Mental health and gun ownership - how would it work?

[PiratePast40]

It seems that both sides of the gun control discussion are bringing up the issue of mental health concerns and gun ownership. Let's say that a law is passed that has something to do with mental health of an individual that is above the current law. Exactly how would increased surveilance for the mental health of a gun buyer or owner occur?

The only way that I can see, other than the current requirement of incarceration or court determination of mental health, is to monitor the physician/therapist/phychiatrist relationship. Possibly go as far as to depend on classmates, neighbors, school administrators, or family members for information on the perceived mental health of people they know or observe? I don't have any answers and don't know how any such legislation would be enforced. If debaters are going to advocate mental health as a discussion point, you think they would have thought it through. I just can't see any scenarios in law that can reasonably be implemented without serious breeches of the constitution.

Anyone else see a scenario that's reasonable and actually does something except makes people feel that they've done something, even if it's useless and most likely counterproductive?

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[Morpheus]

Mental Health is a serious issue in our country. We don't have many answers, and lots of psychiatrists are just drug pushers. Having watch several people go through this type of cycle it seems that they honestly don't know what the hell they are doing.

Take that situation, and now make them obligated to report mental issues to the state. Talk about a mess.

As you pointed out, and just like in the past, people talk about half solutions. They talk about making a list or registry or whatever you want to call it. But they never talk about the appeals process, or process for those who actually get better and no longer have any issues. Yes, it does happen, people can get better it just takes a lot of work.

Unfortunately, I highly doubt any 'law maker' or 'knee jerk' person who won't actually look at the data will ever built a full robust plan or set of rules on this type of crap. They will make some half-assed attempt, toss it together and try to get it past. Oh, and forget about them actually funding it in the bill. That will be left to the states to fund and figure out. But it will be mandatory, and thus just be a larger strain on the states while the Feds get to dictate and enforce it at their leisure.

 

[DBagnall]

I am no mental health expert by any means but I would think that if it is a talking point in their convoluted discussions regarding gun control, it will probably be just another box they can check that counts against one having the ability to own a firearm.

My best guess is that they will include mental health in the criteria they set forth for more involved(invasive) background checks.

And no, another law is not going to make one bit of difference other than create another step towards us losing our freedoms. It makes the powerful feel good because they are taking away a citizens ability to keep said powerful in check....

Talking about mental health is mostly just a farce, it makes people see past the real agenda that is being played out. I can't think of any reasonable way to enforce a law as you have suggested. All this discussion involving mental health is just smoke and mirrors...

 

[PiratePast40]

One of my fears is the link to the proposed national health information database and the firearms background investigation process. I suspect that we're going to see a delay in the background checks based on a search of your health information. I can see the corelation to the "no fly" list when there seem to be instances of people being placed on the list based on a single TSA employees opinion. There is the possibility of someone being placed on the same kind of national list for purchasing or even owning a firearm. If you carry this out farther, it gets scarry. I don't want to seem too far out there in the "tin foil hat crowd" but there seem to be some real possibilities for unfounded statements resulting in someone being prevented from owning a firearm.

 

[RoneKiln]

The need to revamp our approach to mental health is huge. There's just no relationship between it and gun ownership. Mentally ill people acquiring guns is not the real problem, but a symptom following the failure to get them proper care in the first place.

When getting my psych undergrad every single study we ever found on it indicated that therapy on its own was near useless for most cases of depression and anxiety. Medication on its own was near worthless. Combining the two, giving someone meds to deal with symptoms in the short term while getting them therapy to resolve the underlying issues (usually learning better social, lifestyle, and coping skills) had huge success. Unfortunately, insurance companies don't want to pay for therapy. It's expensive compared to just handing someone a pill.

So now we're handing out pills. Pills with all sorts of possible side effects that can be atrocious. Each person reacts differently to them and there is nearly no follow-up care to make sure a person was given the right med at the right dosage for their very unique needs. Nor do many people understand the need to push for this follow-up from their Doctors and most importantly, their insurance company. Bad things happen. Sometimes more meds are given to deal with side effects instead of adjusting the initial medication to get it right. Again with no or minimal follow-up. More bad things happen.

Sometimes you get someone so challenged, you can't just hand them a pill. Nobody really knows a way to help them without extensive research and a lot time with the person. Sometimes even that's not enough. We have no effective way to support these people. There is very good evidence the fellow repsonsible for Sandy Hook was one of these.

None of this is in any way related to guns. It needs to be dealt with. Our laws and funded resources for this don't need to be tied to any gun laws or any rights to use guns. It is its own problem. Even if we deal with it in the best possible manner, sometimes a disturbed individual will slip through the cracks and do something horrendous.

I used to work in Sweden during my summers. One year one of my crew that came over from the US ran out of his meds and started being difficult to deal with. A local doctor was willing to help us and had a copy of my crewmates records sent over so he could renew the RX on the meds. When the file showed up, the Swedish doctor was horrified to see there had been extremely minimal follow-up care on the meds that had been prescribed. He explained to us that the possible side effects were dangerous enough that it was considered criminally negligent in Sweden to administer them without proper follow-up care. He could not ethically or legally write a new RX. Keep in mind this was for a psychoactive drug that is extremely common in the US. And yes, the side effects are widely recognized in the US. We finally had his US doctor send an RX (which should have been what we did at the start) to take some of the liability off the Swedish doctor. Even then, the Swedish doctor made my crewmate promise to get proper follow-up care when he got back to the US a few weeks later before filling the RX (he still had to sign off in support of the US RX).

My buddy got back from Sweden and talked to his doctor about follow-up care. His regular doctor was in complete agreement with the Swedish doctor, it was just nearly impossible for him to get insurance companies to cover the follow-up care. I don't know how they worked out the billing, but when it was all done, my budddy discovered that he could cut his med dosage by about a third so long as he did a good job of keeping up on certain vitamins and exercise. The one third reduction in dosage caused a two thirds reduction in side effects. What if he'd been one of the people whose side effects was explosive anger? That's not an uncommon side effect of those meds. And it has NOTHING to do with gun ownership. It has to do with poor mental health care.

This is just one real world example I've seen out of dozens. The research I saw when studying psych indicated its a problem for millions.

The call for revamping mental health care is legit. It needs to happen. It should NOT be tied to 2nd amendment rights in any way. They are two completely different issues.

 

[RoneKiln]

Edit: Double post.

 

[RoneKiln]

One of my fears is the link to the proposed national health information database and the firearms background investigation process. I suspect that we're going to see a delay in the background checks based on a search of your health information. I can see the corelation to the "no fly" list when there seem to be instances of people being placed on the list based on a single TSA employees opinion. There is the possibility of someone being placed on the same kind of national list for purchasing or even owning a firearm. If you carry this out farther, it gets scarry. I don't want to seem too far out there in the "tin foil hat crowd" but there seem to be some real possibilities for unfounded statements resulting in someone being prevented from owning a firearm.

I am nervous of this as well.

 

[DBagnall]

The call for revamping mental health care is legit. It needs to happen. It should NOT be tied to 2nd amendment rights in any way. They are two completely different issues.

I can most definitely agree with that. However, our wonderful politicians are making them the same issue. Does it take a crazy guy with a gun to force legislators to address the issue? In this case they do what all anti-gun folks do; blame the gun, not the person( or whatever may be wrong with said person).

When I mentioned convolution in my previous response, I meant just that. You have two completely separate issues, like you stated, getting jumbled into one. The solution that they come up with is going to be bad for gun owners and bad for mental health patients too unfortunately....

 

[kibs45]

Having seen some of the side effects first hand, some of those drugs are incredibly scary. I dare say, sometimes the side effects may in fact be worse than whatever is being treated. What can be even worse is the Dr.s response to side effects that shouldn't exist etc. I don't want it to sound like I am anti doctor, but they are all human too. We have a terrible habit in this country of wanting a quick fix. A pill is a "quick fix"... I don't think this is something any government can fix. Unfortunately there are a lot of tangible reasons why it may not be addressed in its entirety. The bottom line is it really boils down to personal responsibility and even beyond that, familial responsibility. We can not assume a single Dr. can fix it, we can not assume a pill will fix it, we can't assume every problem can be fixed. What we can do is watch those around us, help people as much as possible, and actually try to work through things as they arise. For all we know, there can be actual physical reasons for why people behave the way they do outside of brain chemistry etc...

But ultimately I agree that these are not related issues. Fix health care? Sure. Fix mental health care? Sure. Make an effort to isolate truly dangerous individuals from society? Sure. Nothing at all to do guns...

Sorry it rambled so much, kind of got going. lol

 

[ZigZagZeke]

OK, let's rein in the off the wall stuff. The plain fact is that 300 million Americans had access to "assault" weapons last month. All but a handful of them didn't kill anybody.

So does it make any sense at all to address the situation by removing "assault" weapons from our environment? No, for a couple of reasons:

1. If "assault" weapons are not available these murderers will resort to whatever weapons are available.
2. The differentiating characteristic is not access to weapons, but mental state. Each and every one of these murderers was dangerously, demonstrably crazy, and people around them knew it.

So we can try to remove hundreds of millions of firearms from our society, or we can remove a few thousand dangerously crazy people. I vote for removing the dangerously crazy people from our streets. Notice, I didn't say prevent them from purchasing firearms? If they're under lock and key there's no possibility of them purchasing a firearm.

Now before you start going off about massive new government systems and intrusions on our Constitutional rights, let me explain a few things. First, I know something about the situation. In the late 1960's I worked as a mental health worker inside the largest public mental health system then in existence in the US, the California State Mental Hospital system. I've also served some time in law school, though I decided being a lawyer wasn't for me. So let me make a few informed observations.

We once had an effective public mental health system that kept people who were a demonstrated danger to themselves and others off the streets. Yes, it was more expensive than the nonexistent, ineffective, feel-good "system" we now have. Despite what was written in the newspapers and novels of the day, almost nobody who didn't belong there ended up there. I worked on the men's admissions and intensive treatment ward in Stockton, CA. I saw the people who were admitted every day. A typical (true) scenario was that a man would be reported to the police for chasing his wife around the yard with a meat cleaver, wearing no clothing, and shouting about the voices telling him his wife was having an affair with the family dog. This is the kind of behavior we addressed. The patient would be involuntarily admitted for 72 hours, based on the police report. After a short period of observation and interviews with resident psychiatrists and staff, the patient went before a judge where testimony was given as to his mental state. The judge then would order him either released or held for further observation and treatment for a period of 30 to 90 days. At the end of any further treatment and observation, the patient got another hearing and another similar decision was made by the judge. It wasn't perfect, but it kept people with meat cleavers who were hearing voices off the streets.

This is the system that Ronald Reagan dismantled when he became governor of California. He argued that these people could be more efficiently and economically treated in a "community based" setting. So the state released these patients to the care of the counties, who immediately put them on General Assistance (Welfare) at $300/month. These seriously crazy people were expected to show up for regular appointments at outpatient clinics, manage their own medicine, and manage their own money, housing, food, etc. Of course, none of that happened. On top of that, when the legislature voted state funding for these local programs, Reagan vetoed it. The end result was Reagan balanced the state budget by dismantling the state mental health care system and pawning it off on the county outpatient programs.

After I left employment with the state I saw people I had known as patients, standing on street corners talking to nonexistent "friends" or demons, who knows which? I knew some of them to be seriously dangerous people, who, without regular medication and some semblance of order in their lives, would do some seriously crazy and violent things. I predicted at the time that we would see more and more horrific crimes committed by these people, and it was not a year later that one of them killed his mother and cut up her body in the bathtub with a chainsaw. This is where we are today, 40 years down the road in this experiment in "fiscal responsibility".

Today, when family members become concerned for their loved one's safety, their own safety, and that of society in general due to the behavior and mental state of a loved one, there is nowhere to go. Typically, they call their doctor or the police. The police will intervene only if a crime is committed or is about to be. Their typical solution is execution of the offending party. The local news has documented dozens of these cases in the last 10 years. The city of Portland generally gets sued over these incidents. If the loved one survives, or if they leave the police out of the equation, they are routinely referred to the emergency room. The ER doctor is typically not trained in mental health medicine, and will refer the individual to an outpatient clinic. An appointment will be made for sometime in the next few weeks to assess the situation. Meanwhile the dangerously crazy individual is sent home where his family is expected to deal with him until the appointment. This is the best potential outcome. Often there are no resources or programs available, and the family is told to simply deal with it until resources become available.

This is the situation many of the mass murderers were in when they committed their crimes. Families with no training and no resources are expected to control these dangerously crazy people, even though they have jobs and other children and siblings to deal with.

What we need is not more gun laws. Gun laws don't address this issue. Guns are not the issue. Our lack of any system with the capability to effectively deal with dangerously crazy people is the issue, and the answer is not another law about mental health and access to guns. The answer is the re-institution of a state run, public mental health system with checks and balances, and protections for individuals involved in the system. It's not an easy, quick, or cheap solution. It will take new departments or expanded departments of government, new funding, and new, highly trained employees.

But as long as we have vultures like Senator Feinstein, backed by an anti-gun media, with a preconceived anti-gun agenda who are willing to cynically and crassly exploit tragedies involving guns for the advancement of their own agendas, offering easy, cheap, feel-good answers, we will not do anything that truly addresses the situation. If you are a 2nd Amendment supporter it would behoove you to understand that our lack of a viable mental health system is the biggest threat to the private possession of guns in America today. Arguing against any kind of mental health concern in relation to guns only helps the anti-gun cause.

 

[kibs45]

I can't speak to the Reagan stuff. I imagine there is a lot to that situation. I do know someone who looked into having a adult family member involuntarily committed for evaluation in the state of Washington, and without a crime being committed it was next to impossible. Not saying it should be easy to strip someone of their rights, but apparently we have a problem...

 

[tfbit]

I prep and since preppers on "Doomsday Preppers" are generally portrayed as crazy then I must be crazy. No weapons for me...

 

[ZigZagZeke]

The need to revamp our approach to mental health is huge. There's just no relationship between it and gun ownership. Mentally ill people acquiring guns is not the real problem, but a symptom following the failure to get them proper care in the first place.

When getting my psych undergrad every single study we ever found on it indicated that therapy on its own was near useless for most cases of depression and anxiety. Medication on its own was near worthless. Combining the two, giving someone meds to deal with symptoms in the short term while getting them therapy to resolve the underlying issues (usually learning better social, lifestyle, and coping skills) had huge success. Unfortunately, insurance companies don't want to pay for therapy. It's expensive compared to just handing someone a pill.

So now we're handing out pills. Pills with all sorts of possible side effects that can be atrocious. Each person reacts differently to them and there is nearly no follow-up care to make sure a person was given the right med at the right dosage for their very unique needs. Nor do many people understand the need to push for this follow-up from their Doctors and most importantly, their insurance company. Bad things happen. Sometimes more meds are given to deal with side effects instead of adjusting the initial medication to get it right. Again with no or minimal follow-up. More bad things happen.

Sometimes you get someone so challenged, you can't just hand them a pill. Nobody really knows a way to help them without extensive research and a lot time with the person. Sometimes even that's not enough. We have no effective way to support these people. There is very good evidence the fellow repsonsible for Sandy Hook was one of these.

None of this is in any way related to guns. It needs to be dealt with. Our laws and funded resources for this don't need to be tied to any gun laws or any rights to use guns. It is its own problem. Even if we deal with it in the best possible manner, sometimes a disturbed individual will slip through the cracks and do something horrendous.

I used to work in Sweden during my summers. One year one of my crew that came over from the US ran out of his meds and started being difficult to deal with. A local doctor was willing to help us and had a copy of my crewmates records sent over so he could renew the RX on the meds. When the file showed up, the Swedish doctor was horrified to see there had been extremely minimal follow-up care on the meds that had been prescribed. He explained to us that the possible side effects were dangerous enough that it was considered criminally negligent in Sweden to administer them without proper follow-up care. He could not ethically or legally write a new RX. Keep in mind this was for a psychoactive drug that is extremely common in the US. And yes, the side effects are widely recognized in the US. We finally had his US doctor send an RX (which should have been what we did at the start) to take some of the liability off the Swedish doctor. Even then, the Swedish doctor made my crewmate promise to get proper follow-up care when he got back to the US a few weeks later before filling the RX (he still had to sign off in support of the US RX).

My buddy got back from Sweden and talked to his doctor about follow-up care. His regular doctor was in complete agreement with the Swedish doctor, it was just nearly impossible for him to get insurance companies to cover the follow-up care. I don't know how they worked out the billing, but when it was all done, my budddy discovered that he could cut his med dosage by about a third so long as he did a good job of keeping up on certain vitamins and exercise. The one third reduction in dosage caused a two thirds reduction in side effects. What if he'd been one of the people whose side effects was explosive anger? That's not an uncommon side effect of those meds. And it has NOTHING to do with gun ownership. It has to do with poor mental health care.

This is just one real world example I've seen out of dozens. The research I saw when studying psych indicated its a problem for millions.

The call for revamping mental health care is legit. It needs to happen. It should NOT be tied to 2nd amendment rights in any way. They are two completely different issues.

You are spot on. I agree with you 100%, as I have had the same experiences and seen the same things.

 

[PiratePast40]

Some very well thought out and well written responses here. It could be that second ammendment rights and mental health have nothing to do with each other but we've seen politicians on both sides of the issue link the two. I believe that gun rights advocates will lean more toward keeping guns away from mentally unstable people rather than restricting ownership for everyone. And yes, depriving someone of their rights will be a difficult matter, that's why I was wondering about possible scenarios about how to accomplish this because of real, contrived, or imagined mental instability issues.

 

[kibs45]

Some very well thought out and well written responses here. It could be that second ammendment rights and mental health have nothing to do with each other but we've seen politicians on both sides of the issue link the two. I believe that gun rights advocates will lean more toward keeping guns away from mentally unstable people rather than restricting ownership for everyone. And yes, depriving someone of their rights will be a difficult matter, that's why I was wondering about possible scenarios about how to accomplish this because of real, contrived, or imagined mental instability issues.

Unfortunately like most things, it seems simple on the surface. Lock up the crazies, eliminate guns etc. Unfortunately common sense isn't very common, and it gets complicated and murky real quick. Personally what I have seen is that the most dangerous "mentally ill" are the ones that are hardest to diagnose/figure out/find out. Some major personality disorders can be hidden, or even onset quickly. I believe that while the goal of each indivual owning their own rehabilitation/treatment is noble, it may not be what is ultimately best for society. But the issue is balancing social responsibility with individual liberty, as it always has been.

I guess if I had to propose something, I would propose something along the lines of this:

1: Make it easier for a concerned group of close people to an individual to report and request oberservance.

IE: We will not let it become a lock a person up because one person said so. But maybe a threshold of three to four CLOSE relatives/friends can reccomend observation. But there must also be cause. I believe things like an inability to take care of oneself. It would require a very high threshold though, if somebody can't be bothered to keep employment, figure out shopping/eating, general hygiene, particularly if it is a marked shift from previous states of mind to be factors. Where those levels are set would require discussion though, we can't lock up Johnny because he didn't shower for a week. However if Johnny keeps a job, showers daily, brushes his teeth, and generally has a well stocked fridge, but if all of a sudden he leaves his job (especially without notice), doesn't shower, can't be bothered to shop or eat, hangs tin foil in his windows and this behavior continues for a period of time it might be worth observing. The bottom line is, to interfere in a persons life there must be an immediate threat to that persons life or others.

2: Add a third level of competency, Fit, Oberservance, Unfit.

IE: In the above case, petition the court for observance only. The way I understand it currently is you basically have to immediately determine someone unfit to have them observed longer term. What if there was a legal in-between where we flag someone and observe them without going all the way to mentally unfit? It seems like that might be a way to catch some of the more evasive issues.

3: If a person is deemed unfit, actually make it mean something.

IE: If a person is a clear and present danger to themselves or others, do something about it!

Now here is the catch, I don't trust the state, so asking for more state intervention is kind of difficult. Which is why if something like the above were done it would need to have very high thresholds. Secondly, even if the things above were implemented I don't know that it does much to save lives. So the question becomes, is inviting the state into this kind of thing worth the inevitable loss of liberty that will be associated with it? Personally, I don't think it is. Even though I came up with the above, it someone came to me asked me to support the above, I don't think I could. Bottom line, it still isn't an issue related to guns. For it to be an issue related to the mentally ill (as the media defines "Mental Illness") and their access to guns, something like the above would have to already be in place.

 

[Diamondback]

Also, if somebody IS committed and somehow gets the issue resolved so that they are not a danger to self or others, how do you give an avenue to have their rights restored? A lot of mental-health issues get stigmatized in our circles because so many think it means an immediate "you're crazy, so no guns for you again ever"... Where's the safeguard for the individual if it's something they can come back from?

 

[kibs45]

Also, if somebody IS committed and somehow gets the issue resolved so that they are not a danger to self or others, how do you give an avenue to have their rights restored? A lot of mental-health issues get stigmatized in our circles because so many think it means an immediate "you're crazy, so no guns for you again ever"... Where's the safeguard for the individual if it's something they can come back from?

^This. Totally agree.

 

[ZigZagZeke]

I saw the people who were admitted every day. A typical (true) scenario was that a man would be reported to the police for chasing his wife around the yard with a meat cleaver, wearing no clothing, and shouting about the voices telling him his wife was having an affair with the family dog. This is the kind of behavior we addressed. The patient would be involuntarily admitted for 72 hours, based on the police report. After a short period of observation and interviews with resident psychiatrists and staff, the patient went before a judge where testimony was given as to his mental state. The judge then would order him either released or held for further observation and treatment for a period of 30 to 90 days. At the end of any further treatment and observation, the patient got another hearing and another similar decision was made by the judge. It wasn't perfect, but it kept people with meat cleavers who were hearing voices off the streets.

As I said above, it was not a matter of the neighbor feeling threatened by your language or your bumper stickers. It took a pretty serious act of craziness, usually involving the police, to get somebody involuntarily committed. Family who were concerned about the person's safety and that of the public were taken very seriously, but the ultimate decision was whether a psychiatrist could convince a judge, based on real observations, and if the "patient" was lucid and sensible that was really difficult.

We really, really need to get over the paranoia about using mental health records to deny gun ownership to everyday people who've had a bad day. These bad guys were all crazy way beyond needing a prescription for Prozac. They were more like Charles Manson. We don't get to see what they were really like because they mostly killed themselves. These guys weren't just having a bad day. They were bizarre and scary people who the system failed to deal with.

 

[DeanfromOregon]

As I said above, it was not a matter of the neighbor feeling threatened by your language or your bumper stickers. ...

This is, however, one of the reasons I don't believe in bumper stickers!

 

[Diamondback]

Zeke, I'm not denouncing the idea--we do BADLY need an overhaul of the mental-health system and a key part of it needs to be de-stigmatizing mental healthcare and individuals seeking or requiring it; that as part of the effort, we basically need to give the good guys something to reassure them that they won't be looked down on or lose anything, and if anything will be MORE respected for recognizing they had a problem and getting the help they need to address it.

I speak from personal experience on this, living with Asperger's; when I first started serious training I had serious worries about how it would affect my eligibility for a carry permit, and in reply one of the cops who trained me gave what I consider some of the highest praise I've ever received, telling me that after completing standard police training he would be quite comfortable swearing me in as a member of his department. (Though I know there ARE people who are like "Autistic? With a gun? *empties bladder and bowels*")