Mental health experts warn of unintended consequences

Strav

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If there’s one thing Republicans and Democrats can agree on, it’s that mentally ill people should not have access to firearms.

But as lawmakers rush to restrict that access in the wake of recent mass shootings, mental health experts warn of unintended consequences: from gun owners avoiding mental health treatment to therapists feeling compelled to report every patient who expresses a violent thought.

“Many patients express some idea of harm to other people, everything from, ‘I wish I could rip my boss limb from limb,’ to, ‘I have a gun and want to blow that guy away,’” said Paul Applebaum, director of the Division of Law, Ethics, and Psychiatry at Columbia University.

Therapists usually interpret this sort of talk as part of the treatment process, experts say. But under a new law in New York, one of the strongest to be passed to date, therapists may feel compelled to report every instance of violent talk, lest they face legal consequences if something happens. And some say ordinary patients may wind up suffering the most.

“There’s one group of people who are gun owners who may reasonably or unreasonably think, ‘I’m not going anywhere near a mental health person, because if they misinterpret something I say as an indication I’m going to hurt myself or someone else, they’re going to report me and take away my guns,’” Applebaum said.


Several polls conducted since the shooting in Newtown, Conn., have found widespread support for new legislation that would restrict the possession of firearms by the mentally ill, as well as for increased government spending on mental health.

Federal law already bars the sale or transfer of firearms to a person who is known or thought to have been “adjudicated as a mental defective.”

In addition, at least 44 states currently have their own laws regulating possession of firearm by mentally ill individuals, according to the National Conference of State Legislatures.

But not enough states report their mental health data to the federal government, rendering the federal law largely toothless.
New York’s expanded gun law signed by Cuomo on January 15 goes further than most state laws in that it requires mental health professionals to report any person considered “likely to engage in conduct that would result in serious harm to self or others” to local health officials.

Those officials would be authorized to report that person to law enforcement, which could seize the person’s firearms.
Previously, New York judges could compel seriously mentally ill people thought to be dangerous to receive involuntary outpatient treatment.

“I see it very frequently,” Steven Dubovsky, a professor of psychiatry at the University of Buffalo, said of patients expressing violent fantasies. “You see people who struggle with anger or have violent thoughts, and if I thought they were going to act on it right away, I would stop them.”

“Now if you’re mistaken, you’re wrong about this, and you don’t report it, you could face criminal sanctions. I’m not taking any chances at that point,” Dubovsky said. That could encourage therapists to over-report, he said.

Rep. Rob Barber, who was critically wounded alongside Rep. Gabby Giffords, talks about his task force to provide advice on mental health issues to prevent gun-related violence.

There have been cases where better enforcement of laws already on the books might have helped avoid bloodshed, said Richard J. Bonnie, a professor at University of Virginia’s law school.

Bonnie headed a state commission on mental health law in the wake of the mass shooting at Virginia TechShooter Seung-Hui Cho, who killed 32 people and then himself at the university in 2007, should have been adjudicated as mentally defective following a special justice’s order issued two years before the shooting, Bonnie said.

Such a designation, properly reported, would have disqualified him from owning a gun under existing federal law.But that message never got passed on to the feds or Virginia Tech, Bonnie said.Shoring up the flaws in mental health reporting to the National Instant Criminal Background Check System – something Obama addressed in his proposals – would help prevent future mistakes, Bonnie said.

Obama also called for background checks to be required on all firearm purchases – currently only 7 states account for 98 percent of the names prohibited for reasons of mental illness in the NICS database

According to DJ Jaffe, executive director of the Mental Illness Policy Org, which advocates on behalf of the seriously mentally ill, all the talk of mental health and gun violence obscures a bigger issue – a nationwide struggle with how to care for the mentally ill.


“Most of the things they’re discussing are totally irrelevant to helping people with serious mental illness,” Jaffe said. “No one wants responsibility for the seriously mentally ill.”

Anger, violent thoughts: Are you too sick to own a gun? - U.S. News
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I can see how this will make things worse, which is often the case when politicians rush in and enact half thought "we need to do something" legislation.
 

Dilemma

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If there’s one thing Republicans and Democrats can agree on, it’s that mentally ill people should not have access to firearms.

Gee. I hope that collection of dimwit retards in
Washington didn't stay up all night coming up
with that one.

therapists feeling compelled to report every patient who expresses a violent thought
Therapists are part of the problem. Give them
a pill, send 'em home. Hey Dr. Nutsquash; if
you have a patient who is having violent thoughts
it's your responsibility to report it, not drop a Rx on
'em, send the bill and bring in the next person.
 

Deus Vult

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Gee. I hope that collection of dimwit retards in
Washington didn't stay up all night coming up
with that one.


Therapists are part of the problem. Give them
a pill, send 'em home. Hey Dr. Nutsquash; if
you have a patient who is having violent thoughts
it's your responsibility to report it, not drop a Rx on
'em, send the bill and bring in the next person.

Nice wide brush there
 

Dilemma

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Nice wide brush there
Maybe a bit. Do you think our kids are over
medicated? Do you think it's too easy to just
give them a pill and send them on their way?


Every other kid is ADD these days. Whenever Jr.
is acting up, he's ADD or some such thing. Solution?
knock it back with pills.

I personally don't subscribe to this notion. Some
good old fashioned PARENTING would probably go
a long way with a lot of these kids.
 

Deftone

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I'm thinking these drugs are a big part of the problem. Stop taking your meds and you go ape sh!t.

Recklessly prescribed by doctors, pharmaceutical companies are making a fortune. And you can bet politicians are making money of it as well.
 

Thumpalumpacus

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Does the New York law have a process in place for appealing the report of a therapist or other mental health professional?
 

ptate

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That'll be handy for the ones that actually report their mental health issues and have it recorded. What about the ones that don't and those little nasties like PMT, PND and temporary mental hang-ups...?
 

BillB1960

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Does the New York law have a process in place for appealing the report of a therapist or other mental health professional?

Shit Thump...the NY law doesn't even exempt cops from having more than 7 round magazines. Do you really think they thought far enough ahead for an appeal process for incorrect reports?
 

SteveGangi

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Gee. I hope that collection of dimwit retards in
Washington didn't stay up all night coming up
with that one.


Therapists are part of the problem. Give them
a pill, send 'em home. Hey Dr. Nutsquash; if
you have a patient who is having violent thoughts
it's your responsibility to report it, not drop a Rx on
'em, send the bill and bring in the next person.

On the other hand I could see Doctor Nutsquash or Doctor Gunhater reportig EVERYone too.
 

Thumpalumpacus

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Shit Thump...the NY law doesn't even exempt cops from having more than 7 round magazines. Do you really think they thought far enough ahead for an appeal process for incorrect reports?

I haven't read it and wouldn't know, ergo, my question.
 

BillB1960

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I haven't read it and wouldn't know, ergo, my question.

Actually it's pretty much standard practice that you are allowed to petition for relief from disqualification by some process or another so I would assume that this new law has that provision as well.

ETA: Here it is:

(2) The commissioner shall establish within the office of mental
45 health an administrative process to permit a person who has been or may
46 be disqualified from possessing such a firearm pursuant to 18 USC
47 922(4)(d) OR WHO HAS BEEN OR MAY BE DISQUALIFIED FROM CONTINUING TO HAVE
48 A LICENSE TO CARRY, POSSESS, REPAIR, OR DISPOSE OF A FIREARM UNDER
49 SECTION 400.00 OF THE PENAL LAW BECAUSE SUCH PERSON WAS INVOLUNTARILY
50 COMMITTED OR CIVILLY CONFINED TO A FACILITY UNDER THE JURISDICTION OF
51 THE COMMISSIONER, to petition for relief from that disability where such
52 person's record and reputation are such that such person will not be
53 likely to act in a manner dangerous to public safety and where the
54 granting of the relief would not be contrary to public safety. The
55 commissioner shall promulgate regulations to establish the relief from
56 disabilities program, which shall include, but not be limited to,
S. 2230 10 A. 2388

1 provisions providing for: (i) an opportunity for a disqualified person
2 to petition for relief in writing; (ii) the authority for the agency to
3 require that the petitioner undergo a clinical evaluation and risk
4 assessment; and (iii) a requirement that the agency issue a decision in
5 writing explaining the reasons for a denial or grant of relief. The
6 denial of a petition for relief from disabilities may be reviewed de
7 novo pursuant to the proceedings under article seventy-eight of the
8 civil practice law and rules.
 

Skintaster

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My feeling is that something WILL change, has to change really... At least that's how a majority of Americans are viewing "Society and guns" these days.

The guys that want things to stay the same, except for a bigger crackdown on criminals that are convicted of crimes using guns, are not being realistic. If enough of the population views guns as a problem, they may eventually be able to make life more difficult for law abiding, responsible gun owners.

The one thing all of these recent mass shootings have had in common is a mentally unbalanced individual who got hold of a gun. They don't even have "assault weapons" as the thing tying them together, as not all of these guys used semi automatic rifles.

So what's the reasonable thing to do?i think we need to completely reform the way mentally I'll people are handled in this country, and make it a lot harder for them to legally buy a gun. It won't stop the ones that steal one, but it would have stopped the others.

Also, there were warning signs with almost all of these guys. If you're seeing a psychologist, and are having "violent fantasies" or are threatening people, you definitely don't need to own a gun.if you're on certain kinds of meds, you probably don't need one either.

Yes, we should proceed carefully with this stuff, there would need to be an appeals process, and it should not be an agent of the state making those judgment calls, but trying to address guns and mental illness might be one of the few things that will actually work to a degree, and it would have the least adverse affect on the 2nd Amendment rights of responsible gun owners.

The thing is, the public really does want to see something done to address these mass shootings, and just claiming that nothing really needs to change won't stop them from passing something eventually. It would be better to acknowledge that there's a problem, and a lot of it concerns the mentally ill getting guns, rather than seeing draconian federal laws like the state laws we're seeing from places like New York.
 

FrankieOliver

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Bill, that's not the new law, is it...because section 400 which says essentially (must have been ajudicated/committed) is not new here and certainly not new for NICS.
 

Axis Bold As Fuzz

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I agree with Skintaster that change will come in some form. The people want something to be done, and I believe that the current administration feels compelled to actively try to pass something rather than simply condemn the instances and offer condolences. Functionally, I don't believe that anything can actually be done though. We may be able to technically make it harder for a mental ill individual to get their hands on firearms, but we cannot completely prevent it. Someone determined enough will always be able to find them. The shVtbird up in Webster NY (I used to live there), who ambushed the volunteer firemen was a felon who legally could not have purchased the firearms he used. Legislation did not stop him.
 

Thumpalumpacus

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Actually it's pretty much standard practice that you are allowed to petition for relief from disqualification by some process or another so I would assume that this new law has that provision as well.

ETA: Here it is:

I don't see an issue with that section of it, then.
 

Axis Bold As Fuzz

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I am ok with technically making it harder as well, but it wont stop it. Certainly we should try to fix an obvious problem, but there may not really be a solution. There are occasions when I believe that the founding fathers presumed a high degree of civic duty and mental stability to be present in the elected officials and citizens for whom they wrote the constitution. A degree that seems to have declined over time.
 

Thumpalumpacus

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I agree with Skintaster that change will come in some form. The people want something to be done, and I believe that the current administration feels compelled to actively try to pass something rather than simply condemn the instances and offer condolences. Functionally, I don't believe that anything can actually be done though. We may be able to technically make it harder for a mental ill individual to get their hands on firearms, but we cannot completely prevent it. Someone determined enough will always be able to find them. The shVtbird up in Webster NY (I used to live there), who ambushed the volunteer firemen was a felon who legally could not have purchased the firearms he used. Legislation did not stop him.

Understood. No one solution will effect a complete solution. No group of solutions will. That's no reason to eschew improvements, though.
 

coldsteal2

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I'm thinking these drugs are a big part of the problem. Stop taking your meds and you go ape sh!t.

Recklessly prescribed by doctors, pharmaceutical companies are making a fortune. And you can bet politicians are making money of it as well.

Its not the meds, its whey they stop taking them
that they can become dangerous.
You dont just STOP taking psych meds, thats when the
trouble happens.

They can help but going cold turkey causes even
worse phychosis.
 

Skintaster

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Nothing will entirely stop these mass shootings. One will pop up every once in a while no matter what safeguards are in place, but something that can possibly prevent one that doesn't unduly limit responsible gun owners is probably a good idea.

The Virginia Tech killer was a known crazy guy with violent fantasies. With better safe guards addressing the mentally ill, HE might have been stopped.

Thing is, mass shooters are almost always mentally I'll, and not run of the mill criminals. There's no profit motive in shootings a bunch of strangers, and the risk of walking away from them in one piece and free, are also pretty much nil.

It's almost ALWAYS the mentally ill doing these things.
 

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