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Opinion | Republicans blame mental health issues for gun violence. So where’s the money for care?

Opinion | Republicans blame mental health issues for gun violence. So where’s the money for care?

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America’s exceptionalist gun culture is not the source of our exceptional levels of gun violence and mass shootings, GOP politicians say. Something else must be to blame.

Lately, the more politically convenient explanation is mental illness.

“We as a state, we as a society need to do a better job with mental health,” Texas Gov. Greg Abbott (R) said after an 18-year-old gunned down 19 children and two teachers in Uvalde using military-grade weapons he had legally acquired. “Anybody who shoots somebody else has a mental health challenge. Period. We as a government need to find a way to target that mental health challenge and to do something about it.”

This argument has been echoed by other Republicans, including Rep. Tony Gonzales (Tex.), Gov. Asa Hutchinson (Ark.) and, in a speech at the National Rifle Association convention, former president Donald Trump.

Never mind, apparently, that mental health advocates have suggested this is a scapegoat. Many people struggle with mental health challenges, in the United States and elsewhere; most do not resort to violence, let alone slaughter fourth-graders. The easy access to firearms in this country enables a would-be mass shooter to carry out their violent ambitions, whether that person has been diagnosed with a mental health issue or not.

But let’s say these politicians genuinely believe that identifying and treating mental health challenges — rather than, say, restricting access to efficient killing machines — is the key to curbing mass shootings. If that’s the case, why haven’t they put their money where their mouths are?

Texas, for instance, ranks last of all 50 states in overall access to mental health care, according to the nonprofit Mental Health America. The ranking is based on available data on measures such as the shares of adults and children with mental health issues who have been unable to receive treatment.

Among the reasons why: Texas is one of a dozen states that still have not expanded Medicaid, the public health insurance program that covers poor and low-income Americans, and which is the country’s single largest payer for mental health services.

Texas officials’ refusal to expand Medicaid does not appear to be rooted in public welfare nor fiscal responsibility concerns. The federal government has offered holdout states billions of dollars in incentives to expand Medicaid, most recently through last year’s American Rescue Plan. These incentives would, on net, cause state revenue to come out ahead, even after accounting for Texas’s new spending obligations if it were to make more residents eligible for public insurance. Expanding Medicaid would also reduce costs for hospitals that currently provide a lot of uncompensated care for uninsured patients.

Instead, Texas chooses to be the state with the highest share of residents who are uninsured.

It gets worse. In April, Abbott transferred $211 million away from the state’s Health and Human Services Commission, which oversees mental health programs, as NBC News has noted. The money was transferred to support Operation Lone Star, the governor’s controversial deployment of National Guard and law enforcement resources to the border.

Texans have heard before about Abbott’s allegedly deep concern for mental health services, at least in the wake of gun massacres.

After previous mass shootings — including one at a Houston-area high school in 2018 and one targeting Hispanics at an El Paso Walmart in 2019 — Abbott blamed “mental health” as the central cause. To his credit, after the high school shooting, he at least signed a series of bills intended to (modestly) improve state mental health initiatives, such as by providing more mental health training for educators.

But such measures were insufficient to improve the state’s horrific record on mental health services, as a recent Houston Chronicle investigative series documented.

Those measures also, clearly, haven’t stopped mass shootings. Nor have the many other bills Abbott has signed in recent years loosening gun restrictions, such as a 2019 measure giving more teachers access to guns in classrooms.

Texas’s political leaders are hardly alone in their paltry attention to mental health issues, except when it’s helpful to deflect from other political vulnerabilities.

The United States overall ranks worse than most other rich countries on a range of metrics related to mental health, including suicide rates and individuals’ ability to get or afford professional help when experiencing emotional distress. Meanwhile, Republicans, including Trump, have worked to roll back the public health programs and subsidies that enable whatever meager access to care that low- and middle-income Americans currently have.

For too many years, GOP politicians have shifted between saying they’ll prevent gun violence by investing in health care (in lieu of firearm restrictions) and later working to cut access to care. Voters rarely seem to register the disconnect. But the more massacres there are, and the more frequently they occur, the harder it becomes to maintain these charades.

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