ROBERT SIEGEL, HOST:
The man who killed 26 people at a Texas church on Sunday had escaped from a mental health facility five years ago. It happened while he was in the Air Force at a base in New Mexico. This first came to light today from a police report obtained by Houston television station KPRC. The report says that Devin Kelley suffered from mental disorders and was attempting to carry out death threats against his superiors. An official told NPR that Kelley had been confined by his Air Force commander prior to his trial on charges that he assaulted his wife and stepson. Kelley cracked the toddler's skull.
KELLY MCEVERS, HOST:
These revelations are now heightening the long-running debate about mental health and access to guns. President Trump weighed in earlier after Sunday's shooting, blaming the Sutherland Springs massacre on mental illness, not guns. Here's what he said in a news conference in Japan on Monday.
(SOUNDBITE OF PRESS CONFERENCE)
PRESIDENT DONALD TRUMP: Mental health is your problem here. This was a very - based on preliminary reports, a very deranged individual, a lot of problems over a long period of time. We have a lot of mental health problems in our country, as do other countries.
MCEVERS: So what is the Trump administration's record on mental health care? NPR health policy correspondent Alison Kodjak has been looking into this, and she joins us now. Hi, Alison.
ALISON KODJAK, BYLINE: Hi, Kelly.
MCEVERS: So I want to first just fact-check what the president just said and what other politicians have said, too, that there is this direct link between gun violence and mental health. What do the experts say about that?
KODJAK: Well, in fact, most mental health professionals would dispute what the president said in that press conference. I asked Bethany Lilly about that earlier today. She's with the Bazelon Center for Mental Health Law.
BETHANY LILLY: There is no real connection between an individual with a mental health diagnosis and mass shootings. That connection, according to all experts, doesn't exist.
KODJAK: Now, that's not to say that people who commit mass shootings never suffer from mental health issues. Clearly that's not the case. But research shows that people who are mentally ill, who suffer from something like bipolar disorder or anxiety, are no more likely than the average population to become violent. And in fact, people with mental illnesses are 10 times more likely to be the victims of violent crime.
MCEVERS: So what about the record of this White House on mental health? What did you find there?
KODJAK: Well, so that's an interesting question because one of the first things that President Trump did after he took office was to repeal an Obama administration rule that blocked gun sales to some people with mental health diagnoses. And as far as mental health care goes, the president record isn't very strong if you measure it by where he puts federal money. Again, I was talking with Bethany Lilly, and here's what she says about it.
LILLY: I think this administration's record on mental health has been abysmal.
KODJAK: She pointed above all to the president's support for the repeal of the Affordable Care Act.
LILLY: The Affordable Care Act was the largest expansion of mental health services in the past 30, 40 years.
KODJAK: And that's because the Affordable Care Act for the first time requires insurance companies to cover mental health care. And then beyond that, it expanded that insurance coverage to millions of people who never had insurance before.
MCEVERS: So a repeal of Obamacare could reduce access to mental health care. What other policies are being considered that might affect those who need mental health services?
KODJAK: Well, the biggest is tied to those - Affordable Care Act repeal, and that is proposed cuts to Medicaid that have been in all the health care bills that have been considered by Congress. These go beyond rolling back just the Medicaid expansion to reducing future Medicaid spending by hundreds of billions of dollars. Today, Medicaid pays for about 27 percent of mental health services, so cutting that much money is likely to take money away from the mental health care for the poor.
MCEVERS: That's NPR's Alison Kodjak. Thank you so much.
KODJAK: Thanks, Kelly.
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