Sunday, February 13, 2011

Steps to Keep the Mentally Ill from Buying Guns

Posted: 12:00am on Feb 13, 2011


For an alienated and unbalanced young college student, chronic misery is fast spiraling into violent desperation.

In the classroom, he laughs with no cause, stares, expounds bizarre numerological theories. He proclaims his college itself unconstitutional. A professor worries aloud that the young man could shoot up the classroom. When the institution finally dismisses him, he becomes still more agitated, sleepless, paranoid. He enters a Sportsman's Warehouse store and picks out a Glock 19 semi-automatic pistol.

The clerk calls in the required background check — usually cleared while the customer waits — and is told that this customer cannot buy a firearm. Officials at his college had petitioned a local judge to suspend his ability to buy a weapon, and the suspension was entered immediately into the federal database established by the Brady Bill.

A Jan. 8 "Congress on Your Corner" meeting in Tucson, Ariz., proceeds without incident.

Alas, the account above is fictional. No such procedure for preventing a mentally ill and dangerous person from buying a firearm actually exists.

On Nov. 30 of last year, Jared Loughner did purchase the pistol he used to kill six people and injure 14 others five weeks later. Three years before, Seung Hui Cho, despite a history of mandated mental health treatment, bought the Glock semiautomatic pistol that cut down 32 people at Virginia Tech University.

Despite multiple police contacts and obvious signs of mental illness, both Loughner and Cho bought their weapons legally. Clearly we need a procedure for preventing such individuals from buying firearms — the sooner, the better.

Many have blamed the Tucson disaster on a failure of the mental health system. After all, Loughner showed signs of mental disturbance and aggression so obvious and public one classmate always sat near an exit, poised to flee on the grisly day she knew was coming. Surely, the mental health system should have intervened, compelling treatment with or without his consent.

Unfortunately, in a free society, managing potentially violent mentally ill persons poses daunting legal and ethical dilemmas.

Some existing laws do attempt to balance the demands of public safety with the rights of mentally ill citizens. For example, a therapist must break confidentiality and inform the police if a client makes a direct threat against another person. Likewise, any citizen can petition a judge to authorize the involuntary hospitalization of a mentally ill person who presents a danger to self or others.

It is doubtful, however, that either of these legal options could have prevented Virginia Tech or Tucson.

Since neither Cho nor Loughner was in treatment just before the shootings, no therapist had any information to disclose. Pima Community College could have petitioned for Loughner to be hospitalized against his will. But legal standards for involuntary hospitalization require not only bizarre behavior or verbal aggression, but a clear threat of harm to self or others. It is unlikely either Cho or Loughner would have met that strict legal standard before their crimes.

The following relatively simple, twofold legal mechanism might have prevented both tragedies and a significant number of suicides, since research shows many firearm suicides are completed with newly purchased weapons:

■ Any citizen could petition a judge to suspend an apparently aggressive or suicidal person's right to buy a firearm. The potentially dangerous person would not have to be in treatment to be subject to this suspension.

■ Any licensed health care professional with reason to believe a patient posed a danger to self or others could enter an order to block firearm purchases directly into the federal database.

In either case, the affected person would have the right to challenge the suspension, via either a full psychological examination or a legal hearing.

This public safety measure seems as commonsensical as allowing a physician or a judge to suspend the license of a driver impaired by uncontrolled epilepsy or Alzheimer's disease. If you agree, spread the idea around.

It would certainly not prevent every potential tragedy, but it could buy precious time in many situations.

For some husband, wife, parent or friend, that could make the difference between a heart-rending loss and a near miss.

About the author Steven Mangine is a clinical psychologist practicing in Lexington and an adjunct faculty member in the University of Kentucky's department of psychology.