Mental illness and guns

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Sunday, March 23. 2014

A patient of mine sought admission to a small psychiatric hospital. He was feeling depressed and anxious and wanted to be cared for. The hospital had no beds and placed his name on a waiting list. He was admitted to the emergency department holding area of our local hospital and after two days felt well enough to return home. The next week the psychiatric hospital called to say they had a bed. He told them he didn't require admission at this time. They asked if he had a doctor and he told them he did. Then they asked if he owned a gun. He took offense.

"They want to know if I own a gun so they can take it away."

"You don't own a gun," I said, "and maybe they were asking because they were concerned you might be suicidal when depressed or violent when angry. They know your moods and behavior, you've been at that hospital in the past." This is a middle aged man with autism spectrum, what used to be called Asperger's.

"No, they want to take our guns."

Foolish consistency.

Posted by C.T. Azeff at 14:21 | Comments (22) | Trackbacks (0)

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and now of course they consider him a violently paranoid schizophrenic for 1) denying he has mental trouble and 2) saying they want to take the guns he says he doesn't have away from him...

#1 J.T. Wenting on 2014-03-23 15:06 (Reply)

Actually, I believe he is correct. They Do want to take our guns.

#1.1 M Cunningham on 2014-03-23 15:21 (Reply)

of course. But the truth won't set you free, it will get you locked up in a mental hospital...

#1.1.1 J.T. Wenting on 2014-03-25 01:31 (Reply)

Just because you're paranoid doesn't mean they're not out to get you.

I'm a gun owner. In fact I own several guns. Carry one regularly, and support the right of **almost** every one to do so.

I'm also on the edge of the Asperger's end of the spectrum. Lots of the little symptoms and lots of coping mechanisms.

I'd be willing to bet you my next paycheck that the following are true:

1) Over 40% of doctors working in mental health are in favor of something between the British or Australian style gun laws and what Diane Fienstein is on record as supporting.

2) That over 80% of doctors working in the mental health field are of the opinion that someone who has presented themselves to an emergency room or a hospital on multiple occasions for "anxiety and depression" should not have ready access to a firearm AT ALL.

I'm pretty much a 2nd amendment absolutist. I believe that high schools should include firearm training. I believe that if you've managed to get through highschool without committing a violent crime or getting arrested for drugs you ought to get your choice of a .22 pistol or rifle with your diploma.

I think mentally ill people ought not to have ready access to firearms. Although I'd have issues with who gets to define "mentally ill".

#2 William O. B'Livion on 2014-03-23 15:21 (Reply)

These things come up so routinely (at my latest physical exam for example) that they offend. If the staff was on the ball, this could have been handled no only more tactfully but in a more informative and useful manner. For example:

Q. Do you think you feel suicidal when depressed?

Q. Do you think you might harm others or be aggressive when depressed?

Q: is there anything in your home that you feel might be dangerous to you or others which you would like removed for the time being? Such as prescription drugs, large knives, cleavers or axes, firearms, keys to cars etc.?

I'm no shrink but i focussing on guns and guns alone seems to be a shortcoming (See today's NY Post article on the rash of bankers suicides jumping from tall buildings. A suggestion is made to have professional counselors on trading floors!).

You have to prove you are acting to help them, but the gun question invariable comes across as a lack of trust that is political in nature.

#3 DirtyJobsguy on 2014-03-23 16:03 (Reply)

I agree that the question is likely intended to "take his guns".

It would be interesting to know when the last time he went to that hospital was and if they asked him if he had any guns that time. I would venture a guess it was before Obummer came to power. I am led to understand that doctors are supposed to ask about guns in your house when they treat you.

In this instance, the person at the hospital apparently did not know why he requested admission yet he still asked if he had a gun. Certainly there are reasons to ask admittance to a psychiatric hospital for a short stay that would not imply that he should not have a gun.

#4 mudbug on 2014-03-23 16:03 (Reply)

More comment bait, but I'll bite.

Don't know what they wanted to do, but I can assure you that they would most likely take action to forcibly take the firearms. Perhaps not the hospital, but when they reported the answer in the state database.

If one wishes to retain their Constitutional rights, you cannot involve yourself with the psychiatric community. They cannot be trusted. Many are Leftists and are not beyond using their "professional" positions to abuse the rights of those who come within their control. Others, even if not malevolent have reporting obligations that will pass the information to state agents who will take the bureaucrat's way of better to deny a right than risk a remote bad outcome.

Not to mention, having been involved in the psychiatric community it creates a need for reams of paperwork if you ever seek a position of responsibility, such as a security clearance.

And I keep in mind the advice my aunt's pediatrician boss gave her when she was thinking of seeking counseling for her son back in the '70s. Her son was the type of kid educators and the psych community drug to the gills these days, active. The pediatrician advised that if she did get one that was just out of school. After few years of practice, they were crazier than their patients.

#5 JKB on 2014-03-23 16:28 (Reply)

Anecdote rather than data, but...

I can only recall a single instance in my life of sufficient time spent near enough a psychiatrist to actually engage in conversation. We were occasionally side by side on treadmills at the gym.

I no longer recall how the topic was raised but, somehow, the words "from each according to ability, to each according to need" were audible. The psychiatrist then said, paraphrasing, "that sounds like a reasonable way to live."

I replied, "It sounds like a recipe for getting people to minimize their abilities and maximize their needs. And then politicians can step in and dictate who has what abilities and needs. Not a reasonable way to live in my book."

He was seriously miffed and ceased talking to me then and never climbed aboard the treadmill next to me again. I think he had some psychological issues.

#5.1 Knucklehead (Link) on 2014-03-24 11:06 (Reply)

I don't see anything foolish in his point of view.

I have 3 nephews on the autism spectrum. One of them had a severely hard-left caretaker at one point. She felt he should be on an all-organic diet, and pounded her AGW mindset into him.

Today, he eats a modified version of the paleo diet, but the supposed gains she claimed would occur have not followed.
I would classify her view as "foolish consistency".

In addition, you cannot have a conversation with him now without the issue of man harming the environment being discussed regularly. He is so anti-carbon it's ridiculous. In fact, so much so he refuses to speak with me anymore because he knows I disagree with him but I refuse to discuss the environment since he is so poorly informed (not his fault).

You write this as if this poor fellow is being misled. Maybe he is, I say he isn't.
On the other hand, I suspect you believe my nephew is not being misled, when it's so clear to me he has been hoodwinked on many levels by people who have promised to "care for him" (not his parents, who have tried to get him the best care possible since they can't be with him 24/7).

I read a story like yours and realize you're trying to make a comment about the foolishness of the pro-gun mindset. I can make the same comment about the AGW mindset using a person suffering from a similar disability.

These people have difficulty managing themselves in society, but I don't blame them for their single-track points of view, that's part of their disability.

I still agree with your patient, however. They are trying to take our guns. I know people in my office who are offended when I tell them I own guns, and are shocked when I inform them I used to hunt and trap animals in my youth.

I'm anti-trapping now, but I have the experience they don't to make a solid judgement regarding it. I am still pro-gun and still pro-hunting. I am not on the autism spectrum, and the people I work with DO want to take my guns.

#6 Bulldog on 2014-03-23 16:30 (Reply)

It is essential to lie to medical people regarding gun ownership. The only correct answers are, (a) No, I don't own a gun, and (b) There are no guns in my home.

You should always buy your guns on the street so that there is no paper trail. Then you can lie to the police, too.

#7 bob sykes on 2014-03-23 16:33 (Reply)

I am not sure how many times we need to go over this. I guess it is consisitently foolish to keep asking about it. But I too will bite.

If you really think that nobody in the upper reaches of our political spectrum wants our guns then you are truly foolish. Not only did they succeed in passing a ban on the manufacture and sale of "assault weapons" (which weren't actually automatic and thus not actual assault weapons) in the 90s, but they tried again in January of 2013, this time the original bill wanted to confiscicate the AR15s, AK47s, etc that already existed in the hands of law-abiding citizens.

Now your patient might well have overreacted from your point of view. Since he had other mental issues, I would expect him to be a bit unbalanced. But the bigger issue here is your refusal to see what is right in front of your face: the authorities DO want to disarm the public. Just because they haven't tried to do it by force doesn't mean they won't in the future. And now matter how inconvenient a truth it is for you or for Schumer, Pelosi and their ilk: the 2nd Amendment guarantees that we CAN own guns. Not just to hunt with. Not just handguns for personal protection. The Founding Fathers wanted us to own whatever we could get our hands on to protect our liberties from tyrants in government.

I pray that we don't ever have to use our guns for that purpose. But it is what the 2nd Amendment is for. Don't let anyone tell you differently.

#8 Dangerous Dean on 2014-03-23 16:49 (Reply)

Comment bait, but tasty.
There is a rather simple rule....'Don't go to the medical profession for anything that might be a mental issue.' A corollary is 'don't answer any questions which are not directly relevant to one's physical well-being while in the doctor's office.'
Thereby one can avoid a paper trail which will follow you for the rest of your life; a paper trail that can and does block (or make exceedingly difficult) certain types of employment, that may be dragged back up if you encounter the criminal system, that may be used to bar one from certain constitutional rights...
I suppose I am paranoid too. But when a licensed GP doctor suggested the above to me?
The paper trails of today's society have never helped me, but they certainly help the government to corral me.

#9 acairfearann (Link) on 2014-03-23 16:59 (Reply)

It's not paranoid when it is based on observed fact. The only issue is the probability. But as they say, you can't lose if you don't bet. And in this game, it is all downside.

#9.1 JKB on 2014-03-23 19:40 (Reply)

Lesson 1: Do NOT trust anybody in mental health.

Lesson 2: He is perfectly sane; they DO want to take away everybody's guns. Since the 2nd Amendment has been grudgingly accepted as what it obviously is, the attack will come from the "mental health" direction. Just like the old Soviet Union did it.

#10 rj on 2014-03-23 20:48 (Reply)

Question (to paraphrase Hillary Clinton). Since the likely outcome would be they take his guns (regardless of their alternate motivations mentioned in the post), what difference does it make? He'd be right either way.

When people in positions of authority express individualized concern about your well-being, you know that nothing good will come of it.

#11 ruralcounsel on 2014-03-24 21:31 (Reply)

I've worked in acute psychiatric emergency units for decades.

Nice to see everyone sharing their suspicions about us. Some of them might even be true!

Yet I am noticing a decided lack of data to support the contentions above. I just see assertions, dramatically stated.

When y'all can pony up some actual evidence, we can have a discussion. Until then, just have another drink and shout louder, okay? You'll convince each other just fine.

#12 Assistant Village Idiot (Link) on 2014-03-24 22:08 (Reply)

We don't need to have a discussion. The risk of adverse action by psychiatric "professionals" or the bureaucrats they feed data to, when it comes to firearms is to great. It only takes one bad actor to destroy your life and there is no simple way to determine the bad actors, even if they are a minority. The risks of adverse action against the individual when questioned about gun ownership by a mental health professional is significant and from the individual's point of view, offers very little benefit.

Now this case, doesn't mention psychiatric professionals, but it has been allowed to go forward because the State actors used mental health issue claims to take the man's guns. In this case, allegedly in retaliation to protected First Amendment statements supporting gun rights. It should be noted that this case has not had a finding of facts beyond the documented police actions so the retaliation motive is still unproven.

#12.1 JKB on 2014-03-25 09:03 (Reply)

Those that demand evidence and citations that they themselves are unwilling or unable to provide can be safely ignored as irrelevant and immaterial. If you are such a bright informed SOB, how about you show us evidence for your contentions?

Especially those folks that seem to demand some sort of generalized respect based upon a job description; as if that buys you any arms-length credibility. Those that deserve respect don't go around demanding it. Your alleged decades-long experience with "acute psychiatric units" means nothing. Get tired patting yourself on the back much? That's just the sort of arrogance that proves the point of everyone's mistrust of the "mental health profession".

Bottom line: the time for discussions about this are long over. You've picked to go to war with your fellow citizens over the restricting of a what is, at bare minimum, a Constitutional right. There is no credibility left on the restriction-side of this argument. You want to restrict my gun? Come and take it.

#12.2 ruralcounsel on 2014-03-25 18:54 (Reply)

Someone wanted some documentation?

"NEW YORK SECURE AMMUNITION AND FIREARMS ENFORCEMENT ACT (NY SAFE ACT)

NYS Office of Mental Health
NYS Office for People With Developmental Disabilities
Guidance Document

On January 15, 2013 Governor Cuomo signed the New York Secure Ammunition and
Firearms Enforcement Act (SAFE) into law. Reflecting a comprehensive approach to
reducing gun violence, the law toughens criminal penalties on those who use illegal guns;
closes a private sale loophole to ensure all gun purchases are subject to a background
check; allows authorities to track ammunition purchases in real time to alert law
enforcement to high volume buys; requires recertification of pistol permits every five
years; and strengthens the state’s ban on high-capacity magazines and assault weapons.

In addition, the law contains several provisions pertaining to the duties of mental health
professionals regarding patients who may pose a danger to self or others. The following
is a brief summary of these provisions and guidance regarding their implementation.

1. Mental Hygiene Law Section 9.46 - Reporting Requirements for
Mental Health Professionals:

A. Reporting Process:

SAFE establishes a new Section 9.46 of the Mental Hygiene Law (MHL), which requires
four groups of mental health professionals (i.e., physicians, psychologists, registered
nurses, and licensed clinical social workers), in the exercise of their reasonable
professional judgment, to make a report as soon as practicable to county mental health
officials if an individual for whom they are providing mental health treatment is “likely to
engage in conduct that will cause serious harm to self or others.” Upon receiving a 2
Section 9.46 report, if the county mental health official agrees with the mental health
professional’s determination, he or she will then report “non-clinical identifying
information” to the New York State Division of Criminal Justice Services (DCJS). DCJS
will then determine whether the person possesses a firearms license and, if so, will notify
the appropriate local licensing official, who must suspend or revoke the license as soon as
practicable. The person must surrender such license and all firearms, rifles, or shotguns
to the licensing officer, but if the license and weapons are not surrendered, police and
certain peace officers are authorized to remove all such weapons."

And this.

"NY’s SAFE Act: Mental Health Reporting Requirement
As we collectively continue to process the tragic event in Newtown, CT and look for real solutions to the
issue of gun violence, we understand and appreciate Governor Cuomo’s urge to take decisive steps
toward preventing a future event of this nature from becoming reality. However, the swift passage of
NY’s SAFE Act of 2013 has perhaps generated more questions and concerns than it has offered us
comprehensive solutions to the issues that contribute to the problem of gun violence.
Licensed Clinical Social Workers are among the mental health professionals specifically designated in
NY’s SAFE Act as being required to report to local mental health officials when there is reason to believe
a patient is likely to engage in conduct that will cause serious harm to themselves for the purpose of
crosschecking the individual’s name against the new comprehensive gun registration database. If the
individual possesses a gun, the license will be suspended and law enforcement will be authorized to
remove the person's firearm (or the individual may be prevented from obtaining one in the future). This
change is currently scheduled to take effect on March 16, 2013 which is 60 days from the date the
legislation was signed into law.
The SAFE Act also amends Kendra's Law (which authorizes assisted out-patient mental health treatment)
by, among other provisions, extending its effective date for an additional two years- through 2017. It
increases the period of mandatory outpatient treatment from 6 months to one year. In addition an
assisted out-patient treatment assessment will be required before a mentally ill inmate is released from
state prison.
The SAFE Act raises concerns regarding patient confidentiality with regard to their mental health
treatment, the potential for creating additional deterrents to seeking critical mental health services by
those in need of care, promoting the criminalization of persons with mental illness, and the need for
greater clarity on the responsibilities and reporting requirements for designated mental health
professionals.
NASW-NYS is in consultation with the NASW General Counsel’s office and the NASW Assurance Services
Inc with regard to the nature and scope of impact this legislation will have on providers and their
practice liability. As regulations are promulgated for implementation of this legislation we will address
any issues as they emerge and will keep our membership informed on the issue as it unfolds. We are
hopeful and will advocate that this legislation ultimately strikes a balance between meeting the
obligations to protect the public’s safety while not creating any deterrents to accessing critical mental
health care, preserving patient confidentiality to the degree possible and addressing the long term
impact on the lives and recovery of those who may be subject to the law.
What is of particular concern to us is the potential for the intent of the mental health reporting
requirement to be undermined by the permanent exemption for employees of state regulated,
operated or funded agencies from compliance with the social work licensure law which is included in the
Governor’s proposed budget. Implementation of such an exemption would apply to a vast number of
individuals providing mental health care, who because of their unlicensed status would not be directly
subject to the SAFE Act’s reporting requirement. At a time when the competency and qualifications of
mental health providers are most crucial, the Governor has proposed a broad based exemption of such
requirements; a move that is at odds with his earlier commitment to strengthening the mental health
service delivery system. Fulfilling the SAFE Act’s intent to support a safer NY can only be possible
through the use of license qualified mental health professionals."

Taken from the National Association of Social Workers web posting.

Nah, nobody in the mental health field is looking to take your guns from you. Not much.

#13 W.C. Taqiyya on 2014-03-25 11:24 (Reply)

You know what you don't see in that information? Any thought or discussion of due process.

#13.1 JKB on 2014-03-25 14:26 (Reply)

Correct, zero due process. Add to that the sole concern expressed by the professional mental health community being their liability and insurance costs and risks. They don't care about patients, confidentiality or rights, they care about their precious licenses and their pocketbooks. Our brave doctors hard at work for us....

Any more questions? Yeah, I thought not.

#13.1.1 W.C. Taqiyya on 2014-03-25 16:06 (Reply)

After Newtown, here in CT, our state totalitarians, supported by the knee-jerk, bootlicking RINOs we elect, passed a gun control bill that included some changes to inpatient psychiatric admissions.

If you agree to a voluntary admission, then we have to explain to the patient that their firearms will be confiscated, maybe for only 6 months. I can't tell you in practice how this works, because most of our patients either have no firearms, or they've been taken away by family already. Note that this doesn't apply to INvoluntary admissions.

#14 Steve in ct on 2014-03-27 09:52 (Reply)

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Sunday, March 23. 2014

Mental illness and guns