How Should Treatment For Mental Illness Prevent You From Owning A Gun?

IMPORTANT ADDENDUM: Please see link to an important statement about this topic at the end of the blog

I personally favor strict gun control laws. I also believe that that there should not be stigma against people with mental illness. People should be able to see a mental health professional with the confidence that their treatment will be confidential. The exception to this latter point is when the mental health professional believes that the person is  a danger to themselves or someone else, the mental health professional is obligated to act and notify police if indicated and/or hospitalize the patient. This obligation should not be a secret to the patient and anyone seeing a therapist should understand that would be  the appropriate and ethical behavior to be followed in those circumstances.

There may very well be a conflict in the first sentence in the above paragraph and the statements which follow. My thinking about this subject was stimulated by a recent op-ed piece in the NY Times  by Ms. Wendy Burton a former political speech writer titled “Please Take Away My Right to a  Gun” . Ms Burton argues although she might be tempted to get a gun for self protection she also realizes that her depression condition would make her more likely to use it against herself.

She quotes statistics from the Center for Disease Control and Prevention that 38,364 Americans committed suicide in 2010 and 19,392 used a gun.

Federal Law Concerning Mental Illness and Right to Own a Gun

Possession of a firearm by the mentally ill is regulated by both state and federal laws.  The federal law  states “ It is unlawful for any person to sell or otherwise dispose of any firearm or ammunition to any person knowing or having reasonable cause to believe that such person “has been adjudicated as a mental defective or has been committed to any mental institution.” Mentally defective is obviously an outdated term and I am guessing that would probably be interpreted to mean mentally disabled. (meaning low IQ or significant brain damages etc ). I assume that the term “committed“ to a mental institution means some type of  legal involuntary hospitalization. However, I believe that in some states  a person can sign themselves in to a hospital  and be considered to be “committed” and can be held against their will for a certain period of time even if they change their mind and wish to leave. If a person is held in a mental hospital against their will but then is released by a judge  or by another or more senior doctor after the circumstances are clarified, is that person considered to be committed?

What about a person who voluntarily  enters a mental hospital to be treated for a mental condition completly unrelated to any potential violence. For example hospitalization for anorexia, incapacitating obsessive compulsive disorder, addiction to pain medication prescribed by doctors etc. In fact if the condition was such that the person couldn’t care for themselves, they might have even been admitted on an involuntary basis (“ committed “).

State Laws Concerning Mental Illness and Right to Own a Gun

Now I wondered about the wording of the various state laws. I went to the NCSL-National Conference of State Legislatures  website . All I can say is that it is quite a mixed bag on this subject. My state of California says the following :

A person is barred from possessing, purchasing, receiving, attempting to purchase or receive, or having control or custody of any firearms if the person:

• Has been admitted to a facility and is receiving in-patient treatment for a mental illness and the attending mental health professional opines that the patient is a danger to self or others. This prohibition applies even if the person has consented to the treatment, although the prohibition ends as soon as the patient is discharged from the facility;
• Has been adjudicated to be a danger to others as a result of a mental disorder or mental illness or has been adjudicated to be a mentally disordered sex offender. This prohibition does not apply, however, if the court of adjudication issues, upon the individual’s release from treatment or at a later date, a certificate stating that the person may possess a firearm without endangering others;
• Has been found not guilty by reason of insanity of enumerated violent felonies. A person who is found not guilty by reason of insanity of other crimes is barred from possessing firearms unless a court finds that the person has recovered his or her sanity;
• Has been found mentally incompetent to stand trial, unless there is a subsequent finding that the person has become competent;
• Is currently under a court-ordered conservatorship because he or she is gravely disabled as a result of a mental disorder or impaired by chronic alcoholism

Oklahoma law briefly  states : Oklahoma prohibits knowingly transferring a firearm to:

• A mentally or emotionally unbalanced person.

Texas goes into a great deal of detail :

A person is ineligible for a license to carry a concealed weapon if the person:
(1)  has been diagnosed by a licensed physician as suffering from a psychiatric disorder or condition that causes or is likely to cause substantial impairment in judgment, mood, perception, impulse control, or intellectual ability;
(2)  suffers from a psychiatric disorder or condition described by Subdivision (1) that: (A) is in remission but is reasonably likely to redevelop at a future time; or (B) requires continuous medical treatment to avoid redevelopment;
(3)  has been diagnosed by a licensed physician, determined by a review board or similar authority, or declared by a court to be incompetent to manage the person’s own affairs; or
(4)  has entered in a criminal proceeding a plea of not guilty by reason of insanity.

The following constitutes evidence that a person has a psychiatric disorder or condition described by section (1), above:
(1)  involuntary psychiatric hospitalization;
(2)  psychiatric hospitalization;
(3)  inpatient or residential substance abuse treatment in the preceding five-year period;
(4)  diagnosis in the preceding five-year period by a licensed physician that the person is dependent on alcohol, a controlled substance, or a similar substance; or
(5)  diagnosis at any time by a licensed physician that the person suffers or has suffered from a psychiatric disorder or condition consisting of or relating to:
(A)  schizophrenia or delusional disorder;
(B)  bipolar disorder;
(C)  chronic dementia, whether caused by illness, brain defect, or brain injury;
(D)  dissociative identity disorder;
(E)  intermittent explosive disorder; or
(F)  antisocial personality disorder.

The other states vary greatly. Take a look at that link .

Of course the big question might be how is this information determined.

Hospital Records, Gigantic Database or Honor System?

Will the information used to prevent someone from getting a gun permit  come off of insurance records, Medicaid, Medicare forms etc? Will there be a gigantic database of all mental health treatment? Or will this just be the honor system of the person applying for a gun permit? What will happen if someone reports to the  government that they know so and so was treated for a mental condition by such and such doctor or hospital and shouldn’t have a  gun permit? Will mental health professionals  have to release their records or  have to testify about their non- hospital treatment? Will there be any obligation if  a therapist learns in the course of therapy that a patient is applying for a gun permit but actually doesn’t meet the criteria of the state or perhaps of  some new all encompassing federal law??

Let’s Have a Dialog About This Subject

Now is the time for mental health professionals to join in the dialog that this country is going through. Let’ start it here. There are about 15,000 viewers /week on this blog according to the statistics which I get from word press but you are usually exceedingly reticent to send in comments. Perhaps this subject can be the exception. It may be very helpful to mental health professionals and patients if we participate in this national discussion. Please click on the comments button and let’s hear your thoughts on this subject. What should the law be concerning mental illness and the right to own a gun and how should such a law be worded? I also encourage readers outside the United States give us your viewpoint.

ADDENDUM: I was very pleased to see a recent letter by Dilip Jeste, M.D.President of the American Psychiatric Association which makes some very important points on this subject. Click here for the link