Problems with mental health checks

[B!ngo]

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]

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]

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]

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]

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]

Do you trust psychiatrists ? Remember the Fort Hood shooter IS one.

 

[Deer_Freak]

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]

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]

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]

"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]

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]

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]

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]

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]

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]

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]

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]

> 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]

"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.