People With Mental Illness Target of New Gun Law

Supporters of a new gun-control law claim it might have prevented the deaths of 32 people last year in a massacre at Virginia Tech carried out by a student who was mentally ill. Some psychiatrists, however, say the law falls short as a meaningful way to reduce gun violence.

The debate stems from President George W. Bush's signing of a measure in January intended to prevent people with serious mental illness from buying guns.

The legislation (HR 2640), sponsored by Rep. Carolyn McCarthy (D-N.Y.), authorizes up to $1.3 billion in state grants to improve the tracking and reporting of individuals who are legally barred from gun purchases, including those involuntarily confined to a psychiatric hospital. (McCarthy's husband was killed by a mentally ill gunman who went on a rampage on a suburban commuter train 14 years ago.)

Paul Appelbaum, M.D., a professor of psychiatry at Columbia University and chair of APA's Council on Psychiatry and Law, said that a fully funded Virginia background check that looked for involuntary psychiatric care before the gun sales to the Tech shooter and the reporting of his outpatient care by state officials might have kept him from buying his weapons.

“But he could have easily gotten them through other means,” such as private sales and gun-show sales, which are unregulated by the background-check system, said Appelbaum, a former APA president.

The rare bipartisan bill—first introduced five years ago—advanced relatively quickly in the wake of the Virginia Tech killings.

Supporters of the law, including the sponsor of the Senate version, Sen. Charles Schumer (D-N.Y.), said they were disappointed that the legislation did not advance until after the Virginia Tech shootings last April. “Had it become law earlier, it may well have saved the lives of 32 students who were killed at Virginia Tech by another mentally ill gunman,” Schumer said.

The Virginia Tech shooter had been ordered by a court to undergo outpatient mental health treatment, which under federal law disqualified him from buying the two handguns he owned. But his name was never entered into the National Instant Criminal Background Check System (NICS).

The enthusiastic embrace of the new law by both gun-rights supporters and gun-control advocates, Appelbaum said, gave the appearance of wanting to distract the public from the broader gun-control legislation that is needed to produce a real reduction in gun violence.

Enhancing background surveillance of people with mental illness focuses disproportionate resources on a population that commits only 3 percent to 5 percent of gun violence, he said. The characteristics that research has linked more closely to gun-related crimes are gun ownership, gang membership, and drug dealing.

Previously enacted federal law prohibits the purchase of firearms by those who have been “adjudicated mentally defective” or “committed to a mental health institution.” Also forbidden to purchase guns are people who are subject to a restraining order related to domestic violence, people under indictment or convicted of a felony, fugitives from justice, and users of or those addicted to controlled substances.

“They are lumping people who have received mental health care in with criminals,” said Steven Hoge, M.D., director of the Division of Forensic Psychiatry at Bellevue Hospital Center in New York and a member of APA's Council on Psychiatry and Law.

Hoge said that policymakers should focus their efforts on keeping guns from those with characteristics conclusively linked to gun violence. He added that several states allow clinicians and family members to petition to have guns removed from people both with and without mental illness who are displaying violent behavior.

“There is no simple answer” when searching for ways to prevent gun violence, said Howard Zonana, M.D., a professor of psychiatry and a clinical adjunct professor of law at Yale University. “It needs multiple approaches.”

APA joined the National Alliance on Mental Illness (NAMI) in expressing concerns about the vague and insulting terms for people with mental illness in previously enacted gun-control legislation. However, they commended the authors of the measure for directing the attorney general to work with states, local law enforcement, and “the mental health community” to establish regulations to protect the privacy of information provided to the NICS.

Supporters of the new law say that it will fund the addition of millions of mental health records to the NICS, thus increasing the chances that guns will be kept from seriously mentally ill people. However, 17 states provide no mental health records to the background-check system, according to the Justice Department. Some states refuse to submit mental health records to federal authorities because their attorneys general have concluded that doing so would violate federal privacy laws.

The bill's sponsors sought to address privacy concerns raised by mental health advocates by modifying it to include more precise language to define which mental health records states should report to the NICS. It also would allow people to petition for restoration of gun-ownership rights.

Although the protective impact of the law may be unclear, the impact on the public's perception of people with mental illness is obvious to psychiatrists.

“My concern is that this is one more brick in the wall of stigma erected around people with mental illness,” Appelbaum said.

The Council on Psychiatry and Law is preparing a position paper on the law, which it expects to release this summer.

The text of the NICS Improvement Amendments Act of 2007 can be accessed at<http://thomas.loc.gov> by searching on the bill number, HR 2640. ▪