Problems with mental health checks


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MuleRyder
December 31, 2012, 10:42 AM
Many people are suggesting mental health checks as part background checking for purchasing firearms. One of the problems with that some do not realize is the the HIPPA law. This is the privacy act to protect an individuals medical records and information. Mental health is included in the HIPPA act. Laws would have to be changed to allow this info to be shared. I think this would open up a whole nother can o worms. Who would decide what level of mental health problems would disqualify someone. Also, I think some mental health problems could classified as a disability, which would bring forth trouble with Americans with Disability Act.

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Neo-Luddite
December 31, 2012, 10:52 AM
There are exemptions for this sort of reporting in HIPPA ~ not really an issue. In many places the mechansim by practitioners is in place; the Fed Gov threw the states money on this a few years ago to mesh their system with the Fed Gov. Watch; EVERYONE with a mental hyccup will be on the 'no guns' list VERY soon; here in IL, practitioners are absolved by law from civil liability for reporting patients with issues they deem a problem. The climate is such, they'll be faxing everyone on prozac or vallium to Uncle Sugar.

holdencm9
December 31, 2012, 10:54 AM
I agree it is ripe with obstacles to figure out, but I'd personally rather see them tackle those obstacles (even if they fail) then simply take the knee-jerk reaction of banning evil black rifles and "hi-cap" magazines that shoot a type of bullet "that is only use is for killing people, not hunting or target shooting" etc.

Literally that quote I read in an online message board. Ugh.

As far as HIPPA, if a flag was just added to the NICS check such that no one knew what it was, it just flagged you, it would still protect privacy I think. The dealer would just say "you've been denied, sorry" and would not know it was for bipolar disorder or extreme schizophrenia. Just like now, they don't know if you get denied due to homicide or domestic abuse or drugs, AFAIK.

I also agree, there could be a problem being "where do you draw the line?" For instance, I have known a lot of people who have taken or considered taking drugs for depression. Sometimes it is temporary because of a hardship, but sometimes it is just the way people's hormones and internal chemicals are. They are never quite right without medication, but seem totally fine with them. So there would have to be some kind of law that makes it a crime to go off your mandated drugs...but that (as you say) is a whole other can o' worms. I don't believe you should be able to legislate what people do to their body. However I also definitely don't think someone who took depression meds in high school and is now 30 years old living a totally normal lifestyle, should be denied the RKBA.

It is a tough situation all around.

hso
December 31, 2012, 11:26 AM
You misunderstand the limits and exceptions to HIPPA. There is no real barrier to government looking for this information. The problem is finding it.

JohnBT
December 31, 2012, 11:44 AM
"the Fed Gov threw the states money on this a few years ago to mesh their system with the Fed Gov. Watch; EVERYONE with a mental hyccup will be on the 'no guns' list VERY soon"

Some states are still reporting NO mental health info to NICS. Quite a few report very little mental health info - less than 100 people.

Here's one of many articles on the subject - it turned up on the first page of a google search. The sources seem to all be using the same numbers from a government report.

www.npr.org/2012/08/16/158932528/states-arent-submitting-records-to-gun-database

"Since the shooting, Virginia has become a model, submitting more than 170,000 records of people with mental illnesses. But the Mayors Against Illegal Guns report shows 21 other states have reported fewer than 100 records."

John

Neo-Luddite
December 31, 2012, 08:07 PM
JohnBT: Well, I mostly know the details of the IL system ~ which was only inpatient mental (for most/all) loss of FOID card for 5 years AND reporting to Fed Gov. Now, since the 'new' system of reporting to Fed Gov was updated, ANY practitioner can send the paperwork off with basically no justification needed and no worry of civil liability. Hence, loss of gun rights pretty easily AND it is unclear if even after five years if the potential NCIS falg will come down. ANyway, this is JUST IL. The problem is larger and, in the broader sense, is (to me) aimed at adding more and more people to the 'no guns' list. So the best advice is to be careful and stay mentally healthy ~ whatever THAT might mean! Happy New Year!

9MMare
December 31, 2012, 08:35 PM
I think the only way to do it....and there's no comprehensive way...is for people to learn the signs and develop more awareness around identifying people at risk.

Students, parents, counselors, co-workers, teachers, any of us. We all need to learn what to look for. And I'm not sure there are 'lists' out there but they could be developed. We had guidelines when I worked in an HR dept.

Ragnar Danneskjold
December 31, 2012, 08:41 PM
I think the real problem is that by tying a bunch of negative things to whether one has sought mental health, you're just giving people on the fence a huge reason NOT to seek help.

If you truly want those with mental issues to seek out treatment, connecting it with things that could permanently ruin their lives is not a good way to go about it.

Jorg Nysgerrig
December 31, 2012, 08:44 PM
It's pretty much impossible to take any discussion of HIPAA seriously when no one in the thread has spelled it right. The privacy rule of Title II of HIPAA (like the rest of it) is a pretty convoluted thing to navigate and it is hard to make sweeping generalizations about what can and can't be done. The actual requirements are fairly short, but the documentation discussing their implementation goes on and on and on.

JohnBT
December 31, 2012, 11:01 PM
I had yearly training on it at work compliments of the state, the privacy part anyway. I have no idea why they didn't write the regs in simple, clear English.

1. Don't gossip about patients.
2. Keep files locked up.
3. Shred everything when you are finished with it.

WardenWolf
December 31, 2012, 11:07 PM
While I agree the mental health system needs to be fixed, we cannot have the Illinois system where any physician can simply file a report and have someone's rights yanked, possibly for life. There should be a system where a doctor must make a diagnosis that can then be legally challenged, including with second opinions from other doctors. One person's word should never be binding. A person MUST have the ability to get something like this overturned, and doctors performing these second opinions need to be held to a legal standard that they MUST recommend rights be restored if they cannot find valid reason to withhold them, thereby limiting the influence from a doctor's personal opinions on the matter.

ultramag44
December 31, 2012, 11:15 PM
Jorg said:
" The privacy rule of Title II of HIPAA (like the rest of it) is a pretty convoluted thing to navigate and it is hard to make sweeping generalizations about what can and can't be done. The actual requirements are fairly short, but the documentation discussing their implementation goes on and on and on."

I'm the HIPPA Coordinator in a Hospital. Jorg is right, there are so many exceptions on both the Federal and State level, it's mind boggling! Just few fast examples, in my state of Texas, The state health department, Adult Protective Services and State Parole get a blanket exemption to ALL HIPAA requirements. They can just call and say, "Send this." The client's only option is to hire an attorney to appear before a judge and and attempt a quash of the request (demand) of the agency, that is if the client even knows what the agency is up to. In over 10 years of doing this, I recall only 2 successful quashes. One woman was it tears begging us to ignore an agency request.

Despite what the law says in black & white, there are so many grey areas and each case is really quite individual. Everyday I have to make judgement calls. I apply the law as best I know how. Now I have managed to protect
and advocate for some folks. That's usually in ugly divorce cases where a spouse was trying to railroad the other person. If it's the government going after the information, they need a good lawyer!

Bottom line: Anything you tell your doctor or case worker, any tests you do, are not private. Electronic records, with requirements for on-line file sharing, being pushed by Obama, will be the nighmare of all record custodians!

Tim the student
January 1, 2013, 12:00 AM
There are about a million problems with involving mental health checks with a background checks, IMO.

michaelbsc
January 1, 2013, 12:29 PM
I think the real problem is that by tying a bunch of negative things to whether one has sought mental health, you're just giving people on the fence a huge reason NOT to seek help.

If you truly want those with mental issues to seek out treatment, connecting it with things that could permanently ruin their lives is not a good way to go about it.

Ding - Ding - Ding - Ding!!!!

We have a winner!!!!

There has been a push within the mental health community for parity in treatment coverage. Without it the whole problem is tougher.

This is partly why I keep advocating that those of us who are NRA members need to be hammering them to approach NIH, NIMH, the APA, and the APNA and offer to solicit funding. We want that medical community on our side searching for viable solutions that work for us as well as the patients.

Right now those organizations are either working against us or at best willing to let us drown without throwing us a lifeline.

If we become a source of funding for them we'll be a sparkle in their eye. And they'll find solutions.

MB

denton
January 1, 2013, 12:46 PM
Once we establish acceptable mental health as a condition to possess a firearm, just think of the other places we could apply the same requirement:

Voting

Holding public office

Serving on a jury

Writing for a newspaper

Peacefully assembling

Speaking in a public place

Keeping and bearing arms is no less a protected right than any other. The Constitution sets boundaries in how far we can go to solve our problems. As Scalia noted in Heller, certain options are off the table. We have to find ways to solve problems within the bounds that are constitutionally set. If we want to apply a mental health standard to possessing a firearm, then we have to equally consider the same requirement for other rights.

gulogulo1970
January 1, 2013, 01:01 PM
The problem is that it is much easier to ban guns than to know if someone is mentally unfit to own guns. It is a problem, I don't have an answer.

Sniper66
January 1, 2013, 01:19 PM
Until this week, I have been a practicing mental health professional since 1973. I retired from a career as a psychologist and licensed clinical psychotherapist that spanned nearly 40 years of work in hospitals, community mental health facilities and jails in 2 states, Kansas and Missouri. So I can tell you from a wealth of experience that the only predictor of future violence is a past history of violence, regardless of reported or perceived mental health problems. Profiling people with reported or perceived mental health problems would be no more effective than profiling vets, republicans, or gun owners.

Manco
January 1, 2013, 01:51 PM
While I agree the mental health system needs to be fixed, we cannot have the Illinois system where any physician can simply file a report and have someone's rights yanked, possibly for life.

That's right, for example there is no telling how many physicians have the developmental disorder known as hoplophobia, which can cause severe bouts of irrationality that may negatively impact their job performance in this area.

The problem is that it is much easier to ban guns than to know if someone is mentally unfit to own guns. It is a problem, I don't have an answer.

The answer is to do nothing (that we aren't already doing). Seriously. Sometimes stuff happens, and taking people's rights away won't change that (we should first try to actually enforce the laws that are already in the books). If human beings can cope with the knowledge that we're all going to die someday, then we can cope with the fact that some of us will get killed early. Adults who cannot should seek professional counseling for their inability to cope with these basic facts of life.

The only way to improve our chances without destroying our freedom is to develop the ability to defend ourselves (on a voluntary basis), and firearms are the most effective tool for this purpose. Even then, there are no guarantees, but such is life.

9MMare
January 1, 2013, 02:06 PM
Until this week, I have been a practicing mental health professional since 1973. I retired from a career as a psychologist and licensed clinical psychotherapist that spanned nearly 40 years of work in hospitals, community mental health facilities and jails in 2 states, Kansas and Missouri. So I can tell you from a wealth of experience that the only predictor of future violence is a past history of violence, regardless of reported or perceived mental health problems. Profiling people with reported or perceived mental health problems would be no more effective than profiling vets, republicans, or gun owners.

Thank you for sharing this.

Manco
January 1, 2013, 02:21 PM
So I can tell you from a wealth of experience that the only predictor of future violence is a past history of violence, regardless of reported or perceived mental health problems.

That's what I've always heard from other psychologists, as well as law enforcement, so there's a pretty good chance that there's something to it. Then once in a while we'll get blindsided by somebody's first act of violence, which is generally unpredictable. Oh well, that sort of thing will happen.

By the way, perhaps I was being a bit extreme earlier about doing or changing nothing. We could, for example, address the real heart of the issue, which is of course how the media provides incentives for people to commit mass murder instead of mere suicide. Potential mass murderers feed off of the intensely melodramatic and omnipresent media coverage of mass murders, as well as the exaggerated outpouring of grief by the public and politicians. Hundreds of children are killed every year in other ways without presidents squeezing out tears on television, but for some reason mass murder incidents are given special treatment.

As with terrorism, modern media provides much of the incentive for committing acts of increasingly spectacular violence. Then of course the media blames everything and everybody else, including, of all things, inanimate tools. Mass murders are definitely not tragedies for their ratings, I can tell you that. Politicians find them useful, too, because they offer so much opportunity for the manipulation of the public.

TurboFC3S
January 1, 2013, 02:32 PM
The biggest problem is that it would still in all cases be a human judgement decision. Do you or anybody else entrust another person, likely a bureaucrat, with safeguarding your 2nd ammendment rights?

gbran
January 1, 2013, 02:33 PM
Who would decide what level of mental health problems would disqualify someone.

The gov't. at their whim.

Zardaia
January 1, 2013, 02:38 PM
My biggest concern is what becomes the determining factor for denying a purchase or taking what's already owned. Troops could easily find themselves prohibited for a ptsd diagnoses even if they're no threat to themselves or others. Alot of people that could use some help in early stages before they get worse may be/already are hesitant to talk for fear of loosing there firearms. Story awhile back a vet calls hotline, tells operator he has gun in the house and a SWAT team storms the house. Yes mental health is important, but if the antis write the legislation youre 2A'll be gone at the first HINT.

22-rimfire
January 1, 2013, 02:47 PM
I think the only way to do it....and there's no comprehensive way...is for people to learn the signs and develop more awareness around identifying people at risk.

It would be the equivalent to "Just Say No" approach. That would be a good start, but there would have to be mechanisms in place to deal with the identified mental issue (like cost) and at what point is this information given to the government.

That all goes out the door with ObamaCare. Everything will be given to the government which is one of my biggest objections to the program other than essentially forced use and compliance.

John BT... the shred everything approach is good except that the information is already provided electronically to the health insurance companies and eventually to ObamaCare. There won't be much relevant information to "shred".

JohnBT
January 1, 2013, 04:43 PM
"There should be a system where a doctor must make a diagnosis"

A doctor? A plain old doctor? Oh god no. An M.D. - a doctor - has had little or no specialized training in psychology or psychiatry.

To be a psychiatrist, first you finish medical school and become an M.D. THEN you do at least 4 more years of psychiatric training.

And I don't want foot doctors, eye doctors and allergists and making psychiatric diagnoses for some government system.

B!ngo
January 1, 2013, 04:53 PM
Though doubtlessly well-intended, this post is troubling. The more that 'being identified' as a person with his/her mental health in question having ramifications that include a limitation of their future rights or opportunities, the more dangerous are the ramifications of reporting.
On the surface, taking action to report someone, a friend, acquaintance, an office-mate or co-worker seems like a generous and helpful action. But if the reported's records become forever tarnished, as they are likely to be after being reported, the costs of such actions is non-zero.
Will there be lawsuits pursued against those who report another and, in doing so, negatively affect a persons life? A pilot acting oddly at an airport bar. A quick phone call by another of the bars patrons and zap, a career ender.
Perhaps I'm just looking at the corner cases and in doing so, indicting an otherwise good idea.
It's all so complicated.
V

I think the only way to do it....and there's no comprehensive way...is for people to learn the signs and develop more awareness around identifying people at risk.

Students, parents, counselors, co-workers, teachers, any of us. We all need to learn what to look for. And I'm not sure there are 'lists' out there but they could be developed. We had guidelines when I worked in an HR dept.

B!ngo
January 1, 2013, 04:56 PM
But if a doctor can prescribe for depression or other medical disorders, don't they implicitly have the right? I'm not sure I would seek a mental diagnosis from my foot doctor, but a GP is often most informed, of not most qualified, to diagnose such issues in that they see and know a patient over many years. And they certainly do prescribe such Rx's. Just a plain old doctor.
V

"There should be a system where a doctor must make a diagnosis"

A doctor? A plain old doctor? Oh god no. An M.D. - a doctor - has had little or no specialized training in psychology or psychiatry.

To be a psychiatrist, first you finish medical school and become an M.D. THEN you do at least 4 more years of psychiatric training.

And I don't want foot doctors, eye doctors and allergists and making psychiatric diagnoses for some government system.

nyresq
January 1, 2013, 07:06 PM
there are several exceptions to HIPAA when it comes to public safety... IE person with sevear comunicable disease like ebola or bubonic plague can have their name and information sent to police if they leave a hospital against medical orders for quarantine etc... Some one who has been deemed a danger to themselves and others could be put on a list that would be checked by NICS, and that would hold them up on a purchase until it could be investigated further.
The system is already in place to make this happen, it would just take the OK to start doing it. The CDC has had it in place working for years with comunicable diseases and notifications worldwide.

browningguy
January 1, 2013, 07:24 PM
It appears to me, based on many of the posts in this thread, that our 2nd Amendment is going to be effectively lost. Apparantly we (gun owners) can't even agree to keep firearms out of the hands of the insane, instead we come up with a lot of arguments about why it would be difficult, who's to say, how to protect the rights of the insane.

As one of the earlier posts alluded, it just seems we are going to make it easier to simply say "that can't be done" so we'll just ban what we don't want. I guess we can keep taking these discussions to their farthest, most illogical conclusions, just as an exercise in futility. But that won't help the 2nd Amendment.

Crash_Test_Dhimmi
January 1, 2013, 07:53 PM
Unfortunately, I can see this affecting ALOT of returning veterans, at a time when they are trying to reduce the stigma, and get soldiers help with PTSD.

If checking that box at SRP meant having your guns taken, not one soldier would check it.

7.62 Nato
January 1, 2013, 08:53 PM
Do you trust psychiatrists ? Remember the Fort Hood shooter IS one.

Deer_Freak
January 1, 2013, 09:12 PM
If there was a medical test to tell if someone was a danger to society we would be using it. What everyone here is advocating is if one doctor thinks you are mentally ill there goes your second amendment rights. We don't know enough about mental health as a society to say who gets a gun and who doesn't. Trying to pick who is dangerous with a gun is like trying to predict the winner of the lottery.

texasgun
January 1, 2013, 09:16 PM
I think there is a difference between seeing a doctor cause you are depressed or have "moderate" issues and being "locked up" in a mental institution against your will because you threatened to kill yourself or harm someone... the latter ones should be required to be reported to the database. maybe put a provision in for the right to appeal...

Ragnar Danneskjold
January 1, 2013, 09:29 PM
If there was a medical test to tell if someone was a danger to society we would be using it. What everyone here is advocating is if one doctor thinks you are mentally ill there goes your second amendment rights. We don't know enough about mental health as a society to say who gets a gun and who doesn't. Trying to pick who is dangerous with a gun is like trying to predict the winner of the lottery.

This. Our understanding of mental health has changed drastically in the past 100, 50, even 10 years. And 10, 50, and 100 years from now, the ideas we currently have will be just as outdated. And yet we're talking about denying constitutional rights to hundreds of thousands if not millions of people based on the opinion held by a handful of people on a subject no one really knows that much about at all.

This who debate is really just another form of "I don't care what you do to others, just don't take MY guns or ban the stuff I like".

It's the same as throwing video games under the bus, or revolver shooters being ok with banning semi-autos. You don't think you'll have your rights infringed under this, so you're fine if it harms other people. As long as you can look reasonable and appear to be giving up something in a spirit of compromise looking for a solution to gun violence, you don't mind if other people have their rights infringed.


This is a very dangerous line of thinking. Because it's still giving the government and government employees the authority to deny constitutional rights to citizens based on arbitrary opinions. It's giving them a "no gun rights" box, and the authority to decide who fits into that box and why. They're already doing it with "felons". Everyone thought a felony was a super serious crime like rape or murder, and that it was so reasonable to deny rights to ex felons. And what's happened since? The government has just exponentially increased the amount of things that are felonies. Now you can lose your gun rights for having copyrighted software or music. And we're talking about doing it all over again. Who decides who fits into the "mentally unstable=no gun rights" box? The same people who want to ban all firearms. So who's to say what they'll consider "mentally unstable" down the line? Certain political views? Disagreeing with homosexuality? Religious practices? Vets returning from OEF/OIF? Now all of a sudden we'll have tens of millions of citizens with no gun rights and no recourse to getting them back.

DON'T give the government anymore unlimited "no gun rights" rubber stamps. They'll use them on all of us eventually.

JohnBT
January 1, 2013, 10:47 PM
"But if a doctor can prescribe for depression or other medical disorders, don't they implicitly have the right? "

Of course they do, the legal right anyway, and that's why I complained about it. But think for a minute, do you really want to take a drug prescribed by a doctor who has not been trained to use it? Sure, maybe the doc read about it and maybe listened to the sales pitch by the drug company sales person, but I know that much about most of it just from being exposed to it at work for 37 years. Do you want me to decide your fate? No. Get a real expert.

Otoh, some schools/programs/whatever require a diagnosis by "a specialist trained and experienced in the field, etc." They won't accept a diagnosis from a family doctor or generalist.

John

9MMare
January 1, 2013, 11:03 PM
Though doubtlessly well-intended, this post is troubling. The more that 'being identified' as a person with his/her mental health in question having ramifications that include a limitation of their future rights or opportunities, the more dangerous are the ramifications of reporting.
On the surface, taking action to report someone, a friend, acquaintance, an office-mate or co-worker seems like a generous and helpful action. But if the reported's records become forever tarnished, as they are likely to be after being reported, the costs of such actions is non-zero.
Will there be lawsuits pursued against those who report another and, in doing so, negatively affect a persons life? A pilot acting oddly at an airport bar. A quick phone call by another of the bars patrons and zap, a career ender.
Perhaps I'm just looking at the corner cases and in doing so, indicting an otherwise good idea.
It's all so complicated.
V

I understand that you might have visions of Hitler youth and such but that is not what I'm talking about and not likely IMO if there are also plans made for dealing with those identified that do not amount to witch hunts.

Kids, counselors, teachers, already identify & report such people. Ramifications do not need to be negative...as others have said, part of the problem is the stigma associated with mental illness. But support could be provided, observation put in place....parents notified. Parents provided real options for dealing with such instability or anti-social behavior. It also sounds like many parents seek help for their kids...and do not find it.

Deaf Smith
January 1, 2013, 11:18 PM
Many people are suggesting mental health checks as part background checking for purchasing firearms. One of the problems with that some do not realize is the the HIPPA law. This is the privacy act to protect an individuals medical records and information. Mental health is included in the HIPPA act. Laws would have to be changed to allow this info to be shared. I think this would open up a whole nother can o worms. Who would decide what level of mental health problems would disqualify someone. Also, I think some mental health problems could classified as a disability, which would bring forth trouble with Americans with Disability Act.
Schizophrenic, if adjudged by a psychiatrist AND SENT TO AN INSTITUTION, would not violate HIPPA.

We are not talking about being a depressive, or having anxiety attacks, but real delusions. We used to institutionalize people back 40 years ago but due to excesses like frontal lobotomy and electroshock therapy, which was done in excess, and cost of running the institutions the pendulum swung over, to far over, and they were shut down and the mentally ill were let out on the streets (and thus all those 'homeless' people.)

Well some, who should have been in an institution, have now done several mass murders and who knows how many are serial killers. Note the nuts pushing people off the subway tracks in NY! Others killing people on the streets with bricks.

We need to move the pendulum back some, not back to the '60s, but some kind of middle ground.

Deaf

9MMare
January 1, 2013, 11:26 PM
Schizophrenic, if adjudged by a psychiatrist AND SENT TO AN INSTITUTION, would not violate HIPPA.

We are not talking about being a depressive, or having anxiety attacks, but real delusions. We used to institutionalize people back 40 years ago but due to excesses like frontal lobotomy and electroshock therapy, which was done in excess, and cost of running the institutions the pendulum swung over, to far over, and they were shut down and the mentally ill were let out on the streets (and thus all those 'homeless' people.)

Well some, who should have been in an institution, have now done several mass murders and who knows how many are serial killers. Note the nuts pushing people off the subway tracks in NY! Others killing people on the streets with bricks.

We need to move the pendulum back some, not back to the '60s, but some kind of middle ground.

Deaf

See bold.

But we should be. Because many people in this category...usually on medication or perhaps off of it....are the ones doing the shootings, esp. in schools and colleges.

gossamer
January 1, 2013, 11:32 PM
I think the only way to do it....and there's no comprehensive way...is for people to learn the signs and develop more awareness around identifying people at risk.

Students, parents, counselors, co-workers, teachers, any of us. We all need to learn what to look for. And I'm not sure there are 'lists' out there but they could be developed. We had guidelines when I worked in an HR dept.

^^THIS^^

gossamer
January 1, 2013, 11:51 PM
This is a very dangerous line of thinking. Because it's still giving the government and government employees the authority to deny constitutional rights to citizens based on arbitrary opinions. Who decides who fits into the "mentally unstable=no gun rights" box? The same people who want to ban all firearms. So who's to say what they'll consider "mentally unstable" down the line?

I agree with much of what you said but I have to disagree with something. The decisions as to mental capacity are not based on "arbitrary opinions." There is objective, empirical, verifiable, repeatable, peer-reviewed criteria for determining mental capacity. It is not arbitrary. The decisions as to mental capacity are not made by a government they are made by licensed mental health practitioners who face a loss of licensure and prison if they falsify a diagnosis.

barnbwt
January 2, 2013, 12:25 AM
Now all of a sudden we'll have tens of millions of citizens with no gun rights and no recourse to getting them back.

Everyone should bear in mind that once a person's judgement has been questioned (even merely questioned by someone with authority), there is no way for them to prove their sanity; it becomes a proof of a negative, since indicators are used to identify insanity. A sane person does not display sanity, they merely don't display insanity. Hiding these signs is how so many mentally ill go utterly unnoticed.

No politician or beauracrat will go out on a limb to uncheck the "no guns" box on the risk the subject may one day relapse.

I think there is a difference between seeing a doctor cause you are depressed or have "moderate" issues and being "locked up" in a mental institution against your will because you threatened to kill yourself or harm someone...
What if you are merely "suspected," or display "symptoms" of a more serious condition? How different from "benign" crazy is "violent" crazy? Plenty of raving lunatics never hurt anyone, but are barred from dangerous items because their judgement is impaired. Plenty of well-hidden psychopaths fooled everyone including their victims (see Ted Bundy), and are capable of extremely good judgement where it protects their continued ability to harm others. The only real behavior we all know should exclude a person from bearing arms is the intent to kill others maliciously. The only way to know for sure if they will act on it is if they do. That is what we have murder laws for. Guns are far from the biggest responsibility in our lives, and if we can trust a person to walk in the daylight amongst us without restraints, I see no reason they should be denied their rights.

So I can tell you from a wealth of experience that the only predictor of future violence is a past history of violence, regardless of reported or perceived mental health problems.
Very good point. Did any of these mass shooters display prior histories of actual violence, or even crime? I've heard of "tantrums" or "odd tendencies" or them being loners or just "off." And barring these guys preemptively from guns still won't accomplish anything (unless we can magically both detect and treat them preemptively) since they will always still find a way. Remember, that guy that stabbed and decapticated a passenger on a bus in Canada displayed no previous history of mental illness or violence. And yet, he suddenly "snapped" and became a murderer and cannibal. There are always cracks for people to fall through, especially regarding something as nebulous as the human mind.

Remember, the stress of threatened/imminent commission to a psych facility appears to have been what pushed Lanza over the edge. That's not to say that avoiding doing so would have prevented tragedy, but it goes to show that such actions are not without risks, and should not be used lightly. Finding a person mentally defective to the point that they must lose their self-determination is truly to classify them as something less than human. We must be careful to make sure that truly is the case before forcibly removing someone's rights.

TCB

JRH6856
January 2, 2013, 01:36 AM
Rather than using a mental illness diagnosis in background checks, I would rather see us start with improving mental health care, Once upon a time, someone got the brilliant idea that committing the mentally ill to mandatory treatment violated their civil rights so we stopped doing that and made the mentally ill responsible for their own treatment decisions (if you've ever wondered where all of the homeless people came from...). Of course, we still the "insanity defense" so the mentally ill can't be responsible for their actions. Does anyone else see anything wrong with this picture?

Keep more of the mentally ill in treatment centers until they actually can be responsible for their actions and a lot of our crime problems will disappear. But making mental illness a key element of background checks is a big step onto a very slippery slope. The law will have to be very carefully crafted to keep the restriction from being extended to anyone who has ever exhibited any signs of mental abnormality. In other words to everyone. Mentally ill people may do bad things with guns, but the problem is the illness and not the gun. Treat the illness, restrict rights while under treatment, but don't use the history as a condition of denial unless a court so orders for that individual. Otherwise, we might as well just repeal the 2A and get it over with.

TRX
January 2, 2013, 07:42 AM
> Rather than using a mental illness diagnosis in
> background checks, I would rather see us start with
> improving mental health care

We have some drugs of modest palliative effect on depression and schizophrenia, whatever they call it this week. We have various kinds of "zombie juice" for the hard-to-handle and violent. We have people who will urge the mentally ill to talk about their problems. We have continually-broadening definitions to diagnose people and hammer them into their correct little round holes, but not much to do about it.

Basically, "mental health" is like "crime"; we have lots of definitions of what is is, but not much to do about it.

JohnBT
January 2, 2013, 10:10 AM
"There is objective, empirical, verifiable, repeatable, peer-reviewed criteria for determining mental capacity. "

Criteria are guidelines, not a definitive test. It explains in large part why many individuals with mental heatlh problems accumulate multiple diagnoses over a period of years. I've seen the reports, some of the cases going back 20 or 30 years. Some had multiple diagnoses in a year or two.

The problem is that the vast majority of people don't cause a problem until they snap and you can't predict what people will do or when. Unless there is a history of violence, prediction hasn't worked out too well from what I've seen. The problem is that on the day of the mental health appointment the person could be having a good day and be pretty much average.

Sure, the typical questions are who are you, where are you, what day is it and who is the president? Are you working, do you shop for food, etc? Much beyond that it's completely a matter of the interviewer's interpretation of what they are seeing and hearing. The young male schizophrenics I've worked with, and tested for education and work skills, tend to be quite smart. They have their good days and bad days like everybody else. It's the inconsistency that makes working a fixed schedule difficult.

There is no test for dangerous.

Fwiw, one of my thousands of stories: I had a client in the late '70s who went to the mental heatlh clinic at the Medical College of Virginia and told the shrink he wanted to behead a woman - any woman - he hated women. He wouldn't even use the front door because we had women up there. He wasn't ranting at the hospital, just standing in the corner talking and refusing to look at the doc. They admitted him for a week or so.

Last I heard from him he'd taken his heating supplement money and bought 3 things - pot, hookers (he hates women?) and a bus ticket to Baltimore. He called because he'd run his bicycle into some limo at a downtown parking lot and gotten mad at the driver and thrown his bike at the car and gotten his butt kicked up and down the street.

John

P.S. - Fwiw, I attended a training session 15 or 20 years ago. The mental health professional running it asked, "What is the maximum number of clients with Borderline Personality Disorder that a therapist can handle on their caseload at one time."

I got the first answer in, "None" and brought the house down. She even thought it was hilarious. The actual answer was 3.

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