Mental illness, gun access important for doctors to note

Archie Bleyer /

Published Oct 12, 2013 at 05:00AM

The National Rifle Association blames the Navy Yard massacre on a national lack of mental health control. Wayne LaPierre, the NRA’s executive vice president, vehemently criticized the nation’s treatment of the mentally ill: “They need to be committed is what they need to be, and if they’re committed, they’re not at the Navy Yard,” he said on “Meet The Press.”

He stated that the records of the mentally ill are not entered into the national instant check system for gun buyers because “the nation’s mental health system doesn’t detect dangerous persons.”

Yet, the Affordable Care Act blocks physicians from recording gun access or use. The language was pushed by the NRA in the final weeks of the 2010 debate over the act and is tucked deep in the “Protection of Second Amendment Gun Rights” section of the act as a brief statement, restricting the ability of physicians to gather data about their patients’ gun ownership and use. The research restrictions began in the 1990s when the NRA demanded Congress cut funding for the Centers for Disease Control’s division that studied gun violence. In 1996, Congress nullified the agency’s ability to fund that type of research.

More limits came last year in a spending bill, setting restrictions on the National Institutes of Health after gun rights advocates complained about an NIH-backed study that discovered links between alcoholism and gun violence. The provision, inserted by Rep. Denny Rehberg, R-Mont., prohibits the NIH from spending money to “advocate or promote gun control.”

The NRA agenda has targeted states as well, with Florida lawmakers last year submitting a bill to imprison physicians for inquiring about their patients’ gun ownership. Republican Gov. Rick Scott signed a scaled-back version of the bill, requiring health care workers to “refrain” from asking patients about their proximity to firearms unless the providers believe “in good faith” that such information is relevant.

A federal judge declared the law unconstitutional, but the ruling was appealed by the state and is under review.

Last month, the NRA succeeded in having two Colorado state senators recalled for having supported gun control legislation.

As reviewed by The New York Times after the Navy Yard shooting, two states did pass stricter gun laws in the wake of the Newtown shootings, which included a provision requiring mental health professionals to report to local officials anyone who “is likely to engage in conduct that would result in serious harm to self or others.” The legislation requires that hospitals report persons voluntarily admitted for psychiatric treatment to state authorities, who could then either bar them from buying or possessing firearms for six months (New York) or confiscate the firearms and revoke the person’s gun license (Connecticut).

Homicide and suicide cause one-fourth of all deaths in 15- to 39-year-olds in the U.S. and kill more 15- to 39-year-old men and 15- to 25-year-old women in the U.S. than any other cause of death — except accidents.

How are we to attack the No. 2 killer in adolescents and young adults in our country if we can neither research the problem nor record access to guns in our patients? Institutionalizing mentally ill persons, as asserted by the NRA, might prevent some massacres, but it will not reduce the vast majority of deaths by gun.

The NRA would have us report mental illness but not ask about gun possession or access? LaPierre asks us to focus on mental illness after the very organization he leads stealthily induced Congress to prevent us from asking about guns among our patients and their families. Bend Memorial Clinic physicians use a patient information questionnaire that asks for this information. Are they at risk to have their medical licenses revoked by the NRA as it lobbies for their “recall”?