(NewsNation) — Republicans vying for the presidency have cited concerns about a national mental health crisis, calling for measures including involuntary hospitalizations, faith-based treatment and a shift away from pharmaceuticals.

Mental health often gets brought up in political rhetoric following multi-fatality shootings and high-profile criminal trials. It took center stage during the COVID-19 pandemic and has remained a key issue for presidential candidates on the 2024 campaign trail.

Former President Donald Trump is leading the polls in the Republican presidential primary, voter sentiment that was echoed in the latest NewsNation/DecisionDesk HQ poll released Monday. So far, he hasn’t participated in any primary debates or spoken formally about future policies surrounding mental health, aside from announcing a “plan to protect children from left-wing gender insanity.”

During the pandemic, Trump signed an executive order addressing what his administration called the negative impact of prolonged shutdowns on mental and behavioral health. He’s also pointed to mental health in response to calls for gun control after highly publicized deadly shootings.

“Mental illness and hatred pull the trigger, not the gun,” he said after the 2019 shootings in Texas and Ohio that left a total of 31 people dead.

Nikki Haley, former governor of South Carolina and UN ambassador, has similarly linked multi-victim shootings to mental health issues. The Republican presidential candidate has called for placing mental health counselors in every school and has advocated for improved access and insurance coverage for mental health care and addiction recovery.

“We have to make mental health a No. 1 priority because we are losing Americans every day because of a lack of care,” Haley said during a June CNN town hall.

Pharmaceutical entrepreneur and political newcomer Vivek Ramaswamy has emphasized faith-based treatments for mental health over medication.

“Stop pushing artificial pharmaceutical treatments & rely instead on faith-based approaches that restore purpose to people’s lives,” Ramaswamy posted on X.

He’s also been vocal about removing “violent psychiatrically deranged” people from communities and pushed for involuntary commitments to mental health facilities.

Ramaswamy has on several occasions said that being transgender is a mental health disorder — a statement that is not rooted in medical fact. The American Psychiatric Association revised its Diagnostic and Statistical Manual of Mental Disorders in 2012 and it no longer lists being transgender as a mental disorder.

Ramaswamy isn’t alone in calling for involuntary institutionalization. Following a pair of multi-fatality shootings at a bowling alley and a restaurant in Maine in October, Republican presidential candidate and Florida Gov. Ron DeSantis proposed similar tactics.

“I think what’s ultimately effective is holding people accountable, either through mental adjudication if they’re crazy or convicting them when they’re committing crimes,” DeSantis told CNN after the shooting.

DeSantis’ fiscal year 2023-2024 Florida budget includes more than $531 million in funding toward behavioral health services, including support for mental health treatment facilities, competency restoration services and enhancement of 988 Suicide and Crisis Lifeline services.

The language politicians use to talk about mental health can fight or reinforce stigma, said Scott Parrott, an associate professor in the Department of Journalism and Creative Media at the University of Alabama.

“This is an incredibly complex topic and there certainly are people who need serious help and institutionalized care, but just talking about it in this way — anytime you start talking with generalizations, it becomes dangerous and problematic,” he said.

Parrott helped study the words candidates used to talk about mental health during debates in the past two presidential elections and on social media.

Rather than discussing policy, politicians on both sides of the aisle typically used words associated with mental health while “slinging insults” at each other, Parrott said.

Candidates most often used “mental” followed by “crazy” and “insane,” according to Parrot and co-author Hailey Allen’s findings. Politicians also used other mental health-related words with terms including “crazies,” “crazy train,” “losing their minds,” “nutjobs,” “nuts,” “psycho,” “unhinged,” “wacko,” “moron” and “basket case.”

“You can take it with a grain of salt, but at the same time, when you belittle things like that, it can have some real-world impact,” Parrott said.  “You need to watch that, especially if you’re competing to become the leader of the free world.”

Mental health shouldn’t be a topic that only gets attention when it relates to violence, either, he said. A full picture requires a closer look at other contributing factors, some personal and others societal.

“You’ve got to check out the economy,” Parrott said. “You’ve got to check out employment. You’ve got to check out COVID. There are so many different things that can occur to affect people’s mental health, so it’s not that simple.”