US gun control debate turns to mental health

In the drive to prevent further mass shootings in the United States, the public debate has now turned to improving the broken US mental health system in tandem with legislative efforts by Congress to control gun ownership.

At least six states, including Colorado and Ohio, are considering changes in mental health law. New York is leading the changes: the state has just passed legislation forcing mental health practitioners to warn the authorities about dangerous patients.

Stigma

The National Rifle Association has argued that mental illness, and not guns, is the cause of mass shootings. But critics of the changes to argue that they risk undermining the work of psychiatrists.

“I want to be careful here that we don’t stigmatise mental illness,” says Minnesota Democratic senator Al Frank. “The vast majority of people with mental illness are no more violent that the rest of the population, and in fact they’re more likely to be victims of violence.”

Dr Paul Appelbaum, a professor of psychiatry at Columbia University, said the Bill in New York could turn away the people it is trying to identify.

“Patients won’t want their names to get into the hands of the state, so they won’t want to come for treatment and they won’t talk, even in a doctor’s room, about the impulse to hurt themselves or other people,” he said.

John Monahan, a psychologist and law professor, said psychiatrists were required under existing rules to take action if they believed patients posed a threat.

“There is a significant risk that the New York statute will be counterproductive. It is not clear how it will be implemented, how many psychologists and psychiatrists will inform the authorities and what the police will do in those cases,” he said.

Four per cent of violence in US society is attributed to people with mental health issues; curing that will not solve the wider problem of gun violence, said Prof Monahan.