What Donald Trump’s Presidency Could Mean for Mental Health

Donald Trump is the President-Elect, and it is not good news for mental health care. Unlike Hillary Clinton, who had a comprehensive mental-health-care program as part of her platform, it’s difficult to discern what Trump’s plan is — or if he has one at all.

On his official campaign website, mental health is mentioned briefly. Trump will “reform our mental health programs and institutions” and support veterans “by addressing their invisible wounds,” increasing the “number mental health care professionals” and making mental health support available to veterans outside of Veterans Affairs.

Trump and surrogates for his campaign, such as Dr. Ben Carson and Chris Christie, have continually blamed gun violence on mental illness. During the third Republican candidates’ debate, in October 2015, Trump perpetuated an untrue and damaging stigma by conflating mental illness and gun violence.

“I feel that the gun-free zones and, you know, when you say that, that’s target practice for the sickos and for the mentally ill … they look around for gun-free zones” Trump said during the CNBC-moderated debate. “Gun-free zones are a catastrophe, they are a feeding zone for sick people,” Trump told moderators as he pointed to his head for emphasis.

Speaking to CNN’s Chris Cuomo on the phone in August 2015, Trump spoke briefly on the issue:

“Mental illness is a, just a, you know, massive problem, and as you know because of the cutbacks, and you can say it in New York state, you know it very well in New York State, they’ve released a lot of the people that are pretty ill that really should be hospitalized because they don’t have the money to take care of them. And, so they walk the streets and they’re on the streets and sometimes they’re in the workplace. And, you know in the old days they had mental institutions for people like this … So many people are being released now because they don’t have any money, so they’re walking the streets, of all our cities, of all our places. It’s becoming a very dangerous situation … This isn’t really a gun problem; this is a mental problem.”

Trump sounds nostalgic about the hospitals of yore that cared for people with psychiatric illness. The history of psychiatric institutions across not just the nation, but the world is quite horrifying. The first organized treatment center for the mentally ill in the U.S. opened in 1752 with the founding of the Quakers’ Pennsylvania Hospital. The basement had a couple of rooms with shackles on the walls to lock up the most severe cases. A popular pastime for townfolk was to visit that wing of the hospital and gawk at the patients.

Behavioral-based treatments began to spread in the 1950s, and with the discovery of new and safer drugs there was less need for institutions. State psychiatric hospitals across the United States were closed by decree of the Community Mental Health Centers act of 1963. People were released from institutions because mental health care improved. Large inpatient psychiatric institutions have closed their doors as part of a widespread and international deinstitutionalization movement. The field has become increasingly holistic and people with mental illness live normal, productive lives, thanks to new medications and treatment methods.

It was a lack of housing plans, follow-up care and community mental health plans that pushed many former patients to live on the streets. An estimated 33 percent of homeless individuals in the 1980s were living with severe mental illness. Instead of improving outpatient care, homelessness has remained a pervasive issue. Not to mention the rising number of mentally ill incarcerated in the prison system. It is a more complex debate than economics or a lack of places to hospitalize people.

The mentally ill are overrepresented amongst homeless adults. Around 46 percent of homeless adults in shelters have substance use disorders and/or severe mental illness. Contrary to Trump’s commentary, most of the crimes committed by people who are homeless are non-violent offenses, like not paying to get on public transportation or selling things on the side of the street without a license. Research published by the American Psychological Association found that there is no link between repeat criminal activity and mental illness.

Out of all the violent acts committed, 96 percent of them are not due to mental illness. People with mental health problems are likely to be victims of violent crime — over 10 times more likely. The four percent of violent crime that can be attributed to mental illness has been found to be correlated with people who were previously victims of violence prior to becoming violent themselves.

There is no marked difference when it comes to gun violence. Pew Research found that suicides account for 60 percent of gun deaths. If there is reason to restrict access to guns for people with mental illness, it is because of the higher possibility of suicide. Guns are the most common and deadly method people use to attempt suicide. The death rate of firearm suicide attempts is 85 percent. When someone survives a suicide attempt, 90 percent of the time they will not end up succeeding in the future.

There is a difference between mental illness and mental health. Just because someone is making bad choices, it doesn’t mean they have a mental illness. Labeling everyone who seems unbalanced as someone with a diagnosable mental disorder increases stigma for people who have mental disorders. When every greedy fame seeker is diagnosed by armchair psychologists as a narcissistic pathological liar, it does a disservice to the millions of Americans who experience mental illness every year.

According to the National Alliance on Mental Illness, 18.5 percent of the adult population in the U.S. experiences mental illness every year or 43.8 million people. When it comes to severe mental illness that “substantially interferes with or limits one or more major life activities,” 1 in every 25 adults are affected yearly. The solution to mental illness is not more institutions and mental illness is not the cause of gun violence.

Published first on Wear Your Voice Mag