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October 4, 2013 at 6:29 AM

Why Congress won’t deal with mental health reform

The script is familiar now. A mass shooting happens. Gun control advocates demand gun control now. Gun control opponents deflect and demand mental health reform instead.

The Gabby Giffords shooting in Arizona. The Aurora, Colo., theater shooting. The Newtown massacre. And last month, the Navy Yard shooting.

Aaron Alexis during the Navy Shipyard shooting / CNN

Aaron Alexis during the Navy Shipyard shooting / CNN

You know what comes next. Nothing happens. Rinse, repeat.

<How about a third way? Focus solely on mental health reform. The public supports mental health reform: A recent Gallup Poll found that more Americans fault the mental health system for gun violence than easy access to guns. And this is one issue where there’s bipartisan support in Congress.

It would have to include stiffer background checks for people with serious psychiatric histories, as the National Rifle Association suggests. That’s not mental health reform, but don’t tell the NRA. Mentally ill people don’t shoot people. A tiny number of mentally ill people with UNTREATED mental illness (and a gun) shoot people.

Give the NRA the win, but in the end achieve real mental health reform. It should include Sen. Debbie Stabenow’s (D-Michigan) Excellence in Mental Health Act, which would broaden the community safety net. Include also school-focused prevention, such as the Mental Health First Aid Act, to train first-responders on psychiatric illness. And it should address antiquated restrictions that bar Medicaid funding for community psychiatric hospitals larger than 16 beds (ie, the IMD exclusion, described by the National Alliance for Mental Illness).

The cost of a failing mental health system / THE ECONOMIST

The cost of a failing mental health system / THE ECONOMIST

It would be an expensive package, but a strong case could be made for the vast economic (let alone human) toll of untreated mental illness. NAMI puts it at $100 billion a year in lost productivity. That chart at left represents enormous wasted money.

The biggest roadblock to genuine mental health reform? Sen. Harry Reid. He wouldn’t decouple mental health reform from gun control, noted The New York Times after the Navy Shipyard shooting:

Senator Harry Reid of Nevada, the majority leader and a strong proponent of the failed Senate plan to expand the federal background check system, is resisting any move to advance the mental health provisions, fearing that it would be used as a fig leaf by those who oppose expanded checks while closing the door to weapons restrictions in the future.

Some advocates may argue that’s good political strategy. I see it as a moral failure, trading the known grief of untreated mental illness for theoretical (and wildly unlike, in this Congress) gun control .

So our failing mental health system plugs along, caught in a political game. That’s crazy and its Congressional politics in a nutshell.

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