Last month, a bipartisan group of senators introduced a bill designed to improve mental health care in the United States in light of the recent mass shootings at Sandy Hook Elementary School and elsewhere. The Mental Health First Aid Act of 2013, which was praised by mental health advocates, was co-sponsored by Sens. Roy Blunt (R-Mo.), Kelly Ayotte (R-N.H.), Marco Rubio (R-Fla.) and six Democrats.
“As a nation, we must learn how to best care for the mentally ill in the hope that we may help to prevent tragedies like Sandy Hook,” Blunt said in a press release introducing the bill. “I am committed to working with my colleagues to ensure that we do everything we can to prevent senseless acts of violence and protect our children in our schools, and setting up these mental health first aid training programs across the country is a good step in the right direction.”
But Blunt, Ayotte and Rubio haven’t always been the strongest champions of mental health care. In fact, they have voted or spoken out against key pieces of legislation designed to help those with mental illnesses, along with over a dozen of their Republican colleagues.
In 2008, Congress passed the Mental Health Parity and Addiction Equity Act. The bill, passed under the Troubled Asset Relief Program and signed by President George W. Bush, requires health insurance companies to cover mental health services at parity to physical health services.
In the years since its passage, the law has reduced certain copays and deductibles, but it has had a limited impact because the White House has not yet issued a final ruling on what exactly parity means. The Obama administration is expected to announce a final decision in the coming months. Once final regulations are issued, the law is expected to increase accessibility to mental health care by providing more services at a lower cost to people who need them.
Mental health care advocates have praised the law as a landmark victory for those suffering from mental illness. “It was really fortuitous thing that the parity law was passed,” said Ron Honberg, the national director for Policy and Legal Affairs at the National Alliance on Mental Illness.
Blunt -- who also announced last week that he is co-sponsoring another bill to improve the mental health care system, the Excellence in Mental Health Act -- voted against the parity law in 2008, when he was a member of the House of Representatives.
At a press conference announcing the Excellence in Mental Health Act, which would increase federal funding for community mental health centers, Blunt said, "I’m a supporter of parity (for mental health care) in insurance coverage, but it doesn’t help if you don’t have insurance. You need somewhere to go."
He did not respond to HuffPost's repeated requests for comment about his 2008 vote.
Blunt was not the only Republican member of the House who voted against the parity law and is now touting improvements to mental health care as a solution to gun violence.
Rep. Jeff Miller (R-Fla.) criticized President Barack Obama's suggested gun reforms, saying the focus should be on mental illness instead.
“Calls to reinstate the assault weapons ban and limiting the capacity of magazine does nothing to reduce the problem of gun-related crimes in this country,” Miller said last month. “I would have liked the president to focus more on the issue of mental health and enforcing the gun laws that are already on the books.
ThinkProgress notes that more than a half-dozen other members of the House who voted against the parity law are now calling for mental health care reforms.
Rep. Mac Thornberry (R-Texas) expressed opposition to proposed gun control laws and said “a more responsible approach is to take significant steps to address mental illness,” while Rep. Tom Price (R-Ga.) said that “we should make a robust analysis of America’s mental health system a priority” instead of gun safety.
The Affordable Care Act, Obama's signature health care law, is another piece of legislation that would benefit those with mental illness and has been met with fierce opposition. Many lawmakers who voted against the law in 2009 or are now calling for its repeal have, in recent weeks, spoken out in favor of improved mental health services.
In response to Obama’s new gun control push, Sen. Jim Inhofe (R-Okla.) said resources would be better spent tackling mental health. Sen. Chuck Grassley (R-Iowa) said during a recent Senate hearing on gun control that "any serious discussion of the causes of gun violence must include a complete reexamination of mental health as it relates to mass shootings." And Rep. Lamar Smith (R-Texas) said, "rather than curbing constitutional rights, the President should focus on the underlying causes of these acts, including addressing mental illness and violence in the media."
Ayotte, who is leading the bipartisan effort to improve mental health care, was elected to the Senate after health care reform was passed. However, she has since spoken out against the law and even called for its repeal.
Rubio was also elected after the Affordable Care Act’s passage, but remains a staunch opponent. As a recently as Feb. 1, he called it “one of the most economically destructive laws in American history” and vowed to fight to repeal it.
Advocates say the health care law is immensely beneficial to those with mental illness. Honberg explained that one of the biggest challenges facing such patients is accessibility to care. Since many people with severe mental health issues can’t work or are otherwise uninsured, the Medicaid expansion included in the Affordable Care Act -- coupled with the parity law -- really helps them.
“People with mental illness stand to be the largest beneficiaries of all,” Honberg said.
Of course, politicians oppose the Affordable Care Act for a host of reasons that are unrelated to mental health care. Grassley called the individual mandate "unconstitutional" and Inhofe has spoken out against financial burdens associated with the law.
Republicans are also not the only ones who now tout mental health care reform despite having voted against laws designed to benefit the mentally ill. Rep. Jim Matheson (D-Utah) voted against the Affordable Care Act, but said last month that mental health care issues should be addressed before creating new gun control laws. Sens. Maria Cantwell (D-Wash.), Tim Johnson (D-S.D.) and Jon Tester (D-Mont.), meanwhile, have all stressed the importance of focusing on mental health but voted against the parity law as part of TARP in 2008. Those three senators did co-sponsor the original 2007 Senate legislation on mental health parity.
The contradiction extends beyond national politics. Wisconsin Gov. Scott Walker (R) this week proposed nearly $29 million in state funding on mental health initiatives to combat gun violence.
"Just gun control alone may or may not address [violence]. If you've got someone with a severe mental illness that's causing them to take irrational actions like this, banning a certain type of firearms may just move them to some other weapon, some other explosive," he told CBS58 in December. "It really begs the question: what are we doing to address mental illness?"
But Wisconsin, under Walker, has slashed funding for mental health services in recent years. Between 2009 and 2011, Wisconsin cut $107.1 million in mental health funding. Walker did not respond to HuffPost's request for comment.
Like most of the lawmakers mentioned, Walker has received a high rating from the National Rifle Association.
The organization's executive vice president, Wayne LaPierre, has repeatedly blamed gun violence on the nation's failing mental system.
"I think we can also agree that our mental health system is broken," LaPierre said at the Senate gun violence hearing. "We need to look at the full range of mental health issues from early detection to treatment to civil commitment laws to privacy laws that needlessly prevent mental health records from being included in the national instant check system."
But advocates say the NRA has erroneously linked mental health issues and gun violence, arguing that comments like LaPierre's unfairly stigmatize the mentally ill.
“Wayne LaPierre will do or say anything to deflect attention from all the barriers that the NRA has erected to any sort of scrutiny of gun laws themselves,” said Honberg of the National Alliance on Mental Illness.
A spokesman for the NRA rejected that notion.
"It would be wrong and inaccurate to say that the NRA is drawing the link between mental illness and violence in our society. That link unfortunately is being perpetuated in the media as a result of numerous horrific incidents that involve people with some mental health problems," spokesman Andrew Arulanandam said. "For anyone to say that this is an effort to stigmatize people is inaccurate."
Debbie Plotnick, the senior director of state policy for Mental Health America, said that while having a conversation about mental illness is long overdue, she worries that having it in the context of gun violence and mass shootings might be harmful.
“Mental health care is getting a lot of attention, but it's getting the wrong kind of attention,” she said. Pro-gun groups “do seem to be building upon this misbelief” that people who are mentally ill are dangerous.
Statistically speaking, Plotnick said, most people with mental health issues are no more dangerous than anyone else.
“People who have mental illnesses are very, very likely to be victims of crime and we know that in terms of violent crime, only about 4 percent of violent crime is committed by people with mental illness,” Plotnick said.
As The New York Times points out, of the 120,000 murders involving firearms committed between 2001 and 2010, few were perpetrated by someone with mental illness. People like Jared Loughner, the man who shot then-Rep. Gabrielle Giffords (D-Ariz.) and killed six others in 2011 and was later diagnosed with paranoid schizophrenia, are outliers.
A 2005 study found that people with serious mental illness are 11 times more likely to be victims of violent crime than the general population. Furthermore, the National Institute of Mental Health found in 2011 that people with mental health issues more often hurt themselves than anyone else.
Plotnick said that linking gun violence to the mentally ill may keep people from speaking out about their health issues.
“We need to understand that the issue of gun violence is about violence and guns,” she said.
CLARIFICATION: This report was updated to clarify that Sens. Maria Cantwell (D-Wash.), Tim Johnson (D-S.D.) and Jon Tester (D-Mont.) voted against the parity legislation in 2008 because it was part of TARP (which they opposed), but initially supported the measure.
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