If there’s one thing Republicans and Democrats can agree on, it’s that mentally ill people should not have access to firearms.
But as lawmakers rush to restrict that access in the wake of recent mass shootings, mental health experts warn of unintended consequences: from gun owners avoiding mental health treatment to therapists feeling compelled to report every patient who expresses a violent thought.
“Many patients express some idea of harm to other people, everything from, ‘I wish I could rip my boss limb from limb,’ to, ‘I have a gun and want to blow that guy away,’” said Paul Applebaum, director of the Division of Law, Ethics, and Psychiatry at Columbia University.
Therapists usually interpret this sort of talk as part of the treatment process, experts say. But under a new law in New York, one of the strongest to be passed to date, therapists may feel compelled to report every instance of violent talk, lest they face legal consequences if something happens. And some say ordinary patients may wind up suffering the most.
“I see it very frequently,” Steven Dubovsky, a professor of psychiatry at the University of Buffalo, said of patients expressing violent fantasies. “You see people who struggle with anger or have violent thoughts, and if I thought they were going to act on it right away, I would stop them.”
“Now if you’re mistaken, you’re wrong about this, and you don’t report it, you could face criminal sanctions. I’m not taking any chances at that point,” Dubovsky said. That could encourage therapists to over-report, he said.
According to DJ Jaffe, executive director of the Mental Illness Policy Org, which advocates on behalf of the seriously mentally ill, all the talk of mental health and gun violence obscures a bigger issue – a nationwide struggle with how to care for the mentally ill.
“Most of the things they’re discussing are totally irrelevant to helping people with serious mental illness,” Jaffe said. “No one wants responsibility for the seriously mentally ill.”