Candles, Fireworks, and Failures: The Colorado Springs Killings


There is purity in light.  Light illuminates all it touches.  We light candles in hope, in celebration, in reverence, and all too often in sorrow.  There will be candles in Colorado Springs, Colorado, some in the festive spirit of the season, others in sorrowful remembrance of those whose own light expired before its time.

French author Jean Paul Satre said of words: “Every word has consequences. Every silence, too.”  Words created the darkness that descended on Colorado Springs.  Silence created the darkness that descended on Colorado Springs.  Words and silences with consequences.

Anti-abortion radicals provided the words.  Edited words in the smear propaganda videos produced by the nefarious Center for Medical Progress. [C&L]  Provocative words from radical politicians in Congress as they launched five investigations into the activities of Planned Parenthood. [NYT]  Incendiary words, generating as the saying goes “more heat than light,” from Republican presidential candidates. [NYT] Manipulated, provocative, incendiary words created the darkness instead of providing illumination.  Worse still those manipulated, provocative, incendiary words were spread across the nation without filtration. [C&L]

It was almost as if the journalists and broadcasters who amplified these words had forgotten the power of the pen, or in these days, the pixel.  Someone decided that the “heavily edited words” in the propaganda videos counted as “news.”  And the words were unleashed before any illumination took hold. Yes, the tapes were edited for effect, certainly not for edification.  Yes, the tapes were controversial. However, no, the tapes were not authentic, truthful, or informative.  And  the message was further enhanced by the failure of editors and publishers to require that what they broadcasted and printed was authentic, truthful, and informative.

It  seems as though the editors, producers, and publishers were content with fireworks – ephemeral bursts of gaudy light, instead of a steady but less glamorous illuminating candle.

Words can challenge or comfort us.  Those manipulated, provocative, and incendiary words caused some to remember that since 1977 there have been eight murders, seventeen attempted murders, forty-two bombings, and one hundred eighty six arsons against abortion clinics and providers. [Vox] Others noted that in just the last four years states have enacted two hundred thirty one pieces of abortion restriction legislation. [Guttmacher]  Those manipulated, provocative, and incendiary words comforted and validated not only the radicals among us but also the  murderers, the bombers, and the arsonists.

Our words are our own. Once uttered they are released forever, and in the case of some media outlets may be repeated almost endlessly, looping along with stock footage and graphics.  There is a vast difference between freedom of speech, and freedom from criticism which is not always evident in the reactions to radical hyperbole.

The Center for Medical Progress, the creator of the propaganda videos, denounced the attack on the Colorado Springs Planned Parenthood center, but without any acknowledgment that the attack may very well have been informed by the very videos and controversy it created. [HuffPo]  The attack began and ended at the Planned Parenthood center.  Three lives were extinguished there.

Are the radical anti-abortion advocates asking us to please don’t think ill of them because they never intended their words (and pictures) to inflame the murderers, the bombers, and the arsonists?  We’re cautioned about using scatological language in case “small ears” might be listening; do we take as much care when it’s possible small minds might be attending to the messages?

Words can’t be deflected easily.  Most of the Republican candidates sought refuge in generalizations — “everyone should tone down the rhetoric.” But whose rhetoric called abortion providers, “exterminators,” or “a criminal enterprise,” or “killers?”  [NewYorker] No one is arguing that all members of the so-called “pro-life” movement are murderers, bombers, or arsonists – only that the heated verbiage of the radicals provides inspiration and validation for those who are inclined in that direction.

And then there were the silences.

When those 231 pieces of anti-abortion legislation were being considered in State Legislature – how many voices were heard in opposition? How many pro-choice advocates crafted letters to members of those assemblies? To local editors? To local media outlets?  How many legislators decided it was safer to “go along to get along” with radicals rather than risk their wrath?

When the controversy over the video tapes flamed into the news, how many editors and producers succumbed to the temptation to air what was dramatic, flashy, and provocative before vetting the material for authenticity?  We might ask how many times news organizations must get “used” by political groups before they realize that the words and pictures they are disseminating are  propaganda and not really newsworthy?  How many times are these outlets cowered into the shallows of self referential exculpation, as in the convenient “both sides do it” narrative?

The best feature of a candle is its capacity to provide continuous illumination, without flares and flashes.  It may be dim in comparison to electric bulbs, but no illumination is without shadows.  However, to paraphrase Satre: Every candle has the capacity to illuminate. Every darkness the power of destruction.

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The very near future?

It is beginning to look like the swamp won’t be sufficiently drained to allow for some good old fashioned fact based blogging until about December 1, so thank you for your patience and I’ll be back as soon as possible.

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Brief Hiatus

Hiatus Busy Time!  DB’s a bit on the swamped side so the blog will be on hold until the place is drained down to a manageable level.  Thank you for your interest and patience, and posts will resume in the very near future. 

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Thanks for your patience

Busy Busy again, and posting will be a little sporadic. Thank you for your patience, DB will be back soon

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Really? There’s a teacher shortage. “Now a warning?”

Now A Warning There was that memorable moment in “Death Becomes Her” (1992) —

“Glamorous musical star Madeline Ashton’s (Meryl Streep) incredulous response to Lisle Von Rhuman’s (Isabella Rosselini): “But first, a warning…” after Madeline has already drunk the potion: “NOW a warning?!”; the jaw-dropping, award-winning visual effects used to comic effect, including the “backwards walk” when Madeline’s head is rotated 180 (and later 360) degrees, and her shocked cry: “My ass! I can see my ass!” []

And now the chair of the Nevada State Board of Education can see a teacher shortage in Clark County.

“Never has Elaine Wynn, president of the Nevada State Board of Education, felt so alarmed in her job as she did after hearing details of the Clark County School District’s teacher shortage.

During a board meeting Thursday, the former casino company executive and longtime philanthropist told district officials that she would clean house at any private business with such a “horrific” human resources crisis.” [LVRJ]

Before I get out my hankie – there is nothing new about a shortage of qualified teachers.  The problem is that it’s getting worse.  [WaPo]  Not sure? Take a gander at pages 95-98 of the Department of Education’s list of shortage areas in Nevada. (pdf)  Further, it’s not like we haven’t figured out why this is happening:

“What’s going on? Pretty much the same thing as in Arizona, Kansas and other states where teachers are fleeing: a combination of under-resourced schools, the loss of job protections, unfair teacher evaluation methods, an increase in the amount of mandated standardized testing and the loss of professional autonomy.” [WaPo]

That pretty well sums it up. Interestingly enough, most of the proposed “solutions” to the shortage don’t address any of the problems listed above.  First, there is the turnover rate factor – we can offer alternative licensure, up to almost allowing anyone who can fog a mirror and work for minimal wages to be employed in a classroom. However, if they don’t stay there then that’s not really a solution.

Secondly, even if the turnover rate is relatively low (as in Clark County) having people stay isn’t the solution if they can’t be recruited in the first place.   Let’s review: If salaries are lower in public education – especially in secondary specialties – and student loans are becoming more burdensome, then why would we expect a person to select education instead of electrical engineering?  Or, an elementary education major instead of business management? [DB] [DB] [DB] Add under-resourced schools, evaluations based on standardized test scores, the loss of professional autonomy, and taking a huge chunk of the day to do little but Test Prep – and what did we expect?

Recruitment/Turnover and Trends

A comprehensive study by the CPRE (pdf) updated in 2014, listed seven trends “transforming” the teaching force. Abbreviated, they describe a force which is (1) larger, with a high percentage of the increase involved in special education; (2) grayer, as in aging but not to such an extent as to cause shortages; (3) greener, with more rookies in classrooms; (4) more female; (5) more diverse; (6) consistent in academic ability, and disturbingly (7) less stable, less likely to remain in the profession. Of first year teachers who left vacancies in their wake, 20.8% resulted from school staffing action; 35.4% for personal or family reasons; 38.9% to pursue another job; and, a hefty 45.3% because of dissatisfaction.  Among the factors related to dissatisfaction: school and working conditions, low salaries, lack of classroom resources, student misbehavior, accountability issues, lack of opportunities for development, lack of input into decision making, and factors related to school leadership.

Solutions That Don’t Match The Problems

School “reform” is a popular topic on the hustings, but all too often it appears that the solution doesn’t match the problems incurred by our school systems.

(1) Punishing Poverty and Paucity.  Consider for a moment a district or school which has a high percentage of “at risk” students, and the usual paucity of funding for school resources.  What’s the next step?  We read newspaper articles and listen to broadcasts telling us about the FAILURE of the West Moose Tail School District! Then, the next higher governmental entity swoops in to “take over” the school(s) in order to reorganize and apply various reforms.   The “failure,” of course, is to make “adequate yearly progress” whatever that might mean, and the meanings vary among the states.

The obvious question is: Progress toward what? And the usual answer is higher standardized test scores.  Granted test scores are easy to digest, but before swallowing them as a significant indicator of what is going on in a particular school the cautionary tale of Mission High School in San Francisco, CA is in order. [MJ]  The emphasis on test scores creates its own bias – we pay attention to what we can quantify and ignore most of the rest, including classroom work, homework, grading, classroom examinations, the opinions of students and parent, and the school’s relationship to the community.

The default technocratic response is to blame the staff, then offer such reforms as charterization, massive staff layoffs, administrative replacements, and  curriculum changes.  There are issues within these One Size Fits All solutions.  Not the least of the issues is, as the Mission High School example offers us, whether we’re using a relevant definition of “failure.”  In the backwash of all the attention paid to the formulaic news about school failure, based on reports of test results, there is little attention paid to the conclusion of the 2012 Brookings Study (pdf) which reported there is no correlation between testing standards and student achievement.

The disconnect is also related to political rhetoric, of the kind in which critics of public education speak of “tossing good money after bad.”  This talking point is exceptionally handy for shielding the speaker from actually having to explain (1) how we measure success, (2) how we allocate resources between and among schools, and (3) how we analyze the performance of students by any other metric than standardized test scores.   For public education critics, the purpose of test scores is to punish poverty and paucity, not to identify where additional resources might be allocated to their best advantage.

(2) It costs money to be a teacher.  How to recruit the next generation of teachers?  Perhaps it might be a bit easier IF student loans weren’t such a financial burden on young people fresh out of college.  It might have been helpful if Republican members of the U.S. Senate hadn’t blocked S. 2432, a bill to allow those with student loans to refinance them. [TheHill]  And, also helpful if the Republican version of a student loan bill wasn’t a handout to the bank-based loan system. [TP]

It could also be helpful if local school boards weren’t trying to shave pennies at teachers’ expense for health insurance, and other benefits. [C&L]  And, if teacher retirement programs were defined benefit plans instead of less satisfactory defined contribution plans, hybrid plans, or other manifestations of financial industry subsidization.

We might also consider that “Capitalism Works.” If we want more young people to enter the field then money talks.  Teach Biology or enter one of the health care professions? Teach Algebra or enter into one of the  tech fields? Teach Business or enter finance? Teach in an elementary school or go into marketing?  Guess which will ultimately pay more?

“Solutions” which eventually created a down-draft in teacher pay and compensation packages is exactly the opposite of what common sense (and the free market) say will generate greater interest in the profession.

(3) R-E-S-P-E-C-T  is not just a song in Aretha’s repertoire.  What did teachers say were the causes of their dissatisfaction? Once more: school and working conditions, low salaries, lack of classroom resources, student misbehavior, accountability issues, lack of opportunities for development, lack of input into decision making, and factors related to school leadership. If we remove the money elements, there’s “accountability,” “lack of input into decision making, and school leadership.”

Let’s assume the old saw is correct, “10% of the students will cause 90% of the problems.”  How does the school administration handle disciplinary cases? There’s always the “pipeline” solution, it’s easier to suspend and even expel than to find the resources to deal with troubled youngsters.  However, that “solution” doesn’t do much more than to shuffle the youngster into another setting wherein he or she becomes someone else’s problem.  How many elementary schools in the country have full time counselors? Full time social workers? Access to full time psychologists? How many school districts have fully funded alternative education programs?  Again, if the “solution” is “removal,” then we’re not dealing with students, we’re dealing in statistics.

“Lack of opportunity for development?” Classroom teaching is one of the few professions in which in order to move up a person has to move out.  The “merit pay” solution might be effective IF the salaries were what they should be in the first place.   And, even “merit pay” gets tied to things which are not necessarily  indicative of quality teaching – again, test scores.  Perhaps instead of tossing bird seed into a grain silo we concentrated on how we organize our schools, how we utilize the experience and skills of exceptional teachers to mentor and advise the rookies?  How about if we gave classroom teachers more access to the decision making process about community relations? Budgeting priorities? Disciplinary and counseling options?

How about instead of announcing the Failure of West Moose Tail, and then imploding the whole institution, we ASK the people directly involved what needs to be done to improve the school’s performance on more than just standardized test scores, instead of simply firing the lot and hauling in a new batch of the graying, the greener, the females, the diverse, and the likely to leave in five years?  This “solution” doesn’t change much except the identification cards of the people who are supposed to be in the building.

Perhaps instead of doing the politically expedient, the economically parsimonious, and the socially conformative – we actually tried to find solutions to fit the problems?  Then, just maybe, we wouldn’t have to keep repeating, “Now, a warning?”

*Previous Posts: The Numbers Game Part II, The Merit Pay Mirage,  (note the discussion of the Ladue School District (MO) and merit pay criteria) The Ultimate Game, February 20, 2011. The Wrong Answer Can Always Be Found, April 10, 2011.  “Silver Bullets at Moving Targets” April 3, 2011.

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Murphy’s Law: H.R. 2646 and Mental Health Services

Bill Yes, the Republicans have been diverting attention from the regulation of firearms in America by switching to speaking of mental health; and yes, there’s a bill in the House (HR 2646) which seeks to address some of the issues raised by mass shootings.  However, it’s not “gone anywhere” fast; and, it’s not a particularly good bill.

The title is nice, “Helping Families in Mental Health Crisis Act of 2015” – some of the provisions are helpful, others may very well not be.  The bill does provide for more sharing of information concerning a person who has gotten treatment for mental health problems. Section 401 allows for caregivers to receive information about diagnoses, treatment plans, appointment scheduling, medications and medication related instructions, but not any personal psychotherapy notes. This sharing is intended to protect the health, safety, or welfare of the individual or the general public. Caregivers would also have access to educational records in Section 402.  There’s a fine line here. On one hand sharing information could (and possibly should) enable the caregivers involved to have a better understanding of the person’s condition and treatment plan. On the other there’s an element of concern about how much information is shared with whom – especially since mentally ill individuals are 11 times more likely to be victims of criminal acts than to perpetrate them.  [MHA]

Assisted, Involuntary, Mandatory?

Then there’s the questionable use of the English language in the term “Assisted Outpatient Treatment.”  It sounds like it would have the emphasis on “outpatient,” but the word that should be emphasized is “assisted,” as in assisted by the courts.  “Assisted outpatient treatment (AOT) is court-ordered treatment (including medication) for individuals with severe mental illness who meet strict legal criteria, e.g., they have a history of medication noncompliance. Typically, violation of the court-ordered conditions can result in the individual being hospitalized for further treatment.” [TAC]  There are studies which indicate the AOT plans in 45 states do help relieve some of the stress on caregivers, and often result in a reduction of hospitalization.  Thus, what we’re really talking about here is mandatory outpatient treatment.  Whatever we call it, “assisted,” “mandatory,” or “involuntary” before jumping to any conclusions we might want to determine if “it” works.

The efficacy depends on how we measure success.  If the criteria include  re-arrest rates, program costs, or crime rates, then the AOT plan appears successful in general societal and economic terms. [TAC] On the cautionary side, the Phelan Study (NYC 2010) included ‘184 people who were in AOT and compared them to a control group recently discharged from a psychiatric hospital and were attending the same outpatient facilities as the AOT group. Both groups experienced similar reductions in psychotic symptoms.’  “The AOT group members were four times less likely to report an incident of serious violent behavior than those in the control group,” which would be good news indeed, except that the AOT wasn’t the sole factor.  The Duke Mental Health Study (Swanson 2000) found “improved outcomes and reduced violence was associated with simply more frequent service visits over an extended period of time (6 months or more).” [PsychCen]  In short, time and treatment were the most significant factors.

And now we’re left with a question:  Is the success of the AOT programs correlated to the coercion element, or is the success of the program correlated to the extension of the treatment services over time?  If the latter, then we’d expect to be allocating more funding to the treatment services necessary.  Another question raised might well be on what basis are we justifying our political decisions concerning the implementation and funding for AOTs?  Are we successful if we reduce policing costs? Institutionalization costs? Or do we measure success in terms of the mental health of the patient?  There is, most likely, a place for AOT in our mental health care system, how much emphasis we want to place on it is a political decision.

Politicians and Policy

“On June 4, Congressman Tim Murphy introduced legislation (HR 2646) designed to dismantle the federal mental health authority – the Substance Abuse and Mental Health Services Administration (SAMHSA) – which has successfully promoted recovery and community inclusion for individuals with serious behavioral health conditions for 25 years, as called for by President Bush’s New Freedom Commission on Mental Health. The bill would replace SAMHSA with a new Office headed by a politically appointed government official, controlled by Congress ….” [MHA]

This is the point at which the two familiar bugbears of politics emerge: Congressional Control and Funding.

“Threats of sequestration in 2013 had a significant impact on people’s ability to access mental health services and programs, including children’s mental health services, suicide prevention programs, homeless outreach programs, substance abuse treatment programs, housing and employment assistance, health research, and virtually every type of public mental health support. The Substance Abuse and Mental Health Services Administration (SAMHSA) claimed it alone would be cutting $168 million from its 2013 spending, including a reduction of $83.1 million in grants for substance abuse treatment programs.” [Forbes]

What hasn’t been cut in Congressional appropriations for mental health care support for the states isn’t faring all that well in the FY 2015 budget.  Sometimes it seems that “block grant” simply means a way to pile the money together and then cut the whole stack.  For example, in FY 2013 the Community Mental Health Services Block Grant program received a total of $437 million, in FY 2014 the figure increased to $484 million, but in FY 2015 the final number is $483 million.  One provision in H.R. 2646 would allow only medical professionals with certain academic credentials to evaluate block grant requests – which sounds very “professional” except when we consider that some substance abuse and alternative programs may be very successful, but aren’t necessarily conducted with the imprimatur of currently medically credentialed individuals – critics have charged that this is a perfect way to “ossify” the field of mental health care and substance abuse treatment.

There is an alternative bill in Congress which does not eliminate SAMHSA, and which shares many of the provisions of H.R. 2646, is S. 1945.  A comparison of the two bills is available here in pdf format.  Whether the administrative situation is changed or not, unless the funding for the programs is enhanced, or at least made equal to the inflation rate, it may not matter much who is administering a smaller portion of an already diminishing pie.

It’s The Money Stupid

Enforced treatment, coerced treatment, “assisted” treatment, or whatever we may chose to call it without addressing the need for “time and treatment;” combined with Congressional micro-management, Presidential politics; and, an underfunded by a block grant system, doesn’t seem like the best approach to addressing mental health services in this country.

First, we need to get some perspective.  If SAMSHA has focused on alcohol and drug abuse it’s probably because as of 2013 we had 17.3 million Americans who were categorized as “alcohol dependent,” and some 24.6 million who had used illicit drugs in the previous month before the 2013 survey. [DAgov]  By contrast, government figures estimate approximately 10 million adult Americans with serious mental illnesses. [NIMH]  The focus issue is only important IF we’ve decided we can afford to address one problem or the other, but not both. Focus isn’t an issue if we decide that we can do two things at once and proceed to tackle both.

Secondly, there most likely is a valid social use for mandatory treatment especially for those who cannot or will not voluntarily cooperate with evidently necessary treatment plans, and whose behavior is such that the individual presents, in the hackneyed phrase, a danger to himself or others.  Further, while patient privacy is a legitimate concern, it should not infringe on the needs of caregivers and others with whom a seriously mentally ill comes in contact.   (While we’re on this topic – why not consider additional funding for local police and law enforcement agencies to allow training in dealing with the mentally ill?  If the motto is “Protect and Serve,” then might not allowing police officers to receive limited but significant information about a patient serve to improve their interaction with him or her.)

Third, it doesn’t make sense to argue for increased institutionalization, on a short or long term basis, if there are inadequate facilities available.  For example, in 2010 Nevada had 302 beds for the mentally ill, which is calculated to be approximately 25% of the total need. [TAC] [see also LVRJ 2013] If part of the solution is AOT, and the coercion element is hospitalization, then the hospital beds need to be available.

Therefore, if we are truly interested in making life safer for the general public (witness: mass shootings by mentally ill individuals) and safer for the mentally ill (who are 11 times more likely to be the victims of crimes), then it should behoove us to consider allocating some resources toward creating a system in which (1) there are adequate and easily accessible mental health care facilities and services, (2) there is adequate funding for mental health care services so that these facilities are maintained and expanded as needed, and (3) we are not overly focused on Silver Bullet Solutions, but willing to advance and develop a spectrum of mental health care services which include a wide range of treatment options.

There are some good portions of both H.R. 2646 and S. 1945, and some definite limitations and foibles exposed in each.  What neither bill manages successfully is to fully fund the mental health care needs of Americans in the 21st century.

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One Great Distraction: Guns, GOP, and Mental Health

blood money The GOP response to gun violence in America is getting tiresome, and no diversion or distraction more so than when its members cite “mental health” as a topic for discussion.

The Republican Party really shouldn’t get anywhere near this distraction, not with their record on making mental health care available to American citizens. [AmerBlg]   It doesn’t do to blather on about Guns and Mental Health in one breath and then take 50+ votes to repeal the Affordable Care Act in the next.

Before the passage of the Affordable Care Act about 1/3rd of those who did have health insurance in the individual market had no coverage for substance use disorder to services, and 1/5th had no coverage for mental health services, including outpatient therapy, and inpatient crisis intervention and stabilization.  Additionally, even when a person did have coverage there was no guarantee mental health services would be covered comparably to medical and surgical care.   The situation in the small group market was a bit better, coverage for substance abuse and mental health services was more common, but many states did not have “parity” laws requiring comparable coverage with medical and surgical treatment.  Then, there were those 47.5 million Americans who didn’t have any health insurance, and the 25% of uninsured adults who have a mental health condition, a substance abuse problem, or both. [ASPE]

After the passage of the Affordable Care Act mental health and substance abuse are categories covered as part of the package of Essential Health Benefits.  With the finalization of rules as of January 1, 2014 consumers buying health insurance policies can be confident that the health plan will cover mental health services, and importantly, that there will be parity for mental health and substance abuse treatment coverage. [ASPE]

And what was the Republican reaction?  “Repeal.. Repeal.. Repeal…” at least 50+ times. [WaPo]  

January 8, 2011:  There was a mass shooting in Tucson, AZ  six were killed, eleven others wounded including a member of Congress, Rep. Gabby Giffords.   January 19, 2011: The House votes to repeal the Affordable Care Act.  On February 19, 2011 the House passed an FY 2011 continuing appropriations bill with several amendments to “severely limit” the implementation of the Affordable Care Act. The measure passed with no Democratic support.  Further votes were taken to carve up and diminish the provisions of the Affordable Care Act on March 3, 2011, April 13, 2011, and April 14, 2011.  On April 14, 2011 a House resolution advised the Senate to defund all mandatory and discretionary spending associated with the Affordable Care Act.  April 15, 2011 the Republican controlled House passed its version of the budget repealing and defunding the Affordable Care Act.  During the four months after the Tucson Shooting the Republican controlled Congress spent much of its time trying to defund, limit, or outright repeal the law requiring health insurance companies to include mental health services as an “Essential Benefit” and on par with coverage for medical and surgical treatment.  And, they weren’t finished.  Republicans tried to gut the Affordable Care Act provisions on May 3, 2011; May 4, 2011May 24, 2011; and on August 1, 2011 the Budget Control Act cut some mandatory and discretionary funding tied to the Affordable Care Act.

October 12, 2011:  Eight people were killed and another critically wounded by a shooter in Seal Beach, California.  Ironically, on October 13, 2011 the House passed the “Protect Life Act” preventing any funding from be applied to abortion procedures.  More Congressional incursions were made on the Affordable Care Act on November 16, 2011, December 13, 2011, and December 16, 2011.  On February 1, 2012 Congress voted to repeal a long term care insurance program (CLASS).  February 17, 2012 the House voted to cut funding for Louisiana’s Medicaid program by $2.5 billion, and cut $11.6 billion including $5 billion from the Public Prevention and Health Fund.  The cut to the Medicaid program was significant because Medicaid is the insurance provider for low income people, some of whom might be in need of substance abuse or mental health care treatment.  On March 29, 2012 the House version of the FY 2013 budget called for repealing and defunding the Affordable Care Act.

April 2, 2012:  A former student at Oakland’s Oikos University opened fire in a classroom, seven were killed and three wounded.  The House attacked the Affordable Care Act again on April 27, 2012, and more significantly voted on May 10, 2012 to replace the automatic budget cuts to the Defense Department by defunding and repealing portions of the Affordable Care Act. June 7, 2012 the House voted to repeal the medical device tax, and limit the reimbursements for over the counter medications.  On July 11, 2012 the House voted to repeal the Affordable Care Act.

July 20, 2012: 12 people were killed and another 58 were injured in the shooting at the Aurora, Colorado movie theater.  Yet again, opponents of gun safety regulations noted that the shooting was the result of mental illness.

August 8, 2012: A shooter gunned down six people and injured three others at a Sikh Temple in Oak Creek, WI.

September 28, 2012: Six were killed and two injured in a workplace shooting in Minneapolis, MN.

October 21, 2012:  Three died and four were injured in a shooting in Brookfield, WI.

December 14, 2012:  Newtown, CT; 27 died including 20 first grade children. On December 20, 2012 the House voted once more to replace discretionary spending cuts enacted as part of sequestration by defunding and repealing several provisions of the Affordable Care Act.  On January 1, 2013 the “fiscal cliff deal” passed the House including the repeal of the CLASS Act and cutting funds for the Consumer Operated and Oriented Plan. 

On May 16, 2013 the House voted to repeal the entire Affordable Care Act. 

June 7, 2013: Five people were killed in a shooting incident in Santa Monica, CA which ended on the campus of Santa Monica College.  On July 17, 2013 the House voted to delay the implementation of the Affordable Care Act for employers by one year.  Also on July 17, 2013, the House voted to delay the implementation of the individual mandate.  On August 2, 2013 the House voted to prevent the IRS from implementing or enforcing any portion of the Affordable Care Act.

September 16, 2013:  12 were killed and 3 injured in a shooting at the Washington, DC Naval Yard.  On September 20, 2013 the House voted to approve a short term FY 2014 continuing resolution in which the Affordable Care Act was fully defunded, including the prohibition of all discretionary and mandatory spending, and rescinding all of its unobligated balances.  On September 29, 2013 the House voted again to repeal the medical device tax, and to delay the implementation of the Affordable Care Act by another year.  September 30, 2013, the House voted to delay the individual mandate, an action which would effectively render the law inoperable.

Votes were taken in the House on October 17, 2013; November 15, 2013; January 10, 2014; January 16, 2014, March 5, 2014 to weaken the enforcement of the Affordable Care Act.  More such votes were taken on March 11, 2014; March 12, 2014; and, March 14, 2014. [LAT]

April 2, 2014: Three were killed, sixteen injured in Fort Hood, TX, scene of a previous shooting in 2009.

On January 28, 2015 Rep. Bradley Byrne (R-AL) introduced H.R 596, a bill to repeal the Affordable Care Act.  The measure passed the House on February 3, 2015. [RC 58]*

May 23, 2015: Six dead, seven wounded in Isla Vista, CA. June 18, 2015: Nine dead at the Emanuel AME Church, Charleston, SC.  October 1, 2015: Nine dead, nine injured in Roseburg, OR.   Meanwhile, the Huffington Post asked Senators what might be done about the carnage:

“If there’s one issue that these senators wanted to talk about when asked about gun violence, it was the mental health component. Nearly all of those who were interviewed said their attention is on that aspect of the problem, instead of on gun laws.

“What I’ve been focused on, and I think it very much relates to, unfortunately, too many of these mass shootings, is improving our early intervention mental health system,” said Sen. Kelly Ayotte (R-N.H.). “Hopefully we can take some immediate action and find common ground.” [HuffPo]

Improving our “early intervention mental health system?”   What appears to be more than slightly inane (if not outright insane)  is to believe that repealing the Affordable Care Act — such that we cannot assure health insurance coverage for substance abuse and mental health problems, on par with coverage for medical and surgical treatment – is going to augment our attempts at “early intervention,” – or for that matter, for intervention at any stage.

Unless, and until, the Republicans are willing to stop trying to repeal the law that requires mental health treatment coverage as part of an Essential Benefit package, and stop attempting to repeal the provisions saying that the coverage must be on par with other medical and surgical treatment benefits, the noise about “doing something about mental health” is just that – a distracting noise.

Unless, and until, the Republicans are willing to put legislation into the hopper (and bring it to the floor for a vote) increasing (1) federal support for mental health care services, and (2)  increasing the number of low income people in the Medicaid program who have access to expanded coverage, then they’ll have to pardon those who say the “mental health” rhetoric is a hollow, shallow, attempt to distract the nation from any serious and substantive discussion of gun violence as a public health issue.

References: Congressional Research Service, “Legislative Actions to Repeal, Defund, or Delay the Affordable Care Act, July 8, 2015. (pdf) Los Angeles Times, Deadliest Shooting Rampages, October 1, 2015.  Washington Post, House has voted 54 times in four years on Obamacare,” March 21, 2014.  AmericaBlog, “Republicans are using mental health as an excuse to do nothing about gun violence.” October 6, 2015.  International Business Times, “Republicans’ Mass Shooting Response Focuses Not On Gun Control But On Mental Health Reform,: October 5, 2015.  Huffington Post, “Despite Mass shootings, Republicans won’t touch gun laws,” October 6, 2015.

*Nevada Representatives Amodei, Hardy, and Heck, voted in favor of H.R. 596.  Representative Titus voted no.

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Filed under H.R. 1591, Mental Health, Nevada politics, Politics, public health