By Danielle Campoamor

The United States has a suicide problem — one we’re just now acknowledging on a national scale. According to the Centers for Disease Control and Prevention (CDC), nearly every state in the country has experienced an increase in suicide deaths over the last 20 years, half by as much as 30%. The recent deaths of Kate Spade and Anthony Bourdain brought into stark relief the fact that we’re stuck in a cyclical response: reach out to friends, ask for help ourselves, and memorize the numbers for suicide hotlines. But if we are to eradicate death by suicide and support those with mental illness in a substantial way, we must elect politicians who not only understand mental illness but will pass commonsense legislation that will ensure mental health treatment is accessible and affordable for all of the reported 43.8 million Americans who experience mental illness every year.

President Donald Trump is not one of those politicians. In fact, his inability to understand mental illness; unwillingness to learn; dangerous, divisive, and judgmental rhetoric; and precarious policies have arguably made mental health worse for people across the country.

However well intentioned, our collective reaction to deaths by suicide and related issues are emblematic of not only our society’s myopic view on mental health care but also of the lackluster policies that have made that care difficult, if not impossible, to obtain. Those with the power to change health care seemingly refuse to acknowledge the ongoing care those with mental illnesses require and the need to eradicate the stigma associated with a mental health diagnosis and treatment. And now that we’re faced with a rising suicide rate, it’s vital that we take a look at the Trump policies and rhetoric that are adversely affecting people with mental health — and our society at large. How sick is this administration making us? Let’s see:

The Trump administration is defunding and weakening the existing mental health infrastructure.

In December 2017, the Department of Health and Human Services effectively froze a federal database of addiction and mental health treatments that, according to The Washington Post, helped “thousands of professionals and community groups across the country find effective interventions for preventing and treating mental illness and substance use disorders.”

The president’s proposed cuts to Medicaid and Medicare also pose a risk to those suffering from mental illness and substantially limit low-income people and people of color’s ability to seek mental health treatment when needed. According to Isha Weerasinghe, a senior policy analyst focused on mental health for the Center for Law and Social Policy, undermining Medicaid and Medicare will “deter states from providing depression screening and preventive services that maintain and improve mental health. This will be devastating for populations in poverty, particularly people of color, who are most likely to be insured by Medicaid, and would increase racial disparities of mental health.”

Most recently, the Justice Department has decided to back a lawsuit by a group of Republican attorneys against the Affordable Care Act. ABC News reported that the lawsuit could allow insurance companies to refuse coverage based on so-called preexisting conditions. According to CNN, one in two Americans has what was once considered a preexisting condition, includinganxiety, depression, and postpartum depression.

Trump falsely thinks mental health care is a way to catch criminals.

During a meeting with the victims of the school shooting at Santa Fe High School in Texas, Trump reportedly referred to the shooter as a “wacky kid” wearing a “wacky trench coat.” A mother of one of the victims challenged him on the dismissive language. And after the shooting in Parkland, Florida, the president described the shooter as being “mentally disturbed” but did not mention gun control. His comments were not only dismissive and short-sighted, but representative of a lasting mental health stigma that equates mental illness with violent behavior when data has shown that only 3 to 5% of violent acts are the result of a serious mental illness.

Even though Trump seems intent on vilifying mental illness as a scapegoat in the gun control debate, his actions run counter to that rhetoric. On February 28, 2017, the president cut a gun control regulation “aimed at keeping guns out of the hands of some severely mentally ill people,” according to CNN. (It should be noted that according to the National Alliance on Mental Illness (NAMI), people with mental illnesses are more likely to be victims of violencethan the perpetrators of it.) And just two days before the February 14 shooting in Parkland, Florida, the president and his administration introduced a 2019 budget that would cut a reported $665 million in spending from the Substance Abuse and Mental Health Administration and reduce the National Institute of Mental Health’s funding by 30%.

At a cabinet meeting following the shooting in Parkland, Trump said of the shooter, “You know, in the old days we had mental institutions. We had a lot of them. And you could nab somebody like this, because they knew something was off.” Yet what Trump either doesn’t know or refuses to acknowledge is that a reported 50,000 people received lobotomies from 1949 to 1952. These and other “treatments,” including insulin shock therapy, were considered “life sentences” for those suffering from mental illness, and the institutions themselves were often places of abuse, as The New York Times has reported.

If the stigma of mental illness and the decision to seek treatment has a birthplace, it was likely in an asylum, and the idea that we, as a nation, should simply send those with mental illness “away,” segregated from the rest of society, does nothing but reinforce that stigma in our already judgmental culture.

Racism like Trump’s affects the mental health of the marginalized.

The president’s xenophobic descriptions of anyone whom he considers to be “other” — especially Muslims, Mexicans, and immigrants seeking refuge in the United States — pose the most substantial threat to how we collectively view those who need our support, whether it be in regard to mental health or any other avenue of life. His public racism has not only coincided with a rise in hate crimes but is said to adversely affect the mental health of those he frequently targets. In 2016, a reported 3,000 therapists signed what they described as a manifesto calling Trumpism “a threat to the well-being of the people we care for.”

According to the American Psychiatric Association, “repeated traumatic interactions can result in the reduced self-esteem and internalized hatred.” Not only does racism negatively impact the mental health of those targeted, but the rhetoric consistently regurgitated by the president reinforces the idea of the “other” and urges us all not to care about those we do not know. And while it might not be as obvious as calling for the reinstatement of so-called “insane asylums,” his divisive comments about mental health make caring for the mentally ill, and those who die as a result of mental illness, seem unnecessary and even irrational. Sentiments like “Why should we let ‘them’ come into our country?” and “Why should we care about other families before our own?” can quickly devolve into “Why do we care that someone died?”

The Trump administration’s decision to separate migrant children from their parents is also causing long-lasting emotional and mental health damage. According to a statement from the American Psychiatric Association, “Any forced separation is highly stressful for children and can cause lifelong trauma, as well as an increased risk for other mental illnesses, such as depression, anxiety, and posttraumatic stress disorder (PTSD).” More than 600 migrant children were taken from their parents last month alone, according to NPR.

There’s a long-term danger in Trump’s policies and rhetoric.

Throughout Trump’s presidency, he’s seemingly exhibited a desire to create a distance between us and those with whom we share this country and this planet. His words and actions target, question, and attack our empathy, challenging us on our sense of community and torching our sense of togetherness. As a result, we could lose our collective willingness to help the one in five Americans suffering from a mental illness.

This country’s suicide rate is the highest it’s been in 30 years. According to NAMI, suicide is the 10th most common cause of death among adults, and the third most common cause of death among young people ages 10 to 24. Mental health stigma can and does deter people from seeking support, health, and treatment.

There is something we can do about it all, though, beyond sending a poignant tweet after a heartbreaking death. We can vote those who support Trump’s policies out of office. We can vote those who mirror his hateful rhetoric out of a job. And in 2020, we can vote Donald Trump out of the White House.

In their places, we can elect empathic leaders who not only understand the need for comprehensive, long-term affordable access to mental health care for everyone, but who understand that attacks on human rights impact the mental well-being of those targeted. Our lives are inherently political, and policies can, will, and do undoubtedly affect us on every level — especially our mental health.