Why the Connecticut gun law does not improve care for the mentally ill

Like my fellow Connecticut residents still shaken by the Newtown shootings, I was excited and relieved when Connecticut Senate Bill 1160 (“An Act Concerning Gun Violence Prevention and Children’s Safety”) passed. The law establishes a dangerous weapons offenders registry and requires a universal background check for all gun purchases. Those wishing to purchase long guns will need an eligibility certificate which requires fingerprints, a firearms safety training course and a national criminal background check. No firearm may be loaded with greater than ten bullets except in a person’s home or at a shooting range.

However, as a mental health care provider, I am infuriated by one section in particular:

Sec. 10. (NEW) (Effective October 1, 2013) Whenever a person is voluntarily admitted to a hospital…for care and treatment of a psychiatric disability…the hospital shall forthwith notify the Commissioner of Mental Health and Addiction Services of such admission and provide identifying information including, but not limited to, name, address, sex, date of birth and the date of admission. The commissioner shall maintain such identifying information on all such admissions…

In other words, starting this fall, if someone comes to our emergency department asking to be admitted to the hospital for mental health care, our service is obligated to report his or her name, address, sex, date of birth, and the date of admission to the state government. I have to make my patients aware that they are welcome to treatment, but will also become a part of a growing database, even if their illness is completely unrelated to guns or violence.

While this may not seem particularly problematic, consider the delicate scenarios in which people are voluntarily admitted to a psychiatric unit. These are octogenarians for whom the death of a spouse has driven them to the brink of suicide. These are college students with new-onset schizophrenia trying to understand why their roommates have placed tracking devices in their brains. These are people freshly laid-off figuring out how to handle their frustration. These people are entrusting us with their most private pain.

Prior to reading the legislation I thought that perhaps we were entering a period wherein mental health care would receive higher priority. I thought that we as a society finally realized that mental illness is a cage in which our patients find themselves. Instead I am realizing that the Connecticut law serves to strengthen the bars of that cage, expand the cage itself, and put tracking tags on everyone in it.

While this legislation has some groundbreaking provisions that will undoubtedly save lives, I hope that our lawmakers realize the potential outcomes for some of our most desperate citizens. Those looking for solace to prevent possibly killing themselves may think twice to present to the emergency room to avoid being documented on a government list. For the same reason, those with bubbling anger may similarly choose to take matters into their own hands rather than to responsibly seek help.

In sum, the mental health provisions in this law do not improve care for the mentally ill. Rather, these provisions improve the containment and tracking of the mentally ill. By attempting to contain and track rather than treat and prevent, we may inadvertently lose more lives as a result.

Arjune Rama is a resident physician in psychiatry and can be reached on Twitter @arjunerama.  This article originally appeared in the New Haven Register.

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  • Hal E Peno

    Dr. Rama,

    The title of your article should be, “Why the New CT Gun Law Won’t Prevent Criminals From Committing Crimes With Guns”.

    Would this new law, if it had existed, prevented the Newton tragedy? According to press reports, the criminal was denied purchasing a weapon (based on CT law already in effect). How many other existing local/state/federal laws did he break?
    Did the CT legislature also pass “new” laws to cover those as well?

    The answer of course is no. It’s an emotional reaction from politicians thinking they have to do “something”, instead of rationally examining the laws already on the books. Adding “tougher” new laws does nothing to stop someone with no regard for the law in the first place.

    All that’s been done is further punish and restrict law abiding citizen’s 2nd Amendment rights…and create some kind of HIPAA-be-damned police-state database.

    Statistics show the cities with the most restrictive gun laws also have the highest crime rates. CT could pass a law completely outlawing all guns, knives, baseball bats, rope, broken bottles, and any other object used to commit a crime and criminals will still commit crimes against law-abiding citizens…who can no longer purchase anything to protect themselves.

  • Mike

    “I was excited and relieved when Connecticut Senate Bill 1160 (“An Act Concerning Gun Violence Prevention and Children’s Safety”) passed. The law establishes a dangerous weapons offenders registry and requires a universal background check for all gun purchases. Those wishing to purchase long guns will need an eligibility certificate which requires fingerprints, a firearms safety training course and a national criminal background check. No firearm may be loaded with greater than ten bullets except in a person’s home or at a shooting range.”

    ——————————————————

    Why were you “excited and relieved”?

    Are you implying that these laws wold have stopped Adam Lanza, any more than our laws against unlicensed under-21s carrying in public, our laws against bringing guns onto school grounds, and our laws against murder did?

    Please explain.

    • http://www.facebook.com/profile.php?id=1702352 Arjune Rama

      I think you raise a terrific point: will legislation stop future Adam Lanzas? I wish I could say I know for sure. However, I am excited and relieved by the idea that people buying certain firearms are mandated to learn a bit about firearm safety. Will this provision save lives? I hope so. I’m confident that more safety knowledge can’t hurt. Thank you for reading my article and taking the time to comment!

      • Mike

        “I am excited and relieved by the idea that people buying certain firearms are mandated to learn a bit about firearm safety.”

        Only those who legally purchase them. Most people who legally purchase weapons don’t commit crimes with them anyway. Statistically, CCW holders are more law-abiding than the average citizen.

        Now if you can convince the /criminals/ who /illegally/ obtain weapons (usually with an eye to using them illegally as well) to obey your safety mandate….

        But then again, if criminals obeyed laws, they’d obey the existing laws about not unlawfully shooting people.

        • Mike

          Meanwhile, of course, none of the tens of millions of lawful gun owners are ever going to dare to seek mental health treatment if it means being put on an official government Crazy Person List which will see them stripped of their Constitutional rights. My sister had inpatient treatment for anorexia once – under your laws, the government would mark her a Crazy Violent Maniac Person Not To Be Trusted Under Any Circumstances and she’d have to explain to her kiddies why a SWAT Team showed up at their door 10 years later and took away her hunting rifle.

          This is, pardon the term, madness.

          • http://www.facebook.com/profile.php?id=1702352 Arjune Rama

            I am sorry to hear about your sister. Her suffering highlights exactly my problem with the new law: Starting in October, should someone suffering from anxorexia be voluntarily admitted to a psychiatric unit, their personal information including name, address, sex, date of birth and the date of admission will become part of a database even if their presenting illness has nothing to do with violence or guns (just like your sister). While I support many provisions of the new legislation, I, like you am concerned with Section 10 of the new law because it may disincentivize people (including the millions of lawful gun owners) to seek the treatment they desire with the anonymity they deserve! Again, thank you for reading and your thoughtful comments!

  • Mike

    “if someone comes to our emergency department asking to be admitted to the hospital for mental health care, our service is obligated to report his or her name, address, sex, date of birth, and the date of admission to the state government. I have to make my patients aware that they are welcome to treatment, but will also become a part of a growing database, even if their illness is completely unrelated to guns or violence.”

    —————————————–

    And your patients have only the irrational knee-jerk “The Government Ought To DO Something!” zealots like you to thank for it. You probably owe them an apology.

  • Mengles

    And yet you were “excited and relieved when Connecticut Senate Bill 1160 (“An Act Concerning Gun Violence Prevention and Children’s Safety”) passed.” This act will neither prevent gun violence nor help with children’s safety. However, it’s a great bumper sticker slogan.

    Blame yourself for wanting to pass any bill, no matter how bad for your patients, rather than looking at the actual consequences. Seems like “first do no harm” meant nothing to you.

  • medstudentanon

    Thank you very much for your thoughtful comments on how this bill will impact the mentally ill. I am also excited and relieved to see gun regulation being passed in this country, as I believe the measures in this bill will contribute to a healthier gun culture and reduce gun crime. But, like you, I am very worried about the impact this bill will have on the already stigmatized population struggling with mental illness. I would like to see some legislation directed at improving the quality of mental health care in this country, but, unfortunately, I don’t see that happening until physicians begin to forego patient care in favor of becoming politically active. Our congress is just not interested in building policy that is based in sound science. I hope with the upcoming generation of physicians and politicians, this will change. Again, thank you for your article.

    • Mike

      “I believe the measures in this bill will … reduce gun crime.”

      Gun crime has already been plummeting in the United States. And here you demand that policy be “based in sound science”. Ha!

      ——————–

      Poll: 64% of Gun Control Advocates Wrongly Think Gun Crime Up.

      “According to a Rasmussen poll released on Friday, while gun killings have plunged 39 percent since 1993, and non-fatal gun crimes have dropped 69 percent in the same period, those who want gun control think that gun crime is up. Rasmussen reports that only 7 percent of adults believe there are fewer gun owners in the country than there were 20 years ago – and more importantly, 64 percent of those who want more gun control think that gun crime has escalated.”

      You gun-grabbers are pathetic, because you are predicating all of your demands on emotion and prejudice, not on FACT. We can only hope that you show a bit more scientific rigor in your practice of medicine!

      I for one am glad that your unscientific emotion-laden demands that the government “DO SOMETHING! ANYTHING!!” have backfired on you. Maybe next time you’ll think twice before leaping into the political fray on a subject you obviously know nothing about.

  • militarymedical

    Last December, after Newtown’s awful experience, like many I hoped that this would lead to improved care for the mentally ill – even more than greater gun control, though I acknowledge the need for that as well. In the ’60s and ’70s we closed down innumerable mental health facilities (mostly in-patient hospitals) and put those patients on the streets. Those who have been diagnosed since, with equally devastating diagnoses as far as public safety is concerned, have rarely been hospitalized or had their activities restricted, no matter how dangerous their thought patterns may have been or are. Add to that the difficulty in accessing health care in general, never mind the added difficulties in accessing mental health care.
    Recent patterns show that the severely mentally ill have little difficulty in gaining access to weapons. Adam Lanza, if I recall correctly, was given weapons AND weapons safety training via the NRA, by his mother. SHE was the legal owner of the weapons used in Newtown – not Adam Lanza. How do we prevent that sort of enabler? I don’t know. Despite documented concerns, the Virginia Tech shooter was also able to obtain weapons and ammunition legally and without difficulty.
    Knee-jerk gun control laws do little or nothing to limit access to weapons by the mentally ill. I’m one who favors gun control laws and universal background checks in general, but more urgently I want to see a restoration of a robust mental health care system, including institutions, for those who need it.
    Unlike the legal nostrum “better to let nine guilty people go free than to convict one innocent person,” I would rather send one mentally healthy person to a mental health facility than let nine wander the streets … fully armed.

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