“We have to do it now,” Rep. Tim Murphy said on the House floor, urging Congress to act on his mental health system overhaul legislation in the wake of another mass shooting.

That was two years ago. In December 2013, the Pennsylvania Republican introduced his comprehensive mental health bill — which has recently been lauded by top House Republicans, including Speaker Paul D. Ryan, as a potential response to mass shootings. It was near the first anniversary of the Sandy Hook Elementary School shooting in Newtown, Conn., where 20-year-old Adam Lanza killed 20 children and six adults.

For Murphy, a clinical psychologist, it’s unclear why his bill, which he reminds his colleagues of after the nation’s frequent mass shootings, hasn’t moved forward in Congress. “I’ve got a Ph.D. and I’ve practiced in this field for 40 years and I still can’t tell you why some people act the way they do,” Murphy said. “This is — to me it’s beyond comprehension.”

Cornyn Pushes Mental Health Measures in Wake of Oregon Shooting

Despite repeated and bipartisan calls for an overhaul, the legislation has faced roadblocks: navigating the complex mental health system, educating lawmakers about needed improvements and lacking specific, vocal support from leadership.

In March 2013, then-Speaker John A. Boehner, R-Ohio, said mass shootings typically involved someone with “severe mental health issues,” and he said committees would look into that area.

But, according to Murphy and other advocates, Ryan is the first leader in recent memory to publicly push for specific legislation.

The Wisconsin Republican and House Majority Leader Kevin McCarthy, R-Calif., have both pointed to Murphy’s bill amid growing pressure for Congress to take action on gun violence after recent shootings in Colorado Springs, Colo., and San Bernardino, Calif.

The position is not new for Ryan, whose own district was the site of a mass shooting in August 2012, when a gunmen o pened fire at a Sikh temple, killing six. In 2013, Ryan referenced the need to look into the mental health system in the wake of shootings, arguing that an assault weapons ban did not prevent the 1999 shootings at Columbine High School.

After the attack in San Bernardino, Ryan told CBS “This Morning” that, “We think that’s one of the most consistent and common themes, which are people with mental illness are getting guns and committing these mass shootings.”

Murphy said there has been “a sea change” since then. One caveat, though: Ryan implied the problem is that the mentally ill are “getting guns,” but Murphy’s bill does not address obtaining firearms.

A Different Response

“I’m uncomfortable having mental health framed as a response to gun violence because it risks drawing an inherent connection between mental illness and violence, which doesn’t exist,” Sen. Christopher S. Murphy, D-Conn., said. Murphy and Sen. Bill Cassidy, R-La., have sponsored a bill similar to the House legislation. A 2015 American Journal on Public Health report cited data from the National Center for Health Statistics showing that between 2001 and 2010, less than 5 percent of gun-related deaths were at the hands of people with a mental illness.

Paul Gionfriddo, president and CEO of Mental Health America, said gun violence and mental health issues do sometimes intersect, but not often.“[People] will just be disappointed if they think that reforming the mental health system is the single best answer to gun violence or keeping guns out of the hands of people with mental illness. … It’s just not,” Gionfriddo said.

The discourse surrounding gun violence, Gionfriddo argued, has to change so that the discussion is not about keeping guns out of the hands of the mentally ill, but out of the hands of people who are a danger to themselves and others. That includes a fraction of people with mental illnesses, but also expands to terrorists and criminals.Murphy also said the issues were separate, but his bill could lead to a decrease in overall violence by emphasizing early treatment.“The issue is not what’s in their hand, but what’s in their head,” Murphy of Pennsylvania said. “And that’s what we’ve tried to address all along here and get people to understand, to treat this as a brain disease and not as a political issue of what we’re doing about the Second Amendment.”

Although advocates and some lawmakers would like the two issues to be addressed separately, they acknowledge that shootings have given the mental health system much-needed attention. So, in Congress, the narrative persists.

Republicans argue the government must better enforce existing gun laws, and that mental health system changes could help better treat those with mental illness, and prevent the types of mass shootings such as at Sandy Hook or Virginia Tech.

Democrats tend to say mental health overhauls, while necessary, are an inadequate response to reducing gun violence. They say the GOP is pushing for mental health system changes because the public is pressuring Congress to take some action after these shootings, and they do not want to battle the National Rifle Association about changing gun laws.

“Fear of the NRA is greater than desire and willingness and fortitude to help the American people,” said Rep. Elizabeth Esty, D-Conn., who represents Newtown. “Congress should be able to walk and chew gum at the same time. So passing meaningful mental health reform would be a good thing to do. It does not begin to address most of the shootings in America.”

The NRA has backed one bill that includes a provision relating to firearm background checks for the mentally ill. Senate Majority Whip John Cornyn’s Mental Health and Safe Communities Act would, among other things, clarify language regarding the mental health records that are uploaded to national background check system and address the process to restore the ability to purchase a firearm.

Lawmakers are exploring the possibility of tying the Cornyn and Murphy bill together, which is drawing mixed reviews from mental health advocates.

“We know that there’s little consensus on the broader [gun control] issues. The issues addressed in Sen. Cornyn’s current bill are much narrower,” said Ron Hanberg, the national director of policy and legal affairs for the National Alliance on Mental Illness, which has endorsed Cornyn’s bill. “I don’t think Sen. Cornyn is trying to break any new ground here. I think he’s trying to make what is already law clearer.”

Others say inserting any legislation dealing with weapons into a mental health overhaul bill could complicate the overall effort.

“I do think the mixed provisions in Sen. Cornyn’s bill, because they’re specific to the gun background system, might actually make this more of a partisan issue,” said Amalia Corby-Edwards, a senior legislative and federal affairs officer with the American Psychological Association.

Aside from a potential complication with the Cornyn bill, Murphy’s legislation faces some roadblocks on its own. “[Murphy] is touting it as a bipartisan bill but it really isn’t,” said Rep. Grace F. Napolitano, D-Calif., chairwoman of the Congressional Mental Health Caucus. Murphy used to be her co-chairman, but she said the two of them barely met to work together.

Murphy contends he has conducted roughly 40 meetings with House Democrats this year, and met with Energy and Commerce ranking member Frank Pallone Jr., D-N.J., last week. But a contentious subcommittee markup of Murphy’s bill could foreshadow partisan divisions to come.

Pallone said at the Nov. 4 markup that Murphy had been unwilling to negotiate on some of the bill’s controversial provisions, and that Murphy had “launched some personal attacks” against some of the committee’s Democrats. Murphy, who had pictures of five victims from Sandy Hook on his office end table, said he is committed to moving forward.

“I will not yield on anything on this,” Murphy said. “We are going to drive this forward. … If people have better ideas, we’ll continue to entertain those in a bipartisan way. But we can’t give up.”

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