Even before word came of the latest mass shooting in San Bernadino, California, lawmakers were talking about guns and mental health.

It's hard not to.


Speaker Paul Ryan this week said he wanted to push ahead with a mental health overhaul making its way through the House.

An odd couple pair of senators have been building support for a similar, less controversial, initiative in the Senate.

Nobody thinks a mental health bill, no matter how bipartisan or well-crafted, will magically make the violence disappear. And advocates worry that linking mass shootings and mental illness will add to the stigma that already haunts the mentally ill, the vast majority of whom are not violent.

But across the spectrum, lawmakers acknowledge that the mental health system in American needs to be fixed. And that some of the perpetrators of mass shootings have serious mental illness — and easy access to guns.

But again and again, when they try to fix mental health care, they get stuck — often because of the volatile politics of gun ownership in America.

It may be happening again.

The Senate’s No. 2 Republican, John Cornyn of Texas, has been working behind the scenes to drum up support for his own mental health legislation, which includes language endorsed by the National Rifle Association. He says he wants his bill — not the bipartisan one on track for consideration by a Senate committee early next year — to be "the engine that pulls the train" of mental health legislation.

Cornyn says his bill would boost the federal background check system to prevent guns from getting into the hands of those with serious mental illness. His critics say the legislation actually loosens restrictions on gun purchases, under the umbrella of mental health reform.

“The net effect of this bill would be to weaken, not strengthen, our background check system, and make it easier for people struggling with dangerous mental illness to legally access a gun,” said Mark Prentice, spokesman for Americans for Responsible Solutions, former Rep. Gabby Giffords’ gun control advocacy group.

Any push to include guns could create a wedge in the bipartisan coalition that has been working on a mental health overhaul — and trying to keep it separate from the background check fight that has divided Washington at least since the Columbine school killings in 1999.

Cornyn confirmed right before Thanksgiving that he’s talked to Sen. Bill Cassidy (R-La.), a sponsor of the main bipartisan mental health initiative, about packaging the two bills together. A Cassidy spokesman said at that time that Cassidy, who is a co-sponsor of Cornyn's bill, was “supportive” of that idea.

Asked on Wednesday about wrapping guns into mental health legislation, Cassidy said, "I think people may decide to do so, but if they decide to do so, it might rightly be seen as an attempt to defeat the legislation, not to advance the cause of gun control.” He did not specify what type of gun measure he would find counterproductive.

But Sen. Chris Murphy of Connecticut, Cassidy's Democratic partner on the bill gaining traction in the Senate and a progressive who is pushing separate gun control legislation, is not on board with incorporating Cornyn's measures.

“Ultimately, he believes the final product has the greatest chance of passage if it maintains its singular focus on mental health, rather than venturing into other complex issues,” Murphy’s spokesman, Chris Harris, said.

The motives and identities of the San Bernardino assailants are not yet clear, but after the shooting spree, Murphy showed his frustration. He tweeted that gun violence requires leaders to offer more than “thoughts and prayers” and in a statement he begged his colleagues to act.

“I can only pray that America’s leaders will do something — anything — that prevents more communities from knowing this sorrow. Congress’ No. 1 responsibility is to keep our constituents safe, and not a single senator or member of Congress can go back to their state this weekend and claim that they are doing their job,” he said.

The possibility of a schism arising from the Cornyn bill is disturbing both to mental health advocacy groups — many of which didn’t want to be quoted criticizing Cassidy or Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander (R-Tenn.) as they move the issue ahead — and to gun control advocates.

The most recent time the Senate tried to pass ambitious mental health legislation, after the 2012 massacre at Sandy Hook Elementary School in Newtown, Connecticut, sweeping proposals were whittled down. What was left failed when it was tacked onto a gun background check measure that was defeated on the floor in 2013.

Since then, neither the full Senate nor the House has considered comprehensive mental health legislation, although a few, more-modest initiatives have passed.

Neither the Cassidy-Murphy bill nor the House version — sponsored by Rep. Tim Murphy (R-Pa.) — is a done deal; there are plenty of disputes to resolve over patient privacy, court-ordered outpatient treatment and the price tag for an overhaul. But both pieces of legislation had begun to move as lawmakers looked for a way to respond to the mass shootings across the country.

Sen. Debbie Stabenow (D-Mich.), who has long advocated both mental health legislation and tougher gun laws, wants to keep the two initiatives separate. On mental health, she sees a chance at finding the common ground that’s so elusive in Washington. But not if guns are added to the mix.

“This is something that needs to be done and stand on its own,” Stabenow said.

Gun control activists say Cornyn's language allows for patients’ gun rights to be restored immediately upon their release from involuntary treatment. In addition, they say, it would narrow the definition of who is actually prohibited from buying a gun.

Cornyn's measure expands upon a grant program that gives incentives to states that share mental health records with the National Instant Criminal Background Check System, known as NICS. The goal is to prevent anyone who has been adjudicated by a court as mentally ill from buying a gun.

On its website, the NRA says Cornyn’s bill would “protect the Second Amendment rights of law-abiding citizens from continued bureaucratic abuse by the Obama Administration.” Under the system laid out in the bill, prohibiting someone from possessing a gun requires a “full hearing in which an individual has notice, the opportunity to participate, and the right to counsel.”

Cornyn's bill includes other mental health provisions, and he incorporated elements of Sen. Al Franken’s bill on mental health and criminal justice. But the Minnesota Democrat won’t back Cornyn’s legislation because of the gun element.

"We have issues with some language in the bill, so I am not signing on as a co-sponsor,” Franken said late last month.

The House bill by Rep. Tim Murphy does not include any language on guns. However Rep. Martha McSally (R-Ariz.) is pushing a companion measure to Cornyn’s bill, though it is unclear whether lawmakers will try to package the two together if Murphy’s bill makes it to the floor. His bill was approved by the House Energy and Commerce health subcommittee and is awaiting consideration by the full committee. While Murphy's bill has scant Democratic backing on that panel, it does have support from several dozen Democrats in the House as a whole.

In his brief public comments on mental health, Ryan spoke about Tim Murphy's bill and didn't mention gun legislation.

How the simmering Senate fight plays out won’t be clear for some time, and other procedural pathways could emerge.

Alexander is leaving his options open — including opening the door to Cornyn.

“I expect to see the HELP Committee report additional legislation in the upcoming months,” Alexander said during a mental health hearing this fall. “Then we will see what other committees are doing, what the Judiciary Committee might be doing, what the Finance Committee might be doing on Medicaid and Medicare and see if putting all those together, we have a better coordinated response toward mental health.”