After Aurora: Has mental health care improved?

Samantha Hunt, 19, holds her head before a vigil for victims of the movie theater shooting in Aurora, Colo., in July 2012.

On the first anniversary of the Aurora, Colo., theater shooting, has anything changed about the way we handle mental health care?

In the year since the Colorado movie-theater massacre that killed 12 and left 70 injured, the role of mental illness in mass shootings has jumped to the forefront of public debate.

But as Saturday brings the first anniversary of the Aurora shooting, how much has actually changed about the way our country handles mental health care?

Related: A year after Colorado shootings, Holmes still an enigma

After years of spending cuts, advocates say states and the federal government have moved to reinvest in programs for the mentally ill. And they say the Newtown, Conn., massacre forced action on the issue as much as the Aurora theater rampage did.

In Colorado, Gov. John Hickenlooper signed a bill in May providing nearly $20 million in new funding for mental health services. The state plans to use the money to establish walk-in crisis centers, a 24-hour mental health hotline and mobile units to provide on-the-spot mental health services. Though the Aurora shooting was not the only factor leading state lawmakers to push for mental health reform, it helped spur change, said Moe Keller, vice president of public policy for the advocacy group Mental Health America of Colorado.

“This has been the most productive year in terms of mental health services that I have ever seen in the state Legislature, and I’ve been there since 1992,” Keller said Wednesday. “We’ve had decades of reductions in funding. It’s been cuts, cuts, cuts. And this has been true across the country.”

On the national level, it was the mass murder of 20 children and six adults in Newtown, not the Aurora shooting, that has spurred policymakers to focus on mental health care, said Bob Carolla, a spokesman for the National Alliance on Mental Illness.

“Mental health was not really on the radar or the agenda,” Carolla said Wednesday. “Then Newtown happened, and the level of media attention and the level of public concern shifted exponentially.”

Colorado shooting: Family of the Aurora theater shooting victims at a prayer vigilReuters: Rick Wilking, File

Family members of victims killed in the Aurora, Colo., movie theater shooting grieve at a prayer vigil on July 22, 2012.

In January, just one month after the rampage at Sandy Hook Elementary School in Newtown, President Barack Obama added several mental health initiatives to his plan to reduce gun violence. They included placing as many as 1,000 more resource officers and mental health professionals in schools, “mental health first-aid” training for teachers and finalizing requirements in the Affordable Care Act for private health insurance plans to cover mental health services.

To pay for the initiatives, Obama’s budget proposal, announced in April, included $235 million in funding for new mental health programs. That funding has yet to pass, as budget battles loom in Congress.

Related: Obama says meaningful action will follow Newtown

As of February, state lawmakers nationwide had filed approximately 60 bills dealing with mental health matters, according to the National Conference of State Legislatures. Of those, 19 continued or created funding for mental health emergencies, beds for mental health patients or programs for adults and children. Another nine reinstated state funding for mental health and substance abuse programs.

Seven bills  one in Florida, two in Maryland and four in Minnesota  addressed security or mental health programs in public schools. And legislators in Utah proposed changes to the state’s involuntary commitment law.

By June, “nearly every state had proposed something related to some aspect of mental health services/providers,” Karmen Hanson, program manager for the National Conference of State Legislatures, said Wednesday.

In 2011, the most recent year for which data are available, an estimated 5 percent of adults in the United States, or 11.5 million people, suffered from a serious mental illness, according to the U.S. Department of Health and Human Services. Experts emphasize that the vast majority of people with mental illness are not violent.

States nationwide have cut funding for mental health care for many years, Keller said. Decades ago, as authorities moved away from committing the mentally ill to institutions, the public sector created programs to support the mentally ill in their communities. But over the years, budget cuts have chipped away at those programs, Hanson said.

“What we did was make our police departments the first responders for mental health, and we made jails and prisons the new institutions,” Keller said. “In my opinion, we are just starting to reinvest in the mental health systems that will keep people out of emergency rooms, out of police cars and jails, and out of prisons.”

Related: Colorado shooting suspect Holmes did it, lawyers say

Related: James Holmes to be restrained during Aurora trial

In addition to proposals to improve mental health care, some state legislatures have either passed or are considering measures to keep guns out of the hands of those with severe mental illnesses. Last month, Florida passed a law that requires people who volunteer for mental health treatment to give up their gun rights. State law had previously prohibited only those who were involuntarily committed from buying a gun. In Pennsylvania, a bill is pending to mandate background checks for all firearms purchases.

A bill that would have expanded background checks for gun purchases nationwide died in the Senate in April when it was opposed by 41 Republicans and five Democrats.

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