Mental health and gun control up close

Could New York state’s new gun law backfire when it comes to people with a mental illness? Some experts think so.

The law would require therapists, doctors, nurses and social workers to tell government authorities if they believe a patient is likely to harm himself or others. That could lead to revoking the patient’s gun permit and seizing any guns, the Associated Press says.

It could also lead people who most need help not to seek it or get it.

“The people who arguably most need to be in treatment and most need to feel free to talk about these disturbing impulses, may be the ones we make least likely to do so,” said the director of law, ethics and psychiatry at Columbia. “They will either simply not come, or not report the thoughts that they have.”

We know this is likely true based on stringent government monitoring of another area: aviation.

As I noted on The Current last week, the government is very strict with the medical backgrounds of people who fly. Any possible health problem — mental or physical — can mean the loss of flying privileges.

There’s an argument to be made that the nation’s aviation system is among the world’s safest because of this. There’s also an argument to be made that it has made it more likely that someone with a mental or physical problem will fly an airplane.

This is especially true in areas of mental health. Many pilots don’t seek help or therapy because they’d be required to report it during their next FAA medical exam. But because they don’t want to lose flying privileges, they simply do without it.

At least where guns are concerned, the ramifications are obvious.

“If people with suicidal or homicidal impulses avoid treatment for fear of being reported in this way, they may be more likely to act on those impulses,” Dr. Paul Appelbaum at Columbia University said.

And several mental health professionals told the AP that the new law destroys the relationship between the doctor and the patient. “No patient is going to tell you anything if they think you’re going to report them,” said one.

And yet, there’s more talk about tracking people who’s sought help for mental illness. In Massachusetts today, Gov. Deval Patrick proposed legislation today requiring courts to send all relevant mental health records to the state’s criminal justice information system so the federal government could include this information in a national gun license registry.

Is mental health getting too big of the blame for gun violence? Writing in the New York Times last month, Dr. Richard Friedman noted that people with a mental illness are responsible for only 4 percent of violence in the U.S. Alcohol and drug abuse, he said, are far more likely to result in violent behavior than mental illness by itself.

When the head of the National Alliance on Mental Illness met with VP Biden’s task force last week, he suggested the U.S. take steps to improve the mental health system. Too many families wait years to get the treatment they need. The current system is impossible for many to navigate, he said. He also pushed for more availability of mental health services in schools.

Today’s plan included a minimal amount of money in that direction.