Mental Health, Physical Safety: Where Guns and Care Collide

Posted on Jan 18, 2013 by Ailee Slater (G+)

When it comes to stopping gun violence, what is the most important thing that lawmakers can do? Should our legislators focus their attention on violence in video games, and media depictions of the horrors of war? Or, is it better to pass laws restricting access to guns; stronger background checks and more bans on weapons? Or, should our nation think defensively, and work to better arm police and private citizens in order to create a law-abiding populace?

In his recent executive order concerning gun violence, President Obama touched on all of these issues - violence in media, the need for better background checks, and increasing security officers and defensive training in some public institutions. Barack Obama also put a major emphasis upon one another means of stopping gun violence - improvements in mental health care. In his executive plan, titled Now is the Time and released January 16th, the President devoted entire subsections to improving mental health services. According to the plan, those services benefitting the psychological care of youth are especially important, seeing as around 75% of people with mental illness will have developed the disease before their 24th birthday.

Therefore, the President is recommending a number of budgeting initiatives to target the mental health care of young people - Obama has advocated the use of $50 million for training more social workers, psychologists and counselors serving children and teens, and advised that the Secretary of the Department of Health and Human Services as well as the Secretary of the Department of Education make efforts to engage in a national dialogue about youth and mental illness. Another of Obama's proposed initiatives is called Project AWARE. Project AWARE (Advancing Wellness and Resilience in Education) would first of all give $15 million to training programs for teachers and other youth educators. The money would go toward instruction about how to respond to signs of mental illness in children and teens, and how to encourage a young person or family members to seek treatment.

The Project AWARE initiative would also appropriate $40 million for programs to build better connections between schools, law enforcement and mental health organizations - the hope being that with stronger links between these facets of the community, young people in need of psychological support will have an easier time getting the help they require. President Obama's plan notes that similar mental health networking schemes have already been proven to reduce violent behavior. Along with Project AWARE, Obama's gun violence reduction plan includes other provisions regarding young people and mental health. Obama is recommending that $25 million be put aside for state-based initiatives helping youths aged 16-25 who are experiencing psychological or substance abuse issues.

If Obama's plan is approved, another $25 million would also be given to schools nationwide with the goal of increasing mental health services for youths in particular who have already witnessed an act of gun violence. The plan notes that nearly a quarter of school aged children have seen or been involved with gun violence in some way; this $25 million would work to end that cycle of violence and trauma with counseling, conflict resolution programs, and other prevention of violence work inside the school. Mental health care was not the only subject involved in the President's proposals to reduce gun violence. The report also included recommendations to use $10 million to investigate the link between violent crime and violent video games; harsher punishment for gun trafficking; better federal data on where confiscated arms have come from; and an all-out ban on military style assault weapons. And, another part of the gun violence reduction plan did, once again, concern mental health care. In the final subsection of the plan, a subsection entitled "Ensure Coverage of Mental Health Treatment," Obama notes that the Affordable Care Act already requires all new small group and individual health insurance plans to cover mental health care as well as they do physical health care.

With this new proposal, Obama wants the administration to finalize regulations to ensure that existing health plans also offer better mental health coverage, as guaranteed by the 2008 Mental Health Parity and Addiction Equality Act. With parity in insurance plans, mental health services such as counseling sessions or meetings with an addiction support group would be covered by an insurance plan in the same way that a procedure like surgery is already part of every insurer's coverage. The gun violence reduction plan goes on to state another benefit of Obamacare toward improving national mental health care - adding 17 million Americans to Medicaid. Medicaid is already the number one insurance provider of mental health services, and with the violence reduction proposal, Obama is asking the administration to take even more steps to assure that all Medicaid insurance plans do abide by mental health parity regulations, and are covering mental health services as they would physical ones. President Obama's proposal also notes the role of health care providers, both physical and mental, in taking more initiative when it comes to patients and guns.

The executive report clarifies the fact that it is most certainly legal for a physician to ask a patient about gun ownership, or engage in a discussion about firearms. Similarly, the report goes on to clarify that a physician may disclose patient information to authorities if that information concerns threats of violence; in this case, the physician will not be at risk of committing a violation of patient privacy. "We're going to need to work on making access to mental health care as easy as access to a gun." This quote from President Barack Obama aptly sums up the situation in the United States concerning mental health care. Although the President's report is sure to mention that mental illness should in no way become associated with acts of violence, it does makes sense that better mental health services could do the nation plenty of good. Let's see if Congress agrees.