photo: Orange County Archives
A conflict may be emerging between the National Rifle Association (NRA) and several large national medical and mental health associations regarding the expansion of US and state government mental health databases. Medical Daily reported last week that four national medical and mental health associations have sent letters to the US Department of Health and Human Services (HHS) expressing concern about a proposed rule to increase the flow of mental health records into the FBI’s National Instant Criminal Background Check System (NICS). The NICS database holds a vast amount of information about Americans—including people who have no intention of ever buying firearms—to be checked whenever anyone attempts to purchase a gun from a US licensed firearms dealer.
The American Medical Association, the American Psychiatric Association, the American Psychological Association, and the National Association of State Mental Health Program Directors are, in sending the letter, expressing direct opposition to the National Rifle Association’s (NRA) multi-year effort to enhance government restrictions of gun ownership and possession by creating a US government mental health database and encouraging the flow of information into that database.
Recently, the NRA lobbied the Florida legislature to pass and governor to sign legislation that increases the flow of mental health records from Florida to the NICS database. The legislation also expands the prohibition on Floridians purchasing guns or qualifying for concealed carry permits to include not just those involuntarily committed by courts to mental institutions, but also those who at one time voluntarily sought mental treatment after being threatened with involuntary commitment. Florida Governor Rick Scott signed that bill into law on June 28.
In its letter to HHS, the American Psychiatric Association opposes such expansions of gun purchase restrictions to people who voluntarily seek mental health care, stating:
We cannot support attempts by states to broaden mental health disqualifications (e.g., by including voluntary hospitalizations). An individual’s confidence in the privacy he or she will be afforded when seeking medical care, particularly mental health care, often singularly determines whether or not that individual will agree to receive health care treatment.
Additionally, those who agree to mental health care under the threat of involuntary commitment may not even believe they have a mental condition. They may agree simply to avoid the cost, time, and turmoil of opposing an involuntary commitment process. Or, they may prefer having some control over where and how their mental health care is conducted.
Mistaken identity is another serious problem with this expansion of federal government mental health databases. For example, under New York’s state mental health database program, two unfortunate New Yorkers had their guns confiscated. Neither of them met the mental health prerequisites for confiscation, but they did share the same name and approximate age. Buffalo News reporter Lou Michel explains:
When state police received only a name and approximate age, [New York State Police Superintendent Joseph] D’Amico said, his staff checked handgun permits statewide and found two men of about the same age and same name of David Lewis. The state police then contacted the Erie County clerk and another county clerk elsewhere in the state where those people lived.
The outcome was not good for either “David Lewis.” Both had their licenses suspended and guns temporarily removed, though it was eventually determined neither had mental health issues.
With the New York State Police receiving hundreds of reports a day for inclusion in the state’s mental health database, there will be plenty of opportunities for similar mistakes.
It is reassuring to privacy advocates that large national medical and mental health associations are expressing concern about the US mental health database. But stopping or reversing the growth of the US database, along with similar state databases, will require taking on the multi-year NRA effort to expand them. It will also go against the inclination governments have shown to know everything about our private lives, whether that be our phone and internet conversations, where we drive, or our mental health histories.
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