In a recent speech titled “Accelerating Medical Treatments for Serious Mental Illness,” the White House outlined an executive order aimed at speeding up research and access to psychedelic drugs as potential treatments for serious mental illnesses. The speech targets those concerned about high suicide rates among veterans and individuals with severe mental health conditions, employing rhetorical techniques such as appeals to authority and loaded language to emphasize urgency and legitimacy.
Tactics to analyze
Direct Quote: “Indeed, the Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to specific psychedelic drugs, and there are numerous products currently in the clinical trial pipeline for review of safety and efficacy.”
- Technique Name: Appeal to Authority
- Explanation: By referencing FDA designations, the speech aims to lend credibility and legitimacy to the use of psychedelic drugs as treatments. This technique leverages the authority and expertise of regulatory bodies to persuade listeners that the proposed measures are scientifically sound.
Factual context
Claim verification: “The FDA has granted Breakthrough Therapy designation to specific psychedelic drugs”
This is factually accurate, and there’s a clear, documented list. As of March 2024, the FDA had granted Breakthrough Therapy designation to five psychedelic or psychedelic-adjacent drugs: Phillipslytle
There is an important thing to note about the Executive Order’s phrasing though. It talks about ibogaine separately, but close to the statements about the FDA designations without specifying which drugs actually hold them. It would be easy to assume that ibogaine was one of the drugs on the list from the FDA. But ibogaine is still classified as a schedule I controlled substance with limited human research.
The executive order also goes on to cite breakthrough therapy designations as evidence that there is some promise in the research of these drugs for treatment of PTSD and other serious mental illnesses. But the most advanced candidate (MDMA for PTSD), ended up getting overwhelmingly turned down, receiving a 9-2 against vote on efficacy, and a 10-1 vote against on risk-benefit analysis.
Direct Quote: “Critically, veterans often suffer in greater measure from this tragedy.”
- Technique Name: Loaded Language
- Explanation: The use of emotionally charged words like ‘tragedy’ emphasizes the severity and urgency of the issue for a specific group (veterans). This technique aims to evoke strong emotional responses and highlight the seriousness of mental health crises among veterans.
Factual Context:
The executive order claims that veterans “suffer in greater measure”. This is well supported by data. The EO states that the veterans suicide rate is “More than twice as much as the non-veteran adult population”. This is supported by the unadjusted data. That states that the suicide rate for veterans was 34.7 per 100,000 in 2022, compared to 17.1 per 100,000 for non-veteran U.S. adults. Thats from the VA.
As with many statistics though, there is a nuance worth digging into a bit. The veteran population tends to skew toward older males. Both older males, and veterans have a higher baseline suicide rate. When researchers adjusted the data for age and sex, the gap narrowed considerably. After adjustment, the suicide rate for male veterans was 44% higher than for nonveteran men (42.7 vs. 29.6 per 100,000) RAND. And the overall adjusted rate of suicide is 1.5 times higher among all veterans and 2.1 times higher among female veterans compared with the general population PubMed Central.
So, the wording in the EO, “More than twice” is technically accurate, but is using the unadjusted numbers, it happens that the unadjusted numbers are more dramatic, and of course still technically accurate. Its fair to say though, that 1.5x (the adjusted rate) is still a serious difference between veterans and non-veteran adults. This is a classic example of choosing the statistic that tells the best story, without being technically wrong.
There are also some useful bits of data we can look at around veterans access to mental health care.
Military culture promotes inner strength and self-reliance. This can contribute heavily to a stigma around mental health issues. National survey data indicates that while approximately a quarter of veterans screen positive for probable mental health or substance abuse disorder, fewer than a third of those veterans report mental healthcare utilization.
One in five veterans report unmet mental health needs, with barriers to access, concerns about treatment effectiveness, and of course the stigma mentioned above. 25% dont even know where to find care, and 40% doubt the effectiveness of services. (From the NY Health Foundation)
A GAO report found that only 21% of veterans in rural areas used VA outpatient services, compared to 79% in urban areas (Mission Roll Call). And the mental health worker shortage is more pronounced for veterans in rural areas where there are fewer providers, and even telehealth can be problematic due to limitations in internet infrastructure.
Long wait times have plagued the VA system for years (MIssion Roll Call), and the disability claims backlog has left veterans waiting for benefits they need, historically.
Veteran suicide is in fact a problem, the data confirms it. But this executive order is using the most dramatic picture the data supports. The barriers to access to mental healthcare are also significant here. This shows that other improvements could be made to the system.
Direct Quote: “Biden Administration’s prolonged shutdown” (Implies that the Biden administration is responsible for hindering progress, suggesting incompetence or malice.)
- Technique Name: Addressing Partisan Concerns
- Explanation: This rhetorical move aims to deflect criticism by attributing delays or setbacks to external factors rather than internal policies. By framing challenges as a result of broader issues like the pandemic, it seeks to maintain support among those who might otherwise criticize the administration’s handling of mental health initiatives.
Factual Context:
This phrase attempts to cast the blame of the pandemic related shutdowns on Biden and his administration. The actual timeline and actions tell a different story. The COVID-19 pandemic started in early 2020, while the first Trump administration was still in office. The federal government manage the development of several vaccines for COVID-19 through Operation Warp Speed, in 2020. Distribution of the vaccines was then overseen by the Biden administration during 2021. As vaccines rolled out, pandemic related restrictions started to end.
The bulk of the shutdowns, that closed businesses, schools, and disrupted our lives, those happened in 2020, under Trump. Trump was the one who declared a national emergency in March of 2020, and told Americans to avoid gathering in groups of more than 10, stop eating in restaurants, and taking non-essential trips for the next 15 days. That is the closest the federal government came to calling for a nationwide shutdown.
The federal government never issued a national lockdown order under either Trump or Biden. Between March and April of 2020, 43 governors issued orders directing residents to stay at home, and non-essential businesses to close. All of the democratic governors, and many (16 of 26) of the republican governors chose to issue stay-at-home orders. The lockdowns were a state thing, not a federal one.
By the time Biden took office, most of the state-level shutdowns were already done, and lifted. The first real pandemic related non-pharmaceutical intervention method that the biden administration made was to gently recommend that the states did not lift their mask mandates or business restrictions. Biden’s direct mandates were mainly around mask mandates on federal property, and public transit, and testing requirements for travel, and of course vaccine distribution.
Getting back to mental health treatment research and care. The pandemic did in fact disrupt researcha nd care delivery, but this was due to cuts across both administrations. In early 2021, more than a thousand trails were listed as suspended on clinicaltrials.gov. Mostly due to the pandemic. But those suspensions began in 2020.
The COVID-19 pandemic has directly impacted psychiatry practice and subsequent referrals to clinical trials. Delayed progress of clinical research for depressive disorders is particularly concerning, as the percentage of US adults reporting recent depressive symptoms increased significantly during the pandemic. NCBI So, demand for mental health treatment picked up, while the research capacity shrank.
So, when reading this statement, pushing the blame on Biden, that those were state-level actions, not mandates from the Biden administration. It’s also ignoring the Trump-era timeline at the start of the pandemic. The word “Prolonged” is a bit loaded. Biden’s admin mainly focused on vaccines and their distribution, masks on federal property, and travel requirements. They didn’t order businesses shut down, that was state-level. So in short, this is a real issue, but it wasn’t all on Biden, this was a bipartisan reaction to the most widespread global health crisis in living memory.
Closing
In closing, I would just like to summarize, because I do think that the mental health of veterans is a real issue here in the US. Veteran suicide rates are higher than the average adult, but the words chosen by the President paint a skewed picture based on some of the data, not all of it. It is important to have all of the facts. And research was paused around the pandemic, but to blame Biden is simply not fair, actions were taken by both parties during the pandemic to get the country through a very difficult time. Thank you for reading.
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