NPR: Mental Health Professionals Pooh-Pooh New Gun Laws
NPR ran a story about the push for new, broader scrutiny of people suspected of mental illness and violent behavior. The consensus of the experts Jon Hamilton spoke with? Don't expect any of this to work in terms of reducing events such as the Sandy Hook Elementary school shooting.
Snippets:
"We're not likely to catch very many potentially violent people" with laws like the one in New York, says Barry Rosenfeld, a professor of psychology at Fordham University in The Bronx….
A study of experienced psychiatrists at a major urban psychiatric facility found that they were wrong about which patients would become violent about 30 percent of the time.
That's a much higher error rate than with most medical tests, says Alan Teo, a psychiatrist at the University of Michigan and an author of the study.
One reason even experienced psychiatrists are often wrong is that there are only a few clear signs that a person with a mental illness is likely to act violently, says Steven Hoge, a professor of psychiatry at Columbia University. These include a history of violence and a current threat to commit violence….
Whole piece, including audio, here.
On the flip side, you've got to wonder what the effect on run-of-the-mill interactions between mental health practitioners and patients might be. Those relationships are supposed to be based on trust and confidentiality, which will likely be harder to maintain if you think the person you're talking to just might be hitting the panic button under the table to alert the guys with butterfly nets.
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I LOVE that scene. One of my favorite Walken moments, and the funniest part of Annie Hall.
Pretty much the only funny part of Annie Hall. Woody Allen is just terrible.
There's also the Marshall McLuhan bit.
Here's the Walken scene for others.
I don't agree, though I much prefer his earlier, funnier movies. And much of his recent stuff has been forgettable.
What recent stuff?
"One reason even experienced psychiatrists are often wrong is that there are only a few clear signs that a person with a mental illness is likely to act violently, says Steven Hoge, a professor of psychiatry at Columbia University. These include a history of violence and a current threat to commit violence...."
So, a threat to commit violence is a sign that a person with a mental illness is likely to act violently?
I think I'm ready to take whatever test needs to be taken to become a board-certified psychiatrist.
You may be overqualified.
On the flip side, you've got to wonder what the effect on run-of-the-mill interactions between mental health practitioners and patients might be.
You really don't have to wonder at all.
Seriously. I'm so sick of hearing that my psych(ologist|iatrist) should be turning me in to the authorities as a threat to myself.
That's why I'm fucking seeing "mental health professionals".
And I know plenty of ways to off myself that don't involve guns. And many are more lethal.
The one good effect: people might stop believing that mental health professionals can offer much of anything, because most can't.
I'd be worried if I were a mental health professional. You know that after the next shooting, they'll be looking to see if the guy saw a shrink. And if he did, that shrink will find himself in lots of hot water.
Like Italian geologist amounts of trouble.
Which is why - per my wife the nurse - medical professionals will CYA with an automatic screen. They have to assess fall risk, and rather than talk to you and see if you're wobbly, they check boxes. Older than X? On any of this list of meds? Congratulations, you're a fall risk. Got guns in the house? On antidepressants/painkillers/boner pills? Congratulations, you're a psycho.
I went to a routine physical at the clinic yesterday and the nurse must have asked fifteen different variations of "Have you been depressed or had thoughts of violence?"
What happens if you answer yes to any of those questions? Do they have to call the cops?
It varies from state to state. Typically they have to think you are an "imminent threat to yourself or others" or similar.
Being strange, eccentric, or introverted, will one day be a crime. One point for Huxley.
Anyone keeping score in the Brave New World vs. 1984 battle for the dystopian future?
The results were in years ago - Huxley by a landslide. I just reread both.
I lived next to a psychologist once. He said that most teen age boy sociopaths would have turned out fine if they had just gotten laid a few times. Maybe we need registry lists of virgin teen age boys....and force girls to spend a little quality sack time with them?
Maybe we can come up with a better plan once robot girlfriends are cheap and effective.
It's for the children.
Great, now it is going to be even harder to get paranoiacs into treatment.
Lets not overlook that this also comes at a time when there is a push in the mental health fields to include normal grief, such as that incurred after the leather of a loved one, as a mental illness. It would fall under the category of depression, depressed individuals are considered more likely than the rest of us to act in a violent manner against themselves.
Leather of a loved one? Is that an Ed Gein reference?
Im pretty sure they already did that. Adjustment Disorder with Depression and Adjustment Disorder with Anxiety.
Not to mention Asperger Syndrome, ADHD, autism, etc. which parents get their kids diagnosed with as children.
Your mom was a hypochondriac who had you on Ritalin, so now you can't own a gun.
Nobody's suggesting that an ADHD or ASD diagnosis would preclude someone from legally acquiring a gun.
I thought that was a picture of Sigourney Weaver.
I listened to the same segment.
Of course, what never got brought up is medical privacy.
There are three points in Obama's 23 executive actions which are relevant here:
1. He talks about "unnecessary legal barriers" in HIPAA to states sharing information with the background check system. Part of HIPAA deals with privacy in electronic medical records. Presumably, what this order is referring to is loosening the interpretation of HIPAA so that states can enter more mental health records into the database.
2. He speaks of making it clear that docters are allowed to ask patients about gun ownership. Innocuous by itself, but a little creepy when combined with ...
3. Sending a letter to psychiatric professionals making it clear they aren't prohibited from reporting threats to the police.
I don't think 2 and 3 are necessarily that terrible, because doctors are certainly still FREE to not ask about guns and not report on their patients if they don't want to. However, 1 deals with a faceless state bureucracy anonymously gathering your medical records and transferring them to a database which will be used to determine whether you are allowed to buy a gun. What sort of medical records qualify? Certainly not all of them. But where is the line?
Lie to your Doc if he asks about guns.
I'm pretty sure that giving false information in order to prevent yourself from being identified as a prohibited person in NICS is already a crime, so that once your doctor is feeding info into the system, lying to them suddenly becomes a federal felony.
They're free for now, but just as insurance companies have affected how doctors treat patients, I have to think Obamacare will affect how much freedom docs have when asking and reporting these things.