron Alexises will get treatment that could prevent them going on shooting sprees since ... well, pretty much since ever.
Alexis bought his weapon in Virginia, a state where anyone this side of Charles Manson can buy virtually any kind of gun he lusts after as long as he’s a resident. Current federal guidelines bar gun sales only to people who have been institutionalized or “adjudicated as a mental defective.” Neither of these narrow criteria applied in Alexis’s case. Not that it would even matter if one had, as The Atlantic noted; the Virginia Tech shooter had been so adjudicated and still was able to purchase his firepower in the commonwealth. (Alexis, being a nonresident, was blocked from purchasing an AR-15).
Alexis was fairly typical of the type of person who stands precious little chance of getting any mental-health treatment in this country. For starters, he was male, young, and black. That’s an unlucky combination of things to be in the United States for millions of people. But hitting that trifecta and being mentally ill on top of it constitutes the holding of a very unfortunate ovarian-lottery ticket. Single mothers, children, and the elderly all qualify for more forms of assistance than men do. Increasingly, there is a place where men like this wind up where they finally might get a little bit of treatment. It’s called jail. Our prisons are full of mentally ill substance abusers who committed crimes.
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There are two things society can do about future Aaron Alexises. One, it can do nothing to improve mental-health approaches and let people fester, but even then it can at least take tougher steps to prevent the mentally ill from buying guns. Two, it can try to be a little more proactive about this whole category of illness, which affects nearly 60 million Americans (yep, one in five). On both counts, there is one party in Washington that’s eager to act, and one that is perfectly happy to let crazy people buy guns and perfectly content that we have more and more mentally ill people walking around with no treatment. Any guesses?
You may think I have phrased the above unfairly, but this is what the GOP position amounts to. On tougher background checks for the mentally ill, there were provisions in the Manchin-Toomey background-check bill, the one that nearly every Senate Republican voted against. This week New Hampshire Republican Sen. Kelly Ayotte is talking up new legislation. You perhaps have read that “even the NRA” supports toughening mental-illness regulations. That’s nice in theory, but in fact, the Senate is not going to do anything on guns and mental illness right, and the reason it’s not going to do anything is that Harry Reid knows he doesn’t have 60 votes to pass anything, especially with huge votes on a possible government shutdown and the debt limit looming. Republican Sen. Tom Coburn, a physician who isn’t hostile to tighter regulation in this case, acknowledged to The New York Times that “it’s all politics”—which in this case means that no one has the stomach or stones to take another gun-related vote.
They did, however, have the stomach and stones to cast votes over the past few years that have sliced away at funding for mental-health services. Decreased federal grants have forced states to make massive cuts to mental-health services. The National Alliance on Mental Illness referred in 2011 to the “crisis” that has resulted from states’ slashing of mental-health programs. It’s of course mainly Republicans in Congress who pushed for those block-grant cuts. The sequester made things worse. While the sequester doesn’t affect Medicaid, which funds most mental-health services, the non-Medicaid mental-health services have taken a serious hit, including 103,000 fewer treatment admissions in 2013.
And the Republicans will have the stomach and stones to vote very soon here to defund the Affordable Care Act, which, says University of Chicago health-care expert Harold Pollack, “is the most important change to mental-health and substance-abuse policy in decades,” for two reasons. First, the expansion of Medicaid to all citizens with incomes up to 138 percent of the poverty line will mean that millions of people will be able to afford mental-health care who simply couldn’t before. And second, the ACA requires that coverage of mental illness and substance abuse be offered by insurers “at parity” to more traditional medical treatments. Up to now, these treatments have been more expensive, less likely to be covered, and so on.
Republicans on the Senate Finance Committee actually supported those particular provisions of the ACA on unanimous voice vote. So by that measure Republicans are “reasonable” on this issue. But final votes on legislation is where the rubber meets the road, and that’s where Republicans have voted and voted and voted—and will clearly continue to vote—to make sure that we have more potential mass murderers walking among us, listening to those voices until they can’t take it anymore and go out and slaughter innocents. It’s a party of nihilism that has no desire to solve any social problem, holding the rest of us hostage to its craziness as the bodies mount.
