Experts: NY Gun Law Could Deter Mentally Ill From Seeking Treatment
By Dr. Susan Berry Breitbart.Com January 16, 2013
Mental health experts say that New York's new gun control law may prevent the effective treatment of potentially dangerous individuals and even discourage them from seeking assistance.
The new legislation features a requirement that therapists, doctors, nurses, and social workers inform government authorities if the provider believes a patient is likely to harm himself or others. A report of this kind could lead to rescinding the patient’s gun permit and the confiscation of any guns owned by the patient.
Dr. Steven Dubovsky, chairman of the psychiatry department at the University of Buffalo, called the new requirement meaningless. “It’s pure political posturing,” and a deceptive attempt to reassure the public, he said.
Dubovsky said that the new law seems to turn mental health professionals into law enforcement officers, and that it cannot be taken seriously because therapists will not be held liable if they do not report a patient they believe is harmful. Consequently, Dubovsky thinks most therapists will ignore the law and continue to manage potentially harmful patients as they do now.
He added that “no patient is going to tell you anything if they think you’re going to report them.”
Dr. Paul Appelbaum, Director of Law, Ethics, and Psychiatry at Columbia University, said that the new measure could cause patients to refrain from revealing thoughts of hostility or harm, or even from seeking treatment altogether.
“The people who argue 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,” Appelbaum said. “They will either simply not come, or not report the thoughts that they have.”
Appelbaum added, “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.”
Under the Tarasoff ruling of the 1970’s, mental health professionals have a duty to warn potential victims of a patient. According to Appelbaum, this can be accomplished in several ways: 1) the patient can be committed to an institution, voluntarily or not; 2) the patient’s medication can be changed to reduce the risk of danger; 3) the intended victim of the patient can be warned.
Appelbaum added that the patient’s family can be asked to lock up any guns in the home, or monitor the patient to determine if he or she is behaving in such a way that could make violence more likely, like drinking or refusing to take medication. In such cases, the family can contact the patient’s mental health professional.
Appelbaum explained that the current way of managing potentially harmful patients is flexible and does not, in all cases, breach confidentiality. He said that the new law, however, requires that the patient be reported to mental health authorities.
“It undercuts the clinical approach to treating these impulses, and instead turns it into a public safety issue,” Appelbaum stated.
Appelbaum also observed that in many shooting massacres in the past, the gunman had not been under treatment, and would not have been deterred under the new law.