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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsNYS Gun Law includes requirements for Mental Health Professionals to report patients
who are homicidal or suicidal.
How is a MH Professional going to know exactly who may be the next Adam Lanza?
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bettyellen
(47,209 posts)To kill themselves or others. Sounds like a pretty smart thing, if that's the case.
madinmaryland
(64,933 posts)confidentiality, will patients the trust the doctors enough to open up to them? I suppose if it is an open threat to a certain person or to commit a definite act, then yes, then the rules should be similar to attorneys, et.al.
Still Sensible
(2,870 posts)issues of confidentiality, privilege, a boatload of potential gray area.
HereSince1628
(36,063 posts)and many states have similar reporting requirements. These laws have been tested. They stand up.
Mojorabbit
(16,020 posts)that this will increase the suicide rate. Who in that frame of mind will seek help knowing they will end up in some govt. data base. What about the doctor patient relationship? Can you trust your doctor when you know or find out he has reported you when you are at your most vulnerable? Will insurance companies have access to the names of these people? Employers? Will it be public record and available to a myriad of people? Will teens in this position have tis follow them on record for life? I wonder how this will be implemented. I would so prefer increased funding for hotlines, increased access to care, and...... I could make a list of better ways to handle this(for the suicidal).
madinmaryland
(64,933 posts)should not end up in some database. It really opens up a can of worms.
PADemD
(4,482 posts)The handgun used by a mentally ill Allentown man to shoot police on a New York subway was bought in Whitehall by a couple accused by authorities of lying on official paperwork about the sale.
Peter Jourdan, who struggled with schizophrenia and drifted between Allentown and Brooklyn, opened fire with a 9 mm Taurus handgun when officers approached after seeing him move between cars on a Manhattan-bound train. Jourdan, 37, was killed in the Jan. 3 shooting that left two police officers wounded.
http://www.mcall.com/news/local/allentown/mc-allentown-new-york-subway-shooting-arrests-20130114,0,838873.story
Mojorabbit
(16,020 posts)PADemD
(4,482 posts)Mojorabbit
(16,020 posts)If the homicidal threat had been dealt with then the suicidal part would have been moot.
denverbill
(11,489 posts)And Jared Loughner.
madinmaryland
(64,933 posts)and if they were planning anything. Holmes' records have not been released.
riderinthestorm
(23,272 posts)If they are then going to be sued for NOT reading them correctly, or not reporting them, or not discovering truths about their mental health fast enough to suit lawsuits....
Its a can of worms imho. 
denverbill
(11,489 posts)Why would any therapist take any case under the current laws if they have to risk getting sued?
Why would anyone open a movie theater? They are also being sued for not preventing Holmes from breaking in, as is the school in Connecticut.
This isn't about who gets sued after a shooting in this lawsuit nutty country. It's about possibly stopping the killings in the first place in this gun-crazed country. No law can stop all killings. But if a law could potentially have stopped one or more of these massacres (and the stupid lawsuits that they provoke), wouldn't that be worth it?
riderinthestorm
(23,272 posts)A lot of it is intuition and experience. If professional therapists are now supposed to act as arbiters of who is safe to own a gun and who is not, I would imagine that more than a fair few of them will opt out of taking on that responsibility. Especially if they don't call it exactly right and will end up getting sued (or maybe even prosecuted for negligence).
With NY now making a law that mental health professionals must be part of the legal process of who gets "reported" and who does not, then I'm sure some will simply stop talking to any clients where that call may be ambiguous.
James Holmes' psychiatrist getting sued appears to me to be a harbinger of what's to come and will have a chilling effect, especially in light of NY's new law.
As for the NY law itself? I like a lot of it but the mental health aspect of it won't work and is probably detrimental at minimum to really helping solve that problem. Other DUers who are currently involved with mental health issues either personally or professionally have already chimed in on this thread so I won't duplicate their wise words.
As for me, the ONLY commonality with ALL of these shootings is easy access to guns and ammo. So as far as I'm concerned THAT'S where we need to start focusing, immediately.
lynne
(3,118 posts)- as mental health problems have been a consistent factor in these mass shootings. To not address the mental health issue is the same as not addressing the gun issue.
I was very relieved to see that NYS was including a provision for mental health and hope that the federal changes do the same.
etherealtruth
(22,165 posts)This over-rides Dr/patient ... therapist /patient confidentiality!
Who in their right mind would tell a therapist anything if it could be reported to a governmental entity
madinmaryland
(64,933 posts)It is a very onerous provision for MH Professional/patient confidentiality. And it requires the Professional to make a judgement that could stigmatize a person for the rest of their life.
etherealtruth
(22,165 posts)I certainly would not!
NickB79
(19,247 posts)The person having paranoid delusions about people spying on him who really needs help will now be told his name might be entered into a government database? Yeah, that's gonna help get that guy some much-needed medical treatment.
SayWut
(153 posts)etherealtruth
(22,165 posts)An example: If one is reporting TB ... it is based on the presence of specific pathogens ... the diagnosis (in reportable diseases) is pretty black and white.
Psychiatry and psychology (and their diagnosis) are not black and white.
I guess all gun owners could be placed on a national data base that the mental healthcare worker could access and "ping' if they had concerns ... that would be a much more honest way to approach it!
SayWut
(153 posts)Isn't that's what really at stake or the concern here?
The loss of privacy or violation of doctor/patient privilege?
"Psychiatry and psychology (and their diagnosis) are not black and white."
A more accurate statement would be "Psychiatry and psychology (and their diagnosis) are not always black and white.
Physicians are just as capable of making a misdiagnosis as a physicist.
However, there are certainly cases where there can be little question of a persons physical or emotional well-being, and their ability to be behind the wheel of an automobile, or have their fingers on the trigger of a gun.
As I posted earlier, there should be some sort of safety net or process allowing for a second opinion.
etherealtruth
(22,165 posts)Instead of subjecting everyone to reporting of private medical info, I still believe gun owners should be the one on a database. Allowing mental health professionals to check that database if they have concerns about a patient.
SayWut
(153 posts)That doesn't help the debate or solve any problems.
Personally, I'm not fearful of any or all gun owners, however, I do believe steps need to be taken in order to keep firearms out of the hands of those who have no business owning them.
That would include those convicted of violent crimes, felony's, criminal misconduct, stalking, etc as well as those not mentality competent that could pose a danger to themselves or others.
Placing all the onus, blame or responsibility on one segment of society without addressing the
potential for disaster from another segment is poor legislation and planning that only serves half-measures.
Preventing gun violence, in all forms, needs to be addressed.
If it involves a bit of sacrifice from all sides, it's something definitely worth considering.
marybourg
(12,631 posts)
ecstatic
(32,705 posts)When people first seek help, they're probably not as far gone as they end up right before their killing spree. So concerns over the ability to purchase a gun would be the furthest thing from their mind. I'm probably wrong, but I think gun violence is like the Stage 4 of mental illness.
nadinbrzezinski
(154,021 posts)Who met those conditions on an emergency basis.
pipoman
(16,038 posts)since Raygun defunded mental health services, the only way an involuntary commitment can occur in my state is if the petitioning party can self pay or the person commits a crime. If a parent calls the police because they are worried their child is going to hurt himself or others, the police tell them that the son must commit a criminal act. If the parent files for involuntary commitment in civil court, they must be able to pay for the commitment or the case will not be heard. The year after Raygun defunded mental health services 3 state hospitals closed...there is no room for deadbeats..even if the deadbeat is dangerous..it's about the money.
Skidmore
(37,364 posts)can initiate an involuntary commitment for someone if they swear an affidavit in front of a judge letting the judge know the behaviors that the person is engaging in which are harmful to self or others.
SayWut
(153 posts)To become qualified to give a medical diagnosis or opinion?
Hard to say if this is a bad thing or not, but if it keeps even one Adam Lanza, Jared Loughner, Seung-Hui Cho, etc from obtaining a firearm, it's good thing.
I haven't read the full text of the bill, or language that goes into the mental health reporting requirement, but the aggrieved should be able to seek a second opinion, and if at anytime in the future they are deemed well enough to be trusted, there should be an avenue to have their name removed from any database.
Mojorabbit
(16,020 posts)prevent one incident. It is a bad mindset IMO. One can use that to strip the population of every right we have. It is why
we have the patriot act. Once you give up rights you rarely get them back. I agree there needs to be action but I am uncomfortable with this esp with suicidal people.
SayWut
(153 posts)Universal background checks are coming, and are a step in the right direction.
But, if any database is incomplete or not comprehensive, what good is it?
Mojorabbit
(16,020 posts)Last edited Tue Jan 15, 2013, 09:12 PM - Edit history (1)
since 60 percent of gun homicides are suicides... We could fund all sorts of suicide prevention programs, run psas constantly to destigmatize getting help, open access to help for those who need it. Right now if someone threatens suicide they are admitted but that is for an imminent threat. It is after discharge that finding help is hard in many places with waiting lists. My husband is a family doctor and it is a huge problem. A personal story...When I was on Chantix I began to have suicidal thoughts. I was one of the first group of people who had those symptoms and I knew it had to be the drug. I reported it to my doctor, was taken off the drug, and within 24 hours was fine. I would hate to have that incident put me on a list and used to prevent me owning a firearm. If this will be a public record who knows who will end up with access to that information.
edited for spelling
SayWut
(153 posts)Just the same... at the very least, would you object to reporting of persons who are deemed or diagnosed
as a potential threat to the safety of others?
"If this will be a public record who knows who will end up with access to that information".
Safeguards and barriers need to be put in place to prevent that, and if misused or wrongfully accessed, heavy fines and penalties imposed.
Mojorabbit
(16,020 posts)
The Straight Story
(48,121 posts)based on what a few do with them.
Not saying there is legislation to do so but some here are advocating we remove all guns from the many based on what the few have done.
And when you oppose such things you get called a gun nut.
Hard to have a sensible discussion when people won't look for common ground and resort to calling people 'nuts'.
dembotoz
(16,806 posts)not much of an incentive there.
Llewlladdwr
(2,165 posts)...isn't it worth it?
customerserviceguy
(25,183 posts)at all, and it would meet your criteria for safety. It wouldn't meet my criteria of liberty, however.
riderinthestorm
(23,272 posts)How many visits would "qualify one" to be able to judge their patients true intent? Or true state of mind? Or predict the future?
The ONLY constant in ALL of these shootings is easy access to guns!
Denninmi
(6,581 posts)What do I think of this law -- draconian and overreaching. A dramatic violation of medical privacy and a horrible intrusion into the provider/patient relationship.
Will it have a chilling effect on psychiatric treatment -- absolutely?
If I were a resident of the State of New York, would I suddenly feel like I had to either lie to or fear my psychiatrist and therapist? Yes. If you don't think it's hard enough already just to walk into that office, feeling like people are looking at you based on which door of the office building you enter, and then have to admit your darkest, ugliest secrets while trying to maintain the smallest shred of dignity, you are sadly mistaken. This will just make it a lot worse -- the choice will be lie or omit vital information that might make a big difference in your life if addressed properly. If I had the option of seeking treatment in another jurisdiction, NJ or CT, would I? In a heartbeat.
What, exactly, will authorities DO with this information? It seems to be about "taking away guns" from people threatening violence with a gun. But, there are a lot of other dangerous things out there, are we going to go after people who threaten to kill themselves with antifreeze and try to take antifreeze away from the mentally ill? If you're reported, do cops show up at your door, search your house, etc? Does anyone really know?
Is this going to do diddly squat to prevent the next Aurora or Newtown? Nope, not one bit. But those of you out there high-fiving each other because they're coming to round up all of the crazy people like me can think so, at least until the next tragedy.
Yeah, good idea, further stigmatize people who are already faced with taking the shit society feels like dishing out to them on a day to day basis.
Because, you know, you just can't enough degradation and humiliation in one life. Heap on some more for good measure.
Ok, rant over, I'm going to go stick my head in the oven now. It's been that kind of a day all around. Later....
(Oh, lighten up, it's a joke, I may not have civil rights but I still have a sense of humor, even if it's dark humor)
pipoman
(16,038 posts)is a disqualifies a person from purchasing a firearm. States are supposed to report involuntary commitments to NICS. First there must be a way to gain involuntary civil commitment for authorities or loved ones..but there just isn't any funding for such things...they'll commit them AFTER they commit acts they have threatened to do..not before..
Denninmi
(6,581 posts)...we would probably be able to solve a lot of our problems. Especially the part about committing the authorities, at least the R/Teabagger ones. 
I think you meant "by authorities ...."
pipoman
(16,038 posts)thinking Maricopa County might be a good test case..
Denninmi
(6,581 posts)Sherrif Joe is miles in front of me in the race to the funny farm.
DanTex
(20,709 posts)It's a breach of confidentiality/privacy, and it could easily have the effect of dissuading people from discussing suicidal thoughts with a therapist. Even non-gun owners. Would you want to be on some government list of suicidal people?
HereSince1628
(36,063 posts)In that respect the NY law is like laws in many states that already require this.
DanTex
(20,709 posts)Does it have to be an actual threat, or just having suicidal thoughts (e.g. "I thought about suicide" versus "I'm going to commit suicide"
? I would hate to have someone suffering from depression being afraid to tell a therapist about suicidal thoughts.
HereSince1628
(36,063 posts)What I fear is loss of equal protection and due process resulting from overly broad arbitrary rules that assign persons with mental illness into databases.
My BIG FEAR is 10s of millions of innocent people having their names placed in databases and having civil rights violated by decisions to list as prohibited anyone, for example who takes an SSRI, or anyone who has say bipolar disorder, PTSD or borderline personality disorder. I fear that such databases will be underfunded and consequently not be kept up to date and would often be inaccurate. I fear such inaccuracies would be the basis of denying persons the same rights as other Americans. And I fear that once much money is spent on such efforts, people will want to offset that cost by finding uses for the data, and that these databases could have their access expanded for other things than gun purchases. I hope that my BIG FEAR isn't going to be realized.
The reporting of threats to self and others to police is already the law in many states. It is the policy of the Veterans Affairs Mental Health programs. These laws have withstood legal tests.
Why don't I feel this is a terrible thing:
A clinician would be reporting as a consequence of specific statements or behaviors. It's isn't arbitrary like a computer program searching medical records for specific illness codes or a prescription that may or may not always be associated with mental illness.
The reporting is followed up by an investigation...which is what is needed to stop a suicide, and at least in principle could also be important in preventing shootings of others.
The intervention follows rules of due process. Typically police follow up, make an assessment, and as necessary can take a person into involuntary detention where an psychiatric evaluation can be made about matters of committment etc.
Typically the evaluating psychiatrists won't make the committment (but these things do vary by state and I haven't had a chance to read the NY law)...they have to argue that outcome before a panel or an officer of the court. THose persons make a decision, and usually the patient can be represented by counsel.
THAT IS DUE PROCESS,it deals with each event on a case-by-case basis and it ensures equal protection.
DanTex
(20,709 posts)You seem to know quite a bit more about this than me, so the fact that you don't think this is terrible makes me feel better about it. I definitely agree that the big database of anyone who ever had any mental health issues is a really bad thing.
libdem4life
(13,877 posts)opinion is insufficient and will not be in any, way shape or form, a legal pronunciation. It may begin a process, but it must include more than one opinion, and ultimately be adjudicated before a judge. Then it may be legal and recorded. Until then, unless it breaks a law, it is strictly anecdotal.
Failing this entire process or a legal event triggering a police report, there will be no legal authority to preclude a person from their 2nd Amendment rights. I have known circumstances where a person was in this process, seemingly temporarily insane, and the police out of the goodness of their hearts, did not file a report knowing it would impact this person and their families for the rest of their lives. It is not an action lightly taken.
HereSince1628
(36,063 posts)like what is standard practice in states across the nation.
I was expecting NY to go to something much more like California's rules. I can't say NY didn't, because I haven't read anything that really provides much detail
ecstatic
(32,705 posts)be used for gun checks, I'd be all for it. In that case, the worst that could happen is a mentally competent person is wrongly denied the ability to buy a gun, which isn't that big a deal. However, based on history, only a fool would be satisfied with such guarantees.
HereSince1628
(36,063 posts)Mentally ill advocates are concerned because they have raised sensitivity to existing widespread discriminated against the mentally ill.
HereSince1628
(36,063 posts)in front of a therapist, or in front of family or other associates.
If it's in front of a therapist NY will now require the therapist to report it. It's probably still something of a judgement call.
What few people seem to be taking notice of is that family and associates are the front line in getting people who are not currently in treatment to treatment. Either by convincing the person to voluntarily get help, or by calling the police for a possible intervention that leads to an involuntary detention.
There really needs to be a public education project to get people up to speed on this important citizen contribution to getting persons to mental health care.
libdem4life
(13,877 posts)minimum $500 a month counseling or $80,000 a year life time lockdown "therapy?" A government psychiatrist earns a minimum $400,000 a year. How many more should be hired? How many more lockdown mental facilities do we have the funds to build when we struggle with funding for health care for our young and elderly citizens?
It's always been that way. Just more political positioning. In and out ... in and out ... shuffling responsibility ... back to the family...in and out... until someone gets killed. Then off they go to real prison.
HereSince1628
(36,063 posts)I was released 16 hours later. I had to pay $1800, and I was never even given a meal.
In most states, medicaid covers the cost for persons unable to pay. BUT many states are cutting back on medicaid eligibility.
There is really no point to detaining people who aren't going to be treated.
Blue_In_AK
(46,436 posts)What about doctor-patient privilege? I would assume now that the potential mass killer will just keep his delusions to himself.
libdem4life
(13,877 posts)out on the streets...and likely very pissed off. Often the meds are mixed up too, even worse. Think about it ... not really useful and definitely not successful ... and dangerous.
RW BS. No one but a judge can declare someone insane, or a police officer to arrest someone as a public threat and put them in an institution...for 3 whole days...before they get out...unless they are prison bound. A professional is already bound to report any threat to law enforcement...has been for decades. Just nothing happens, as most professionals know, because society cannot afford to care for every nutjob wacko for the rest of their life on the public dime...no, really. So, they just cease to "therapy" them.
Just like tasking elementary school teachers to learn how to fire weapons and kill intruders to protect them and their students from potential psychos with LEGAL WMD. It's just another fancy Red Herring. Like...let's obliterate poverty and racism, and the 300 million armed elephants in the living room gun problem will be magically solved. Right, in who's lifetime?
Gun apologists and marketers are still getting filthy rich on the MIC, more so from the hyped paranoia wing. Not worth discussion..."Looky over here...over here...no, over here..."
Sunlei
(22,651 posts)I remember reading somewhere that thousands of discharged military are restricted from gun ownership.
HereSince1628
(36,063 posts)The VA I attended doesn't do involuntary commitments, I'm not sure if that is a policy for that hospital or the entire system.
When the local VA thinks there is an issue with suicide they in turn make a call to the local cops.
I hadn't read anything about number of them prohibited from purchases.
rustydog
(9,186 posts)but if someone is suicidal or homicidal, there are things that must be done.
I mentioned before about this gentleman I know who is ok when he is on his meds. The voices telling him to murder people are muted but are still there and he can deal with them. When he goes offf the meds...and he does, he is a very dengerous person. If he got his hands on semi auto weapons...holy shit.
HereSince1628
(36,063 posts)than most mental illnesses. Such psychosis is readily detected and nearly universally understood to be serious mental illness.
About 1 in 10 Americans has symptoms of depression each year. That's 30 million people, it's estimated that as few as 3% get treated for it.
Depression is one of the most common psychiatric conditions associated with the ~17,000 gun suicides each year.
The dramatic mental illnesses are the public's perspective of mental illness, but the reality of mental illness is it is often much less dramatic and much more easily unnoticed.