LG: SAFE Act Reporting Provisions Raise MH Community Concerns

Mandatory Reporting Provision Of The SAFE Act Raises Concerns In The Mental Health Community

By TG Branfalt Jr. Legislative Gazette March 11, 2013

The mandatory reporting of people with potentially dangerous mental health conditions provision of the SAFE Act takes effect this week and there are still prevailing concerns and confusion within the mental health community regarding how these new laws will impact their profession.

According to the reporting provisions of the state's new gun laws, individuals determined to be at risk for violence will be entered into a database which would prevent them from purchasing or owning any firearms.

There seems to be one overwhelming consensus among mental health practitioners: the reporting requirements could have the undesired consequence of deterring people from seeking, or fully disclosing during, treatment. And while mental health professionals are currently obligated to explore violent impulses expressed in care, they are not required to report those impulses.

"A lot of people express a lot of impulses in a confidentiality relationship that, in the end, is ventilation not a plan for danger," Harvey Rosenthal, executive director for New York Association of Psychiatric Rehabilitation Services, Inc. said. "A lot of people are actually able to calm themselves by being able to talk it out. I just worry this is an environment of hysteria where we are linking violence to mental illness."

Rosenthal also expressed concerns about the potential for "over reporting" which might lead to people being listed in the registry as dangerous.

Celisia Street, communications and professional development associate for the New York state chapter of National Association of Social Workers, shared Rosenthal's concern, saying "the client-therapist relationship is one rooted in trust, therefore is of great concern that fear of information disclosure generated by this new reporting requirement could actually serve as a deterrent to clients sharing of information."

Street's chapter of the National Association of Social Worker's is also very concerned about a proposal in the Executive Budget that would provide a permanent exemption for state employees from compliance with the social work licensure law. Under the proposal, unlicensed social workers employed by the state, such as aides working in state-run group homes, would be exempt from the reporting requirement.

"Implementation of such an exemption would apply to thousands of individuals providing mental health care, who because of their unlicensed status would not be directly subject to the SAFE Act's reporting requirement," Street explained via email.

The original exemption was enacted in 2004 and had a sunset provision attached. The exemption has been extended twice since 2010, and according to the Executive Budget, would be extended permanently. The exemption affects state employees working under the guidance of the Office of Mental Health, Department of Health, the State Office for the Aging, the Office of Children and Family Services, Department of Corrections and Community Services, Office of Alcoholism and Substance Abuse Services, the Office of People with Developmental Disabilities.

Glenn Leibman, CEO of Mental Health Association of New York, said, "as advocates we are not happy with the law.

"We don't think mental health and gun legislation should be combined. People with mental illness are no more violent than the general population," he said referring to The Population Impact of Severe Mental Illness on Violent Crime, an oft-cited 2006 study which found mentally ill people to actually be 12 times more likely to be victims of violent crime opposed to perpetrators.

Leibman, too, expressed concerns over the potential deterioration of the therapeutic relationship.

"The key to recovery for a lot of people is the relationship that is developed between the clinician and the individual and you don't want the confidentiality impacted in any way," he said, "[The law] changes the conversation and dynamic. The number one reason people don't seek services is the stigma associated with mental health illness."

Neither the Mental Health Association of New York, the New York Chapter of the National Association of Social Workers, nor the New York Association of Psychiatric Rehabilitation Services, Inc. have held discussions specifically with the governor's office in regard to the gun laws.

Richard Azzopardi, the governor's spokesman, said in an email, "All reporting will be conducted in the strictest confidence in accordance with state and federal confidentiality requirements - as are current standards regarding the reporting of an imminent threat of physical harm, child abuse, or similar circumstance," the statement said. "These new reporting requirements are secure and comprehensive and we will work with the mental health community during the implementation of this critically important part of the NYSAFE Act."

"I think [practitioners] are looking for the clarification language, the standard," Leibman said.

The New York State Office of Mental Health declined to comment on any progress by the Governor's Office.

Unless there are any amendments to the Provisions Related to Persons with Mental Illness chapter of the SAFE Act, the reporting requirements are scheduled to take effect March 16.