Yesterday, President Obama announced two dozen new initiatives to deal with gun violence - several of which focus on mental health. In his remarks he said, "We will make sure mental health professionals know their options for reporting threats of violence - even as we acknowledge that someone with a mental illness is far more likely to be a victim of violent crime than a perpetrator." His administration wants to strengthen the effectiveness of mental health registries used to stop firearms sales to potentially violent individuals.
It's a debate that's familiar to psychologists and psychiatrists. Many question the effectiveness of registries and worry about the unintended consequences. A 2009 report from the American Psychiatric Association puts it this way: "Questions have also been raised about the possible counterproductive effects of [such] registries. Persons with treatable mental disorders may delay or avoid obtaining treatment because of concern about adverse consequences should their conditions become known to others or because they are unwilling to forfeit their right to use firearms for legitimate purposes (e.g., hunting), especially in regions of the country where recreational firearm use is deeply embedded in the culture."
Meanwhile in Colorado, the surviving widow of a man killed in the Aurora theater shooting has filed a lawsuit against the psychiatrist who treated the alleged murderer - for failing to report him as a danger to others.
How good are mental health professionals at assessing the risk of violence? What is the line between patient privacy and the government's right to know about potentially violent individuals? How effective could a perfect mental health registry be? Would it have stopped previous mass shootings?
Dr. Steven K. Hoge, M.D., Director, Columbia-Cornell Forensic Psychiatry Fellowship Program; Member (and former chairman) of the Council on Psychiatry and Law, American Psychiatric Association; Member of the 2006-2009 Work Group on Gun Control and Individuals with Mental Illness, American Psychiatric Association