Better Mental Health Screening

[Romeo 33 Delta]

This is an area with which I have NO KNOWLEDGE. I'm searching for answers and this is intended to be a SERIOUS question on my part. The following is not intended to be 100% correct and I've made certain assumptions ... but the point is to find out what our members think.

In terms of disqualifying a person from owning a firearm, it seems to be rather straight forward when we speak of what I'll call "contact with the legal system". Generally, if you are found guilty of commission of a felony, you are disqualified. Correct? I know we also have things like "domestic violence" which I believe is not ever/not always a felony, but it is still a rather clear line. (I'm NOT making a judgement on whether or not I think it's proper to be disqualified for a misdemeanor offense).

There are various stages of contact with the legal system: As a suspect, you are investigated, possibly detained for some brief period. Then, if authorities think they have something, you are arrested. If not, you are released. The DA then determines if they have sufficient evidence for a trial. It may be determined they don't and you are released. Then you have a trial where you are found either guilty or not guilty. If not guilty, you are released.

The point I'm getting at is that there are these various levels of contact with the legal system and each level represents a more serious contact, but each level also has an "escape loop" if you will in that the authorities at any point can make a determination not to take it further up the chain. It also appears to be very clear cut; there are clearly established lines of demarcation and only the last level of contact results in disqualification, depending on that outcome.

We now have increasing demands for better cooperation between agencies concerning sharing of mental health records, with the same insistence on cooperation between states. It's a daily drumbeat: "People with mental problems shouldn't be allowed to own guns". Now, I don't think people with dangerous mental problems should own or have access to guns (among other things) but this is where I start having a problem.

1. Exactly what is a "dangerous mental problem"?
2. Does the equivalent of the legal definition of "felony" exist in mental health in terms of being a disqualifying line?
3. It appears that any number of mass murderers have been perscribed various drugs. Can the use of certain drugs be used to draw a disqualifying line?
4. Isn't it wrong to deny a person an individual, fundamental right just because they might do something illegal at some point?

I don't even know how to phrase this next question so it doesn't sound inflamatory ... so here goes: Mr. X is on a drug which permits him to function in society.

Is there any positive proof that if Mr X stops taking the drug that he will become criminally dangerous?

Who checks up on Mr X to see that he is taking the drug as perscribed?

Will Mr. X ever get to the point where he is "cured" and no longer needs the drug?

If yes, does that mean he can't be allowed to own firearms while under treatment, but once "cured" he is no longer disqualified since he's no longer a danger?

Who makes that decision? Do those decisions have the same level of clearly defined line that exists in the legal system?

As there are various levels of contact with the legal system that do not result in disqualification, what are the levels of contact with the Mental Health system that are equivalent, if any? If not, then how can one fairly separate the different kinds of contact?

These are some of the questions that were tossed back and forth during a recent discussion a group of us had. None of us in the group have had contact with either the Legal or Mental Health system so we couldn't go further than just raising one question after another. Friends ... please contribute. I don't need to know anything of a personal nature. I think you can see that from the tone of the questions. I'm concerned about this because of the media hype and the apparent lack of knowledge on the subject. I think that someone like Lanza should have been disqualified, but I also do not want to see a point where just because you've had some level of contact with the system that you become disqualified. I see that as a real danger in this present climate that demands that the politicans do something ... anything ... even if it doesn't work. Just do something!

 

[Chris-bob]

I don't know, but I refuse to be subject to mental health screenings.

 

[JohnBT]

"1. Exactly what is a "dangerous mental problem"?"

The person has to actually do something dangerous. Threatening behavior might qualify, just like it would for you or me.

"2. Does the equivalent of the legal definition of "felony" exist in mental health in terms of being a disqualifying line?"

Nope. Now, if the person's behavior causes the legal system to become involved, then the legal system can disqualify them from owning guns, just like for you and me.

"3. It appears that any number of mass murderers have been perscribed various drugs. Can the use of certain drugs be used to draw a disqualifying line?"

Nope. For example, according to NIMH (Nat. Inst. of Mental Health), there are 2.2 million Americans with schizophrenia. A great many of them take meds and don't become violent. Another example, according to NIMH, 2.6% of the American population is bipolar. Many take meds and aren't violent. There's no way to predict who will be until they do something. Threats might qualify, just like they would for you and me.

"4. Isn't it wrong to deny a person an individual, fundamental right just because they might do something illegal at some point?"

Of course.


""People with mental problems shouldn't be allowed to own guns""

Which mental health problems? There are dozens and dozens of diagnoses in the DSM-IV (soon to be DSM-V). The list includes sleep disorders, eating disorders and all sorts of things. Here's a good example: kleptomania (312.32) is an impulse control disorder that could lead to a shoplifting conviction, but until it does it's just a diagnosis in a book with a code to use for billing the insurance company/medicare/etc.

http://counsellingresource.com/lib/distress/dsm-codes/dsm-code/

 

[wow6599]

I don't know, but I refuse to be subject to mental health screenings.

Same here.

I could see: "Well, I'm sorry your wife and kids left you.......we'll hold on to those until you're mentally well". Or, "Sorry you lost your job today.........we'll hold those until you're better".

No thank you.

 

[Bob2222]

1. Exactly what is a "dangerous mental problem"?

I'd think that if one's behavior was aberrant enough that it required a 911 call to the police and a trip the emergency room instead of to jail, that might raise suspicion. If one is taken to jail, there would be a legal record. If to the emergency room, disclosure of whatever might have happened in the emergency room is prohibited. In the case that such an event has occurred recently, it might not be unreasonable to require a psychological evaluation.

Adam Lanza, James Holmes, Jared Loughner, Nidal Hasan and Seung-Hui Cho had, by many accounts, given plenty of warning. Unfortunately, political correctness and laws that were supposed to protect the mentally ill prevented effective action to prevent the massacres.

It's been said before, but it's one thing to be open-minded, and another to be so open-minded that one's brains fall out. IMO, we've gone well past that point in an effort to protect certain classes like the mentally ill.

I don't know, but I refuse to be subject to mental health screenings.

I'd actually be OK with it as long as politicians were required to go through a mental health, drug screen and criminal background check before they are allowed to run for political office. (Don't worry, I don't think it would even be Constitutional, and if it were, they'd never agree to it!)

 

[IlikeSA]

As someone who works with people with mental problems, but not a psychologist or counselor, I can speak on a limited basis about how the system works here in Colorado. Different states have different laws though.

If you call the police or are found by them to be a "danger to yourself or others" you can be placed on an M1 hold. A doctor, law enforcement officer, or certified counselor has the authority to place someone on an M1 hold. Usually they are brought to the local hospital, where they are not free to leave, but have to be kept in the least intrusive environment. Basically it means I keep you from leaving and make sure you don't hurt yourself or others. The hold can last up to 72 hours, but it is rare that I see it last that long. After a short time, and medical clearance, a psych team member will come and do an evaluation. They will talk to the person on the hold, and to related family members/friends. The decision will then be made by both the MD and counselor as to release the person, or place the person in a mental health facility.

If they are placed in a facility, then I believe a judge has to become involved in ordering it, with the MD's recommendation.

On a side note, there are some people that I work with that I am glad do not have access to arms. While I am in favor of better mental health screening, I think that the ruling should fall more for freedom than against it. In other words, I would rather chance 10 people who should be barred from arms for safety reasons having access, than 1 wrongfully barred. It also brings up the question: who decides mental competency, since what I decide is not necessarily what someone who could have ulterior motives (gun grabbers) could decide.

 

[JohnBT]

"I'd think that if one's behavior was aberrant enough that it required a 911 call to the police and a trip the emergency room instead of to jail, that might raise suspicion. If one is taken to jail, there would be a legal record."

Are you using aberrant behavior in the general sense or the legal definition? The legal definition requires "criminal behavior". Notice how things always seem to hinge on observable behavior?

http://definitions.uslegal.com/a/aberrant-behavior /

Aberrant Behavior is a single act of unplanned or thoughtless criminal behavior.
[U.S. Sentencing Guidelines Manual, ch. 1, pt. A, 11 4]

 

[Bob2222]

Are you using aberrant behavior in the general sense or the legal definition?

The general sense. I'm using the criteria that incidents like psych ER trips should be reported. Police aren't mental health professionals. (I've read that about half or shootings by police involve shooting someone who was later found to be mentally ill.) If they think someone is crazy, he or she must be really, really crazy. If the individual is taken to jail, it would be reported. If to the ER, it should be reported, too. The law enforcement/arrest/emergency room criteria not an awfully high bar.

I doubt the majority of individuals posting here or on any of the other firearms interest boards have ever been arrested and taken either to jail or to the emergency room. Firearm ownership appears to correlate positively with income, success and education, in spite of the efforts of the media to portray the opposite.

In the case of Major Hasan, he was surrounded by mental health professionals who believed that there was something wrong with him. Instead of dealing with it, they promoted him and transferred him to Texas. It's not an uncommon bureaucratic response, but there should be penalties for his supervisors who made such poor decisions.

Once, while presenting what was supposed to be a medical lecture to other psychiatrists, Hasan talked about Islam, and said that, according to the Koran, non-believers would be sent to hell, decapitated, set on fire, and have burning oil poured down their throats. A Muslim psychiatrist in the audience raised his hand, and challenged Hasan's claims. According to the Associated Press, Hasan's lecture also "justified suicide bombings." In the summer of 2009, he was transferred to Fort Hood.

I can't say that I've attended any psychiatric Grand Rounds presentations lately, but those statements do strike me as being more than a little unusual for a psychiatrist and US Army major.

 

[DJW]

I think any narcissist who would desire the public spotlight and unlimited power enough to enter politics is by definition "mentally unstable" and should be locked up before they can destroy the freedom of American citizens.

 

[Romeo 33 Delta]

Thanks for the responses thusfar. My problem with using "mental health screening" as a means of disqualifying one from gun ownership is based on what I see as a fairly loose standard of application, coupled with the range, complexity and severity of the many forms of "mental illness" when compared to the legal system which seems to be more structured.

I'm concerned with our being able to protect society ... but am also concerned that one does not get disqualified as a result of mis-application of what appears to be for the most part, a non-standard. Clearly, there are instances where the person is "a danger to himself or others" or actually has crossed the line (without a firearm). Those levels are equivalent to having been found guilty within the legal system.

My question and concern is how far back up the line can you REASONABLY apply the disqualification standard before you violate a person's rights to own a gun?

Further, in the legal system we don't disqualify a person because "they might
commit a crime" ... so where in the mental health system is that same line if it even exists?

 

[AlexanderA]

How about the standard for disqualification being an involuntary, court-ordered commitment where the patient was represented by legal counsel?

And how about a mechanism where the disqualification could be removed if it was shown that the patient was no longer a danger to himself or others?

What we don't want to do is discourage people from seeking treatment, worrying that their gun rights will be taken away. This would be highly counterproductive.

Realistically, this "mental health screening" for gun possession is easier said than done.

 

[woodguru]

First of all I can't ever see everyone having to be subjected. It's what process would be used to bring those who are dealing with mental health issues and or mind state altering drugs.

It's a weird concept that would make people afraid to get the professional help they need for mental or emotional issues.

 

[d-dogg]

Always remember.

When asked about his own obvious oral fixation, Sigmund Freud replied, "sometimes a cigar is just a cigar".

Psychology is an inexact science, and often, the inmates run the asylum.

 

[TAKtical]

The law here says that you cannot own a firearm if you have been adjudicated mentally defective. Thats the best you can do to stop the mentally i'll from having guns. Try pushing the mental health issue more and anyone who has ever been treated for anything will have a "history of mental illness".

 

[jon_in_wv]

Its pretty simple really. Just apply the law as written. I believed the government is applying the "Clintonian" philosophy of gun control. Don't enforce the laws on the books so you can justify getting even more. As the law is written if you have been "adjudicated mentally defective" or institutionalized against your will you are disqualified from possessing a firearm. As it stand Congress does not fund a system like the NICS for criminal offenses for state agencies to report mental health disqualifications. Only 4 states regularly report disqualifications and only 23 report them at all. Why are we talking about changing the law or making new ones when no attempt has been made to even make the law on the books effective.

The problem is a lot of people in Congress don't agree this law does enough to prohibit enough people from possessing firearms. They have in the past proposed bill sto strengthen the law, not by making it more effective but to help it prohibit more and more people. If you are ever treated for depression, alcoholism, have PTSD, or get counseling for stress they want you prohibited. Millions of regular people and especially Veterans would have their rights stripped away from them without at due process at all. That is truly the goal. To get us used to the idea that Congress can oppress out rights through a bill rather than the due process of an order of the court. If the government is going to oppress your rights you should have your day in court to face the government and let them argue why it is necessary for them to oppress your rights and to give you the right to defend it. Sadly, just like the prohibition on felons and crimes of domestic violence we have grown comfortable with the idea they can oppress it without due process because it doesn't effect us and we don't care about the people it does effect. So at LEAST if you are going to have your rights oppressed due to a mental illness it should be on from an action of the court. Not some snooty Doctor with a 10 cent degree.

A good example would be my own experience. I was having problems and in the past many people like me were treated for depression when it turns out I had low testosterone. Under laws congress had proposed I would have been prohibited from exercising my rights to keep and bear arms for life because of depression I didn't even suffer from.

Tread very lightly and carefully when you talk about good reasons to oppress the rights of an entire groups of people. First we discriminate against felons, then people with marital problems, then the mentally ill. Now I hear people say illegal immigrant shouldn't have any rights because they aren't citizens. Your rights are HUMAN rights, not given by the government, the Constitution, or citizenship. You can only respect rights or oppress them. You can't give them or take them away. Oppression of civil rights is a very serious subject and I just think we should keep the bigger picture in mind when we talk about who and when we are OK with the systematic oppression of those rights.

 

[Romeo 33 Delta]

Again, thanks for the continued input and I like the fact that more and more of you are both filling in the information blanks as well as pointing out that the data base, the science and consistant application are all a problem.

I also appreciate it being pointed out that there is a lack of enforcement, if you will; either unintentional ... or much worse, absolutely intentional with an end to be able to "prove" that current laws are inadequate.

There's all this talk about Executive Orders and one I heard mentioned yesterday/today(?) was that Obama could use his EO powers to force prosecutions for violations to which I say: GREAT! I'm of a mind that there are more than enough laws already on the books that would limit the wrong folks from getting firearms. ... if they were more strictly and more consistantly enforced. Years back a friend on the local PD contacted Chicago BAFT about a situation here where there was a felon in possession. He told me (and I have no reason to disbelieve him) that they asked how many guns were involved? He replied: one. He was then told that one gun was not worth their time to be bothered with. I know it's anecdotal evidence, but that is certainly a law NOT being properly enforced.

Jon in wv raises some interesting points that I touched on at the outset. Just what minor level of contact with the Mental Health System should (not does currently, but should) trigger a disqualification? As it stands, there is a "standard" (adjudicated mentally defective or institutionalized against your will) . Why try to expand this? If a proposed law simply throws out either a bigger net or one with smaller openings with the intent to simply drive up the gross numbers of disqualifications ... that's wrong and worse than useless. The fact that Congress hasn't funded a clearing house for reporting mental health disqualifications IS at the heart of the problem then. Create it as a NICS adjunct and require that all 50 States report at least as often as for criminal disqualifications seems to be a must. With respect to Domestic Violence disqualifications; I don't want to see spouses needlessly endangered, but I think this law was a gross over-reaction, it seems too vague and too broad. I believe that some states treat this as a felony, others as a misdemeanor. I can see loosing your rights for a felony ... but for a misdemeanor? Due process ... absolutely essential.



OK, once the police or hospital has become involved, certain events follow (or should follow) automatically. IlikeSa notes that you go through a process and can be detained (and at least temporarily are disqualified) or you are released (no disqualification). If that's is done as consistantly as in the legal system contact (through a trial with the same result options) that's a positive for the mental health system.


AlexanderA ... yes to your post.

A person shall be disqualified from owning/possessing firearms in the case of: Involuntary, court-ordered committment where the patient is represented by legal counsel, with some sort of mechanism whereby the patient can have his rights restored when it has been determined he is no longer a danger to himself or others.

I also agree. I want folks to get help, but I don't want them to be put in a box that will forever deprive them of their rights (not just to own firearms) ... just because they had some form of contact with the Mental Health System and it's my fear that is what some folks out there think is acceptable.

That was one reason for raising the question about whether or not certain drugs which are perscribed should be factored into the equation as well as touching on the fact that there are many forms of mental illness, many of which, while debilitating to the individual, are not prone to render him dangerous.

I agree that it's terribly hard to make mental health screening workable, that's why I started this thread. I don't really like that phrase ... the "screening" part. It makes it sound as though every gun buyer will undergo some sort of exam when all that would be involved is being cleared through a data base, not at all different from our present NICS check. I see it as another area of NICS information. (Crudely: you're not a criminal and you're not nuts). But, that's why I'm looking for equivalence between the legal system process and the mental health process. In order to be EFFECTIVE, both data bases have to be as complete as possible. To be FAIR, both data base have to be accurate as possible.

Making precisely that point for me, I've even heard some talk of using the Terrorist Watch List (afterall, if you're a terrorist, you certainly shouldn't be able to buy a gun). The problem is, apparently the TWL is neither complete nor accurate. That is what I want to avoid in a POTENTIAL mental health data base.

 

[JohnBT]

"that's why I'm looking for equivalence between the legal system process and the mental health process."

Here's the problem. A conviction in the legal system is a fact. A diagnosis in the mental health system is an opinion and one that changes frequently for many people as they see different mental health providers. There's no test for mental illness much beyond determining if the person is aware of their name, location, date and the name of the president.

Here is an article I googled up at random. It recounts a few patients' stories and their trail of diagnoses. (These are very common situations; I've read the reports for decades, working with one client at a time. JT)

"Diagnosis Roulette
Psychiatric patients can be labeled with numerous conditions during their treatment"

http://articles.philly.com/2012-07-31/news/32942918_1_bipolar-disorder-dsm-5-mental-disorders

 

[Pointshoot]

Does anyone know what mental health questions are on form 4473 that you need to fill out when purchasing firearms from an FFL ? I don't recall if this is asked.
(I ran into some glitch with my computer when trying to download a pdf of the form. I might have a softward problem.)

Thanks

 

[JohnBT]

11 F

 

[Pointshoot]

Thanks JohnBT

 

[jon_in_wv]

I would fully support the creation of a Federal clearinghouse for states to report those adjudicated mentally deficient or involuntarily institutionalized. This is the law anyways. Enforce the laws we have. Don't ignore them in the hopes you can get more like you did in "fast and furious". That is the MO of the left. Create the problem, then become everyone's savior by pretending to fix it.

 

[Romeo 33 Delta]

jon in wv ... thanks for the post ... it's just the direction I was heading in ... confirmation is most helpful.

It's come to me that only two types of people commit crimes of "gun violence":

1. Those who are Mentally Damaged (Lochner and Lanza come to mind).
2. Those who are Morally Damaged (Neal, gangbanger who stabbed a deaf
guy who was signing, thought he was flashing gang symbols at him)

We can handle the later with our present NICS system and, hopefully, the former with a new, enhanced NICS system (with a mental health data base component).

Just looking at the Form 4473 it's clear what the disqualifiers for criminal and mental health issues are. There's apparently no need to cast a wider net, no need to plumb further the depths of mental health (at some point you cross over from "fact" to "opinion" ... a dangerous and unacceptable line to cross). What needs to be done is:

1. When you lie on Form 4473, Section 11a, (strawman purchase) you
commit a felony and while difficult to prove and prosecute, ignoring
it is NOT acceptable.

2. When you lie on Sections 11b thru 11l, it's also a felony and if you,
as a disqualified person, attempt to buy a firearm, you need to be
prosecuted in accordance with existing law.

The problem is that there is no national data base for those disqualified from reasons of mental health, the questions on #4473 notwithstanding. This needs to change.

1. Establish a data base along the lines of NICS. States will be required
to report at least as often as with the current NICS system and this
should include not only additions, but deletions (if applicable).

2. Once the information is distilled, it passes into the regular NICS
so when a prospective gun buyer is run through the system, it tells
the dealer that he's cleared both criminally and mentally.

3. The sensitive, medical information collected is to be retained only long
enough to create a rating of "Go" or "No-Go" for the subject. Such
information must be handled with extreme care and the rating
needs to be as early in the process as practical.


I appreciate that this new system is not perfect. (I don't believe that Lanza would have necessarily been weeded out before he acted), but that doesn't mean it is without merit. Frankly, I think it's beyond comprehension that we have disqualifying questions on form 4473 and yet, have no real way to verify the answers. Unacceptable! Failures to follow through with prosecutions because of some misguided "cost/benefit" analysis or "little fish/big fish" must stop immediately. BATFE and DOJ ... JUST DO YOU JOBS!

Can anyone see where I've missed anything? Any problems with the proposals? Anything seem unworkable? Anything seem to be missing the point of preventing the wrong folks from legally acquiring firearms?

 

[Gordon]

REgarding question E on the 4473, I mentioned to lots of FFL holders that if the person has a Medical Marijuana card it would seem, under Federal law, to make them in a prohibited category ap priori . They grinned and said "not so far"

 

[jon_in_wv]

There is no "sensitive medical information" that would need to be passed on to the system to be retained or deleted. Adjudication of a mental defect or involuntary institutionalism is an act of the court just like a felony conviction. The only thing that would need to be reported is the existence of the court order. Just like NICS the reporting agency is responsible and liable for the accuracy of the report. There is NO need to report any of your medical history at all.

 

[JohnBT]

"1. Establish a data base along the lines of NICS."

Why reinvent the wheel and add a 2nd separate database?

Do you really think telling federal agencies to do their jobs when Congress won't give them the money is going to accomplish anything? It's all been said before, year after year.

John