Uvalde massacre prompts calls to expand mental health resources

Despite growing calls for gun reform in the wake of the Uvalde school shooting, a Texas Senate committee discussing legislative responses to the massacre spent little time debating firearm safety measures in two days of public hearings.

While senators questioned mental health, law enforcement and school safety experts for hours, the group flew through testimony from gun control activists. The advocates had gathered at the Capitol to call for stronger background checks, waiting periods when purchasing assault-style rifles, and “red flag” laws that would temporarily remove firearms from people deemed a danger to themselves or others.

“Solutions that only address mental health and school security are not adequate alone,” testified Nicole Golden, the executive director of the nonprofit advocacy group Texas Gun Sense. “Even with more funds and better enforcement of policies, experts have said there’s no indication that intensifying school security has prevented violence.”

Wednesday’s hearing was scheduled to address mental health and firearm safety, but the former dominated testimony. Texas’ Republican leaders have emphasized mental health services after the Uvalde massacre, as well as new investments in school security, while rejecting calls from the left to restrict gun access.

Members of Moms Demand Action hold signs Wednesday, June 22, 2022, outside the Senate chamber in the Capitol in Austin before the start of a meeting of the Senate Special Committee to Protect All Texans. The committee was convened in the wake of Uvalde’s Robb Elementary School shooting in which 19 children and two adults were killed by a teenager with an AR 15-style assault rifle.

William Luther, Staff Photographer / Staff photographer

Top mental health officials told lawmakers that if they want to bolster student counseling services, as Texas leaders have suggested since the mass shooting at a Uvalde elementary school, they’ll have to entice more people to work in the field. They also advocated expanded student telehealth services, early crisis intervention and a concerted effort to extend health insurance to all Texans.

“We have to strengthen the workforce,” testified Sonja Gaines, a behavioral health official at the Texas Health and Human Services Commission. “We just simply have to do that.”

The Uvalde shooter was an 18-year-old high school dropout who exhibited signs of violence that were never reported to authorities, according to state officials. People interviewed after the massacre described him as suicidal and cruel to animals.

Andy Keller, the president and CEO of the Meadows Mental Health Policy Institute, said school shooters generally have a distinct profile: boys under the age of 20 or 21 who, in almost all cases, were exposed to early childhood trauma, bullying and severe abuse.

Members of Moms Demand Action hold signs Wednesday, June 22, 2022, outside the Senate chamber in the Capitol in Austin before the start of a meeting of the Senate Special Committee to Protect All Texans. The committee was convened in the wake of Uvalde’s Robb Elementary School shooting in which 19 children and two adults were killed by a teenager with an AR 15-style assault rifle.

Members of Moms Demand Action hold signs Wednesday, June 22, 2022, outside the Senate chamber in the Capitol in Austin before the start of a meeting of the Senate Special Committee to Protect All Texans. The committee was convened in the wake of Uvalde’s Robb Elementary School shooting in which 19 children and two adults were killed by a teenager with an AR 15-style assault rifle.

William Luther, Staff Photographer / Staff photographer

“There’s an identifiable crisis point, usually with suicidal [ideas], and self-hate turns against others,” Keller said. “The issue is that while that is the profile of these school shooters, it is also the profile of other young adults who are never going to do that.”

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Democrats and gun control advocates have noted that the gunman would not have been able to murder 21 people and injure 17 more within minutes if he could not obtain an assault-style weapon.

In written testimony submitted to the Senate committee, eight Texas health organizations — led by Dr. Gary Floyd, the president of the Texas Medical Association — called for a multifaceted response that includes mental health investments and “sensible firearm safety measures.”

Members of Moms Demand Action hold signs Wednesday, June 22, 2022, outside the Senate chamber in the Capitol in Austin before the start of a meeting of the Senate Special Committee to Protect All Texans. The committee was convened in the wake of Uvalde’s Robb Elementary School shooting in which 19 children and two adults were killed by a teenager with an AR 15-style assault rifle.

Members of Moms Demand Action hold signs Wednesday, June 22, 2022, outside the Senate chamber in the Capitol in Austin before the start of a meeting of the Senate Special Committee to Protect All Texans. The committee was convened in the wake of Uvalde’s Robb Elementary School shooting in which 19 children and two adults were killed by a teenager with an AR 15-style assault rifle.

William Luther, Staff Photographer / Staff photographer

Gun violence, including many suicides, results from a number of factors — but “some include ‘toxic’ stress, persistent childhood adversity, and a frayed health and community safety net that leaves many children and families without the health care and social services they need to overcome them,” Floyd wrote.

Still, several people who testified Wednesday stressed that there is little evidence mental illnesses cause mass shootings or that people diagnosed with them are more likely to commit violent crimes. They also warned that blaming mental illness could stigmatize the wide range of people who live with psychological disorders.

“It’s very important that we all keep in mind that mental illnesses on their own do not cause violence. Violence itself is not a mental illness,” said Keller, though he noted “severe mental illness drives slightly more risk … for violence of any type, against self or others.”

An untreated psychosis, Keller said, makes someone 15 times more likely to commit murder.

“The wonderful thing about that statistic is treatment alleviates that risk,” he said. “So, these are treatable illnesses. They’re not the same as evil.”

Stephanie Chapman, a behavioral health psychologist at the Houston-based Center for Children and Women, said integrating mental health services into pediatric primary care “breaks down a lot of the stigma that keeps families from engaging in behavioral health care in the first place.”

“Most children and adolescents see their [primary care providers] at least annually, often many more times than that, and pediatric primary care providers are often the most trusted health authority that families engage with,” Chapman said.

One program established under a state-run child mental health consortium trains primary care doctors to treat mental health issues in young patients, though the initiative — like others enacted after Santa Fe — has been slowed by the COVID-19 pandemic.

The consortium also runs TCHATT — Texas Child Health Access Through Telemedicine — that provides virtual services to public school students who need mental health treatment. Texas currently spends $25 million annually to provide those resources to about 40 percent of the student body, and House Speaker Dade Phelan has suggested investing another $37.5 million each year to expand the services statewide.

In any case, recent consortium data indicates that few students are referred to the telemedicine care for harming others. About 41 percent are referred for anxiety, and another 34 percent for depression, while 17 percent were at risk of suicide and 14 percent self-harmed. None were referred for harming others.

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