The H.R.137 Healthcare Bill and Legislative Process


The intersection of human rights, gun violence, and mental illness is one the most discussed topics in the US, where gun bearing is allowed in many states. Mass shootings that occurred in Newtown, Connecticut, in 2012, the Stoneman Douglas School shooting, and other similar cases signal about the need to introduce new policies to protect citizens (Philpott‐Jones, 2018). While Republican and Democratic leaders dispute about strengthening gun control laws, an improved access to mental health care is another solution that is expected to decrease gun violence. In this connection, it is important to explore the H.R.137 Bill that seeks to authorize funding for improving the access of mentally-ill individuals to relevant care services. This paper aims to understand the proposed legislation, discuss the legislative process, and form an opinion about its potential impact.

Proposed Legislation

“H.R.137 – To authorize funding to increase access to mental health care treatment to reduce gun violence” is proposed by the representative of Democrats from Texas (District 18), Sheila Jackson Lee. Currently, the bill is at the introductory phase, as it can be viewed on the Congress’ official website (“To Authorize Funding to Increase Access”, 2021). This bill places a particular emphasis on the protection and promotion of human rights, the strengthening and empowerment of civil society, and the necessity of primary care. The implementation of the bill will enable people with mental disorders to more easily access mental health and social support services. As a result, it is expected to decrease gun violence and avoid human victims. A better access to mental care implies being treated by qualified health workers in a general health care setting. It is also important to allow people with mental issues to participate in the organization, provision, and evaluation of services so that their needs are taken into account during care.

Speaking of the importance of H.R.137 to the nursing profession, it is useful to refer to the definition of mental health. It is a state of well-being, in which a person realizes his or her abilities can withstand the stress of life, work productively, and contribute to their community. In this positive sense, mental health is the foundation of human well-being and effective community functioning (Philpott‐Jones, 2018). The problems with mental health lead to numerous behavioral disorders that are dangerous not only for this person but also for people around. Nurses, who are at the forefront of the battle for a healthy society, are expected to help people with mental distress. They are the first who recognize the symptoms and potential negative outcomes that may occur. Therefore, to contribute to public health, nurses should be aware of the policies related to mental health support (American Nurses Association, 2015). More to the point, they are expected to evaluate the current state of public mental health and participate in a policy-making process.

Gun violence is a serious concern in the US, where mass shooting is extensively discussed in the literature. According to Odom-Forren (2016), “over 30,000 people in the U.S. die as a result of gun violence every year and another 60,000 are injured by guns” (p. 285). It is also found that suicide, homicide, and accidental shooting compose 88 percent of deaths daily (Odom-Forren, 2016). At the same time, the US holds the first place in the list of the high-income countries, the residents of which privately own firearms. This statistics means that the presence of firearms at homes is associated with an increased risk of gun violence of different types. As estimated by the Law Center to Prevent Gun Violence, the annual costs for gun violence in the US are $229 billion, which is $700 for every American (Odom-Forren, 2016). To compare, these costs are much higher than those for obesity that is considered another epidemic.

Personally, I consider that the level of mental health of a person at any given time is determined by numerous social, psychological, and biological factors. For example, violence and sustained socioeconomic pressures can be recognized as a risk factor for mental health issues, such as anxiety, depression, post-traumatic stress disorder (PTSD), bipolar disorder, and so on. Mental health problems are also associated with discrimination, social exclusion, and human rights abuses (Philpott‐Jones, 2018). In this connection, I am confident that a better access to mental care services can significantly reduce gun violence since people would receive the help they need. For example, some persons who initiated mass experienced bullying and discrimination, others suffered from relationship problems in their families. As a nurse, I am enthusiastic about helping the population to resolve their mental health issues so that they would not use firearms to harm themselves and others.

Investigation of Legislative Process

Legislations related to health care are started by lawmakers, who introduce the bill to the House of Representatives, which is further referred to the Senate. Legislative acts are the general basis for federal legislation, and nurses or other medical staff can act as information sources or promoters of a certain bill (Mason et al., 2020). The proposed legislation is to pass through Congress and be signed by the President. At the same time, if a President rejects a piece of legislation that has passed through Congress, it can still become law if two out of third members of each house of Congress vote to invalidate such a veto. The statutes and laws are published in the Code of Laws and codified in the United States Code.

Today, H.R.137 was introduced by the Representative Sheila Jackson Lee on January 4, 2021. To support her claim, the Representative clarified the clauses of the Constitution that allow for pursuing the given legislation. Namely, it meets the provisions of the Article I, Section 8, Clauses 1, 3, and 18 of the US Constitution (“To Authorize Funding to Increase Access”, 2021). The Committee on the Judiciary and the Committee on Energy and Commerce received the proposal to consider the issues that are within the jurisdiction of these committees. The period for the consideration of the proposal is to be identified by the Speaker. The mentioned action was taken by House of Representatives, which also means that it was introduced in the House.

The next phase of developing the legislation is passing in the House. When the committees release the bill, it would be put to be debated, voted, and / or amended. The necessary adjustments can be taken into account during the second or third readings. After passing in the Senate, it would be referred to the President for the final consideration (Mason et al., 2020). Ultimately, it is expected that the proposed H.R.137 bill would pass all the phases at the federal level within 2021-2022.

Opinion on Legislation’s Merit

There are policymakers and politics, who support the idea of ​​toughening checks against the buyers of weapons. In most cases, it is considered that the mass shooting is initiated by mentally-ill people. To solve this problem, the ex-president Trump proposed opening new psychiatric hospitals across the United States (Santucci, 2019). The main argument is that it is necessary to create new medical institutions of this type to provide assistance to mentally-ill people. In my point of view, this idea seems to be correct since people need professional medical assistance. However, I believe that the access to mental care should not only be provided in special facilities but also in hospitals, counseling centers, and other related organizations. For example, if a woman whose partner practices domestic violence is at a high risk of homicide, and the situation can be facilitated if they both would visit a psychotherapist, who would carefully evaluate their relationships and provide relevant help.

The review of the literature shows that the correlation between domestic violence and violence against children was established. Of all children who have suffered in one way or another from violence, 40 percent report the facts of violence in their home (Almış et al., 2020). Domestic violence also has a direct link with the problem of homelessness: 50 percent of homeless women and children fled from domestic violence, and it can be assumed that many victims of domestic violence would suffer from homelessness at least once in their lives (Almış et al., 2020). Domestic violence is a serious health problem as it significantly increases morbidity and mortality and increases the risk of negative health consequences, including mental disorders, chronic diseases and poor pregnancy outcomes.

Providing the victims of domestic violence with accessible qualified assistance, including medical examination and treatment, as well as legal and psychological assistance, will help increase the appeal of victims to specialized institutions for support. This increases their ability to cooperate with law enforcement agencies in criminal, administrative, and civil cases. However, psychologists, lawyers, and other professionals working with victims should have a good understanding of the dynamics of gun violence, being sensitive to the problem. Without the support and accompaniment of lawyers, most victims are unable to effectively participate in proceedings, including in relation to granting them a protection order or changing the conditions of its validity. The provision of such types of assistance can be carried out to federal and local budgets through funding from the state and / or through financing the non-profit sector.

It seems to be important to emphasize the role of a coordinated public response as one of the most effective measures to prevent and protect against gun violence. In particular, an interconnected network of services and counseling that can comprehensively respond to cases of gun violence, reducing and eliminating it in the lives of people, is required. One part of the system (for example, a lawyer) helps people receive the services from other parts of the system, including medical examination, psychological counseling, et cetera. On the contrary, in an uncoordinated system, the victims must seek help independently, reducing their chances of receiving real support. In this case, funding is necessary to formulate and design special instructions, programs, measures, and strategies, which are needed to effectively coordinate the actions of institutions within one sector and between different sectors, such as police, health care, social services, education.


To ensure that both people can refer to gun violence and their actual and potential victims would have the opportunity to prevent unwanted behaviors and recover, funding is needed. A better access to mental health services implies that


Almış, B. H., Gümüştaş, F., & Kütük, E. K. (2020). Effects of domestic violence against women on mental health of women and children. Psikiyatri Guncel Yaklasimlar, 12(2), 232-242.

American Nurses Association. (2015). Nursing: Scope and standards of practice (2nd ed.). American Nurses Association.

To Authorize Funding to Increase Access to Mental Health Care Treatment to Reduce Gun Violence. H.R.137, 117th Cong. (2021). Web.

Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (2020). Policy & politics in nursing and health care (8th ed.). Elsevier Health Sciences.

Odom-Forren, J. (2016). Gun violence: A public health and nursing concern. Journal of Perianesthesia Nursing, 31(4), 285-288. Web.

Philpott‐Jones, S. (2018). Mass shootings, mental illness, and gun control. Hastings Center Report, 48(2), 7-9. Web.

Santucci, J. (2019). Trump advocates for more mental health facilities to address gun violence. USA Today. Web.

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