Mental Illness And Gun Ownership

Anyone who has purchased a gun recently is familiar with the mental health question that appears on both the federal and state gun-purchase applications: "Have you ever been declared incompetent or involuntarily committed to a mental institution?" This question seems reasonable enough. Most people just answer "No" and move on to the next question.

Virtually everyone agrees that individuals suffering from serious mental illnesses should not be allowed to purchase firearms. For their part, most gun buyers assume that federal and state authorities verify the accuracy of the answers provided for the mental health question. That, unfortunately, is not the case.

After a prospective gun buyer completes the federal and state gun-purchase applications, the gun dealer normally picks up the phone and calls the FBI or the state police. He requests that the gun purchaser's name be checked against the data contained in the National Instant Criminal Background Check System (NICS). While the NICS criminal-record database is considered to be reasonably accurate and up to date, the same cannot be said for the NICS records of involuntary mental hospital commitments.

There are an estimated 3 million living Americans who have been involuntarily committed to mental institutions. The NICS database only contains the names of about 90,000 of these individuals. There are only 17 states that provide information on involuntary commitment for inclusion in the NICS database. Many of the noncompliant states simply have not computerized their records on involuntary commitment. However, a large number of the noncompliant states are also grappling with serious health-information privacy issues and are reluctant to provide the required data to NICS before these issues are resolved.

Under the federal Health Insurance Portability and Accountability Act, mental health records may only be released to medical professionals, health insurance workers and quality-control personnel. Ohio's attorney general has not yet determined how to gain access to the medical records needed to process CCW applications. Because Ohio has a relatively new CCW law, sheriffs are being asked to assist temporarily in checking courthouse records for involuntary-commitment orders. This exercise is both time-consuming and labor-intensive. It's also unlikely to produce all of the information needed to verify the accuracy of answers provided on Ohio CCW permit applications.

Although federal and state laws establish involuntary commitment as a prohibiting factor for gun purchases, mental health professionals contend that there is no scientific basis for this prohibition.

According to Dr. Paul Applebaum, vice president of the American Psychiatric Association (APA), "checking for involuntary commitments...doesn't make sense because past mental illness does not predict future violence."

Scientific research appears to support Dr. Applebaum's position. The Foundation for Research on Mental Health and the Law monitored 1,000 former mental patients for eight years after they were released from institutions. The researchers found that the former mental patients were only slightly more prone to violence than the general population. A study by the MacArthur Foundation indicated that former mental patients were no more violent than individuals who were not mentally ill.

There is no guarantee that the prohibition on gun purchases by involuntarily committed individuals will weed out the potentially most dangerous gun purchasers. Schizophrenics, severe manic-depressives and other seriously ill individuals may legally purchase firearms. Many of these individuals are highly intelligent and may be notoriously difficult to diagnose. In a statement, the APA cautioned that "psychiatrists have no special knowledge or ability with which to predict dangerous behavior" by patients. Although schizophrenics and others with similar illnesses may be delusional and have distorted perceptions of reality, they may be able to control their symptoms long enough to complete the gun-purchasing process. Firearms in the hands of these acutely disturbed individuals are a menace to society.

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Some anti-gun organizations have suggested that all mentally ill individuals should be prohibited from purchasing firearms. Just for the sake of argument, how would one go about identifying all mentally ill people?

The former U.S. Surgeon General estimates that 20 percent of Americans suffer from some type of mental illness. How would mental illness be defined?

The U.S. Department of Health and Human Services says that "mental illness is any diagnosable, behavioral or emotional disorder that interferes with or limits a person's ability to live, work, learn and participate fully in the community."

Such a broad definition could easily be applied to more than 20 percent of the population. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the bible of the mental health profession, even lists cigarette smoking and coffee drinking as mental illnesses.

If all mentally ill persons were prohibited from owning guns, many nonviolent individuals would suffer unjust consequences. Many of the police, firefighters and EMTs who responded to the 9/11 disaster in New York felt that they had been mentally scarred for life. At the very least, they may have had post-traumatic stress disorder, a recognized mental illness. People who lost friends and loved ones in the terrorist attacks experienced extreme grief and other emotional disorders. These individuals, while "mentally ill," probably pose no threat to anyone and should be allowed to legally purchase firearms. Some of these people might even be comforted by the feeling of safety that a personal-defense handgun can provide.

A prohibition on gun purchases by all mentally ill persons could also raise constitutional issues. The Fifth and Fourteenth Amendments guarantee that no person shall be deprived of life, liberty or property without due process of law. Because involuntary commitment is the result of a court proceeding, the individual being committed is deprived of liberty through due process of law. All other Americans have a Second Amendment right to keep and bear arms. Passage of federal or state legislation to prohibit gun purchases by the mentally ill would deprive a large number of Americans of their constitutional rights without due process of law. Such legislation would undoubtedly be ruled unconstitutional.

We are still confronted by the dilemma of how to keep guns away from dangerous individuals while at the same time protecting the rights of law-abiding Americans. The continued gun ownership prohibition for involuntarily committed individuals seems reasonable. But in order to enforce that prohibition, the NICS apparatus must undergo extensive repairs. Federal and state governments must ensure that the NICS database of involuntary commitment is as complete and current as the criminal-record database.

Other potentially dangerous mentally ill persons must be prevented from purchasing firearms. This responsibility falls largely upon relatives, friends and medical personnel. There must be effective teamwork among these caregivers if there is to be any chance of keeping deeply troubled individuals away from firearms. Unfortunately, this is hazardous duty. When severely disturbed individuals commit violent acts, 85 percent of victims are family members or friends.

Millions of mentally ill Americans live full and complete lives thanks to advances in medication and psychotherapy. For many of these people, firearms are a part of everyday life. Armed attacks by acutely mentally ill individuals are extremely rare and are known as "high impact/low probability" occurrences. While psychiatry is an imperfect scientific discipline, many of the most threatening mentally ill individuals can be reliably identified and denied access to firearms.