The relationship between guns and mental health is much trickier than those who support gun control laws would have you think. First, most people who have mental health conditions are not dangerous. Second, singling out people with mental health conditions stigmatizes them, and could further harm their mental health. Third, requiring doctors to disclose to the state anyone who may have mental health conditions, with the consequence of depriving them of a civil right, may chill the doctor-patient relationship, and inhibit people who are in need of help from talking to a professional.
New York’s Safe Act requires doctors to report to the state anyone who is “likely to engage in conduct that would result in serious harm to self or others.” Then, as the NY Times reports, the state “rubber stamps” those names and puts them on a no-gun list, where they remain for 5 years. Any existing permit is immediately revoked, and all firearms are seized. Only after the permit is revoked–likely with no notice–can someone go to court and petition a judge to remove the name. Already, over 40,000 people have been added to this list. This program exacerbates all three problems I mentioned above.
First, as the Times (not me) explains, most people who are diagnosed with mental health conditions that may harm others are not dangerous.
But the number of entries in the database highlights the difficulty of America’s complicated balancing act between public safety and the right to bear arms when it comes to people with mental health issues. “That seems extraordinarily high to me,” said Sam Tsemberis, a former director of New York City’s involuntary hospitalization program for homeless and dangerous people, now the chief executive of Pathways to Housing, which provides housing to the mentally ill. “Assumed dangerousness is a far cry from actual dangerousness.” …
Mental health professionals and advocates point out, however, the vast majority of people with mental illnesses are not violent. Accurately predicting whether someone will be violent, they said, is also a highly fraught process.
Second, singling out these people may frustrate their treatment:
Similar laws in other states have raised the ire of gun rights proponents, who worry that people who posed no threat at all would have their rights infringed. Mental health advocates have also argued that the laws unnecessarily stigmatized people with mental illnesses.
Third, making the doctors must-reporters means the doctor-patient relationship will suffer:
Several mental health experts said the data obtained by The Times renewed their fears that the reporting requirement would discourage patients from seeking help.
“The threshold for reporting is so low that it essentially advertises that psychiatrists are mandatory reporters for anybody who expresses any kind of dangerousness,” said Dr. Mark J. Russ, director of acute care psychiatry at Zucker Hillside Hospital in Glen Oaks, Queens, which has filed many reports to the state.
Finally, the process seems designed to maximize the number of people on the list, without any meaningful oversight.
Under the 2013 law, the reports prepared by doctors, psychologists, nurses and social workers are first sent to county officials. If they agree with the assessments, the officials then input the names into the state database. The information is retained for five years. If the authorities find a person in the database has a gun permit — necessary to purchase a handgun in New York — they are required to revoke the license and seize any guns. The people in the database are barred from obtaining a permit until their names are purged.
The way the law has played out, local officials said, frontline mental health workers feel compelled to routinely report mentally ill patients brought to an emergency room by the police or ambulances. County health officials are then supposed to vet each case before it is sent to Albany. But so many names are funneled to county health authorities through the system — about 500 per week statewide — that they have become, in effect, clerical workers, rubber-stamping the decisions, they said. From when the reporting requirement took effect on March 16, 2013 until Oct. 3, 41,427 reports have been made on people who have been flagged as potentially dangerous. Among these, 40,678 — all but a few hundred cases — were passed to Albany by county officials, according to the data obtained by The Times.
As of Saturday, the state updated the database to 42,900 reports, and said that roughly 34,500 of those were unique individuals. The rest of the names were duplicates because people had been reported more than once.
One such state officer admits that he is just the “middleman” and he doesn’t even read most of the applications.
Kenneth M. Glatt, commissioner of mental hygiene for Dutchess County, said that at first, he had carefully scrutinized every name sent to him through the Safe Act. But then he realized that he was just “a middleman,” and that it was unlikely he would ever meet or examine any of the patients. So he began simply checking off the online boxes, sometimes without even reviewing the narrative about a patient.
“Every so often I read one just to be sure,” Dr. Glatt, a psychologist, said. “I am not going to second guess. I don’t see the patient. I don’t know the patient.” He said it would be more efficient — and more honest — for therapists to report names directly to the Division of Criminal Justice Services, which checks them against gun permit applications.
This is hardly consistent with due process, as serious deprivations of civil rights are being made without eventt he care of checking the decision of a doctor to report. And remember, the individual receives no notice in advance.
I also don’t have much faith in the New York judiciary, if this example is indicative of how courts treat revoked permits:
Patients can challenge the revocations of their gun permits in court, and at least one has: a man in Otsego County, in central New York, who lost his gun license after being admitted to a hospital because he had threatened to harm himself, according to court papers. He also said he had accidentally exposed himself to a young girl and was racked with guilt. The county judge ruled the license could be revoked.
Supporters of this law will say something to the effect of, if a single live is saved, then this law is worth it. See the Brady Campaign:
Gun control supporters argue a wide net is appropriate, given the potentially dire consequences. Even if just one dangerous person had a gun taken away, “that’s a good thing,” said Brian Malte, senior national policy director of the Brady Campaign To Prevent Gun Violence.
I don’t accept this calculus. As I’ve documented elsewhere, the number of mass shootings by people with diagnosed mental health conditions is extremely small. The overwhelming majority of gun violence is by people who have never been diagnosed by mental health professionals. Extreme steps are being taken that can deprive thousands of people of their rights of due process, to say nothing of the Second Amendment, with the slim chance of possibly keeping a single gun out of the hands of someone who may be dangerous.