President Obama spoke Tuesday about his “Common Sense Gun Safety Reform” and the White House issued a “fact sheet” on new executive orders to reduce gun violence. Among these is a plan to spend $500 million to “increase access to mental health care” and a reference to increased reporting of “relevant information about people prohibited from possessing a gun for specific mental health reasons.”
First of all, $500 million isn’t going to change the nation’s access to mental health care without fundamental reform in the way that patients are treated (undertreated) by third-party insurers, who act as gatekeepers.
Cancer research at the National Cancer Institute is funded at over $5 billion. And that doesn’t count how much money is spent treating and preventing cancer by the government, let alone private industry.
So, $500 million will not transform mental health care in America and, thereby, reduce gun violence. I have written extensively about the multifaceted ways our mental health care needs to be rebuilt—including legislation that would need to be put in place to do it. The fact is that our mental health care system’s safety net has been torn apart, such that even people who freely admit that they are considering harming others are not given comprehensive care, including ready access to psychiatry visits, medication and hospitalization.
Even more important, the plan to make mental health care providers report “relevant information about people” who should not have guns is a hornet’s nest of trouble for mental health providers and citizens.
Mandating that clinicians report that certain patients should not have guns in their possession is a blunt instrument that could be used to deprive tens of millions of Americans of their fundamental Second Amendment rights. Major depression, alone, affects nearly 15 million Americans. Another 6.1 million suffer with bipolar disorder. Over 60 million Americans experience a diagnosable mental disorder in any given year. The vast, vast majority of these individuals pose no threat to anyone and never will. Yet, without extraordinary safeguards, social workers, nurses, mental health workers and psychiatrists worried about malpractice liability could certainly decide to report patients in a wholesale way and have their guns confiscated or their right to obtain gun licenses blocked.
The president’s plan to use mental health care providers to inform on gun owners is a Trojan Horse that could potentially undermine the rights of 60 million Americans every year.
Those who currently pose a danger to self or others can already be hospitalized against their will. And in that context, assessments can be made about whether family members should surrender guns to authorities.
It should also be stated that those who commit acts of violence can certainly choose methods other than firearms, including motor vehicles, explosive devices (like the rudimentary ones used to kill and maim people at the Boston Marathon, in 2013), knives or poisons (like the Tylenol killings, back in 1982).
President Obama’s claim that suicides can be prevented by removing guns from the people who use them to kill themselves is absurd. Sadly, those intent on suicide can find many ways to end their lives—and do. People don’t kill themselves because they own guns. They kill themselves because they are ill.
In fact, I have argued before that restricting the gun rights of Americans, in any wholesale manner, can easily have a deleterious psychological effect—leading Americans to feel disempowered, defenseless and less likely to assert their other Constitutional rights, like the right to free speech.
Another effect of tapping mental health care providers to inform on patients who ought not have guns is that those very patients—again, a tiny minority of the overall patient population—may avoid mental health care clinicians, entirely, thereby short-circuiting the possibility that they would have been helped to not be violent by therapy or medication or hospitalization.
President Obama’s early volley to make the make therapists and doctors gatekeepers for gun control is a misfire. And his $500 million nod in the direction of increased access to mental health care wouldn’t even add two impressive psychiatric centers to the nation’s armamentarium of mental health care resources.
Keith Ablow, MD is a psychiatrist, and was host of the nationally-syndicated "Dr. Keith Ablow Show." He is a former member of the Fox News Medical A Team.