Mandatory ‘mental health alert’ could dissuade people from seeking psychiatric care

When Governor Andrew Cuomo put his name to the Secure Ammunition and Firearms Enforcement (SAFE) Act, just a month after the mass shooting at Newtown, Connecticut, he told supporters that the bill’s mental health provisions lay at the core of the legislation.

The act includes, among its various controls on gun ownership, something called a “mental health alert”, which requires mental health professionals to report patients who they believe pose a threat to themselves or others.

“People who are mentally ill should not have access to guns,” Mr. Cuomo said. “That’s common sense.”

Hard to argue with that. Mental illness has clearly been at the centre of some of the country’s most notorious mass shootings. But could the new law have the unintended consequence of making it harder for the mentally ill to seek help? Anneliese, a native of Westchester County who agreed to speak to the BBC on condition of anonymity, has battled mental illness since she was a teenager.

She never thought about doing harm to anyone, except herself. She’s conquered her demons for now, but says the new law would have made it hard to seek help in the first place. The key to successful treatment, for Anneliese, was a relationship of trust with her therapist. Anything that threatened that relationship might have undermined the whole exercise.

Mental health professionals and advocates fear that as a result of the new law, those who need treatment will stay away from the very people who ought to be able to help them.

Mr. Andersson, who now supports others with mental illness, has previously been diagnosed with bipolar disorder and post-traumatic stress disorder. In the early stages of his illness, he had thoughts of harming himself.

Anonymity

Mr. Cuomo’s office failed to return several BBC calls seeking guidance on the new regulations. Those who will find themselves legally obliged to follow the SAFE Act’s provisions say they’re still in the dark.

“We’ve received no guidance,” says Professor Paul Applebaum, director of law, ethics and psychiatry at Columbia University.

“We’ve been asking for it,” he says. “Should no guidance arrive, we will have to come up with our own ad hoc rules.”

Like others in the field of mental health, Mr. Applebaum fears that patients, who already do their utmost to maintain their anonymity, will recoil at the new regulations.

“Lots of people, because of the stigma associated with mental illness, don’t want anybody to know that they’re in treatment,” he says.

“They don’t use their insurance coverage. They pay out of pocket, so their employer and their insurer won’t know. They may not even tell their spouse.”

The thought that their doctor might now report them to a local official, he says, could be disastrous.

“It may be enough to scare them away forever.”

‘Reasonable’

But the SAFE Act has plenty of supporters.

Westchester County’s Board of Legislators passed a resolution urging similar action by federal leaders.

The board’s chairman, Ken Jenkins, says the act has adequate protections and that no one should fear that the mental health provision will be used for anything other than preventing the sale of handguns and assault-style weapons to those who have been reported.

He says it’s only reasonable that gun ownership now comes with an extra burden.

Perpetrators?

But those who live with the consequences of mental illness every day suspect that a vulnerable community is being singled out to assuage the sort of fears memorably expressed by the National Rifle Association’s executive vice president, Wayne LaPierre, last December.

“The truth is that our society is populated by an unknown number of genuine monsters,” Mr. LaPierre said, in the NRA’s first reaction to the Sandy Hook killings.

“People that are so deranged, so evil, so possessed by voices and driven by demons, that no sane person can ever possibly comprehend them.”

Talk like that makes Anna-Christina Allen’s blood boil. Her two sons, Shawn and Billy, both suffer from mental illness. Shawn, the oldest, is sometimes violent. Anna doesn’t want him anywhere near a gun, but says the new law is driven by fear and ignorance.

“Let’s blame the weakest part of society,” she says, with barely concealed anger.

The mentally ill, she says, are more often victims of violence, not the perpetrators. Research has shown that mental illness is associated with an extremely small proportion of violent crime in America (as little as 4.3 per cent, according to one 2003 study). “They’re the ones that society pushes down and kicks,” says Ms. Allen. “Over and over again.”

President Barack Obama has said that it should be as easy, in the future, to gain access to mental health care as it is, now, to buy a gun.

In New York, some people are worried that it’s about to get a little harder. — © BBC News/Distributed by the New York Times Syndicate