Did mental health advocates win or lose re: Manchin-Toomey?

We can say with some confidence that the failure of Manchin-Toomey leaves things in the muddle much as they were. It is clear that M-T will not be the mechanism by which Congress will clarify the exception to HIPAA reporting restrictions for mental health records. Not that such a formal exception would really change much. The Obama administration has already made it clear its opinion that reporting of patients deemed dangerous to themselves or others is not restricted by HIPAA. So this doesn't change anything directly re mental health records.

BUT, unknown to many, M-T carried a load of double digit percentile penalties to disability funds given to the states and tribal governments if they didn't comply to meet reporting requirements. While it's unclear to me how many states, if any, would have resisted enhanced reporting, it's fair to say, T-M will not be the mechanism by which such penalties will be mete out.

The language of Manchin-Toomey promised to create more control of access of weapons to the 'seriously' mentally ill, it left the language of 'seriously' undefined. Indeed, it was so vague as to be inoperable. IMO the authors of the bill very much recognized that, as well as the realization that no one really has the capacity to predict, with any reliability, who might be such seriously mentally ill persons as to need to be denied possession or purchase of a firearm.

Consequently, the Manchin-Toomey amendment also created a joint commission of Congress to research and make recommendations for future federal action that might limit mass violence in America. The commission would have been empowered to contract expert research by mental health professionals (as well as experts in other professions). It's hard to know how such a commission would have played out with respect to future recommendations. But it's plainly evident that the public and elected officials currently think that psychosis is the most dangerous of mental illnesses with respect to gun deaths when, in fact, it is the most common of mental illnesses that is most related to gun deaths--depression. M-T will not be the means by which the public and Congress will improve their understanding of the role of mental illness and gun violence.

Finally, with M-T having failed, it will not be the means by which $100 million will be made available for improving reporting by states into the instant background check system. As persons with mentally illness are disproportionately more often victims of violence than the general population, the mentally ill may lose as much or more due to the continued gaping holes in the FBI's database than the general population.