President Donald Trump appeared to blame the Florida school shooting Wednesday on mental illness and promised to take action, although he did not give specifics.
In remarks from the White House, Trump said that he was “committed to working with state and local leaders to help secure our schools, and tackle the difficult issue of mental health.” Earlier in the day, he posted to Twitter calling alleged shooter Nikolas Cruz “mentally disturbed.”
Mental health advocates give the Trump Administration a mixed report card on mental health issues so far, however.
Trump has offered some support to mental health programs, including a proposal in his budget to spend $10 billion to address “opioids and serious mental illness.” That includes funding for block grants to allow states to address mental illness and new support for mental health measures supported by the medical community.
Read More: Transcript of Donald Trump’s Remarks on Florida School Shooting
But mental health policy experts say those proposals are a small piece of the puzzle and do not reflect the challenge Trump’s broader agenda could pose to mental health in the U.S. Perhaps most significantly, Trump has proposed cutting Medicaid subsidies by more than $1 trillion. More than 25% of non-elderly adults with severe mental illness received medical coverage through Medicaid in 2015, according to a report from the Kaiser Family Foundation. The administration has also called for cuts to funding for housing programs, which often help those with mental illnesses.
“We really need to look at the big picture,” says Ron Honberg, senior policy advisor at National Alliance on Mental Illness. “When you start peeling back the component parts, I can’t say that there’s been wholesale support.”
In one case, Trump also undid a measure explicitly designed to address gun violence from
Trump has also taken measures explicitly designed to address violence attributed to mental illness. In the early weeks of his presidency, he signed the repeal of an Obama rule that blocked gun sales to people determined to be “mentally incapable.”
The response to the shooting in Florida isn’t the first time Trump has shifted to talking about mental health in the face of mass violence. “I think that mental health is your problem here,” Trump said after a mass shooting in Texas that killed 26 people last November. After a man drove a truck into a bike line in New York City killing eight, Trump described the driver as a “very sick and deranged person.”
Research has suggested that link between mental health and mass violence to be less significant than often assumed. Not all, or even most, mass shooters are mentally ill. And, while mental health experts support a public discussion about mental health, they also warn that Trump’s willingness to jump to conclusions about mass shooters contributes to stigma surrounding mental health, making the problem worse.
“Using mental illness as a political football in the aftermath of tragedies — it hurts,” says Honberg.
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Write to Justin Worland at justin.worland@time.com