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Responsible Gun Laws Are A Public Health Necessity

     

On Thursday night, President Obama took the podium in the West Wing and addressed the nation in the wake of yet another mass shooting. In his speech, the visibly frustrated and upset president made a forceful call for action on guns, rather than just words of condolence. We echo his passionate call for responsible gun laws as a matter of public health.

According to the Massachusetts-based group Stop Handgun Violence, 87,423 Americans have been killed by gun violence since the tragedy at Sandy Hook in 2012. According to press reports, there have been 294 mass shooting so far this year. Those figures are staggering and profoundly sad, and a clear indicator that gun violence is a significant public health concern. The victims of these tragic events are often young people at the very beginning of their lives. There is not any one solution to the problem of gun violence, but there are certain actions we can take that will help.

The APA supports common sense measures, such as background checks and waiting periods before gun purchases, closing the gun show loopholes, product safety regulation, safe storage requirements, and gun-free college campuses and hospitals. As physicians, we have the opportunity to educate our patients about the risks of keeping guns in the home particularly in the presence of children, adolescents, people with dementia, people with mental illnesses, including substance use disorders, who are at risk of harming themselves or others, and people who abuse children or partners. Currently, a number of states prevent physicians from asking questions about guns. This needs to be changed.

Temporary firearm restraining orders may also be a way to protect potential victims of these tragedies. A policy recently enacted in California, the Gun Violence Restraining Order, or GVRO, would seem to hold enormous promise. The GVRO is based on the same principle as a domestic violence restraining order. It would allow family members and/or law enforcement to go before a judge and request that guns be temporarily removed from an individual who is likely to be dangerous toward himself and/or others (while allowing for due process). Notably, a GVRO does not rely solely on mental illness as a marker for violence. As research shows, the overwhelming majority of individuals with mental illness will never be violent toward others (the risk of self-harm is far greater). Stronger indicators of risk include a history of violent behavior, domestic violence and drug or alcohol abuse. We urge states to develop new procedures for the temporary removal of access to guns during periods of elevated risk.

87,423 Americans have been killed by gun violence since the tragedy at Sandy Hook in 2012.*

294 mass shootings in 2015

*Source: Stop Handgun Violence

We also believe in a fair and reasonable process for the restoration of access to firearms after a suitable waiting period. This restoration should only occur following a thorough, individualized assessment of risk. Psychiatrists and other mental health professionals can work with law enforcement and judges to identify who should have their access to guns restricted, and when and if they should have that access restored.

As the president said in his address, our hopes and prayers will not be enough to stem the tide of gun violence in our country. We need decisive action in favor of responsible gun regulation. Until then, gun violence remains a significant threat to America’s public health, and as physicians, we have a vital role in advocating for change.

     

Post by Renée Binder M.D.

Renée Binder, M.D. is the Immediate Past President of APA. Read Dr. Binder's full biography.

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Comments (8) Add a Comment

  • iSeries Pistol Case

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  • Richard Eaton

    I also liked your post and believe that enactment of appropriate GVRO statutes should be strongly considered in jurisdictions which do not already have them. An additional point of concern is the ability of mental health professionals to alert authorities if a patient under their treatment has threatened to kill himself or others. My understanding from speaking to a psychiatrist is that authorities can only be notified if the patient being treated makes a specific threat to kill or harm a particular person. Thus, so I am told, a psychiatrist cannot report to authorities if the patient under treatment makes a generalized threat that he wishes to harm others. If this distinction is legally valid, or if it is consistent with practice guidelines, then it points up a serious deficiency in the law. The whole point is to create an early warning system of potential trouble so that harm to others can be avoided. Authorities cannot prevent what they do not know about. I believe mental health professionals must be permitted to alert authorities if their patient declares a desire to kill himself or others, even in a generalized way. At least some of the tragic shootings we have witnessed might have been prevented. We need to further empower authorities, consistent with due process, to protect ourselves and our children. I would like to know if APA has been or plans to advocate on this specific issue.

  • Susan Delphine Delaney MD, MS

    Gun violence IS A PUBLIC HEALTH CRISIS. And we already have IN PLACE a public health system for treating TB: daily witnessed taking of the meds by a public health worker who comes to the patients house. What if we used THE EXISTING SYSTEM to have public health officials witness the daily taking of psychiatric meds for those who have been convicted of any crime. Of course, a court order by a judge after a hearing would provide due process. The system is already in place. No new wheels need to be invented.

  • MDP

    Well stated response and I agree! My general/adult psychiatry residency was in Texas and I consider the Mental Health Deputy System to be an excellent idea (notably understaffed however still excellent in concept). I personally witnessed (and assisted) with numerous situations regarding mentally ill patients that were quickly de-escalated by Mental Health Deputies. Similar encounters with regularly trained police officers would not have ended so well. I am personally appalled by the poor follow through (and follow up) of the current mental health/legal system. The current laws may indeed work well if they were properly staffed and enforced. I thank you for your comments and support them as well.

  • MDP

    Dr. Binder, As a fellow psychiatrist, I have some concerns and questions regarding your recent statement regarding the APA's stance on curbing gun violence and mass shootings. Your statement includes support for "closing the gun show loopholes" as well as support for "gun-free college campuses and hospitals." I am very curious as to your personal understanding of "gun show loopholes" as I find this topic to be often misunderstood and misinterpreted. I would furthermore mention that the vast majority of colleges and hospital campuses are currently gun-free and yet this does not appear to deter criminals or the mentally ill from opening fire on innocent students in such locations. I would also comment that "gun-free" locations appear to be overwhelmingly preferred targets for mass shooting incidents (Sandy Hook, UVA, UCC, Military Recruiting Centers, the Aurora Colorado Theater, and the church in Charleston, SC). I fail to understand how gun-free locations provide protection to the public and I also fail to understand why the APA would support such standards as they appear to be inadequate (and possibly contraindicated) for the improvement of public safety. In the essence of full disclosure: I am not a present or former member of the APA and furthermore I am a member of the National Rifle Association, a gun collector, an avid recreational shooter, and I also possess a Concealed Weapons Permit . I certainly hope that my personal beliefs will not restrict or interfere with your personal response or the response from the APA regarding it's currently held standards.

  • Tango

    I liked your post , and believe you made good points There are many that will expound on gun violence, and the mental health of mass murderers that have brought gun violence to the crisis that is felt from coast to coast. No one speaks to the millions in this country that have been terrorized, abused, socially maligned, denied their civil rights to pursue their lives peacefully, and enjoy their rights guaranteed by the US Constitution on a daily basis for generations. Their prayers for peace have gone unheard and the injustice has been ignored. The mass murderer's pull the trigger on their guns. Social injustice causes the rage and hopelessness that locks and loads that fire arm. In the 1960's we could take a 22 to school on a school bus to go home with a friend and hunt at their house. What changed? The guns? The people? The social acceptance of public persecution? Seething anger by some in segregation states because they lost their privilege to deny other human beings their Constitutional Rights and Protections?

  • Tango

    I liked your post , and believe you made good points There are many that will expound on gun violence, and the mental health of mass murderers that have brought gun violence to the crisis that is felt from coast to coast. No one speaks to the millions in this country that have been terrorized, abused, socially maligned, denied their civil rights to pursue their lives peacefully, and enjoy their rights guaranteed by the US Constitution on a daily basis for generations. Their prayers for peace have gone unheard and the injustice has been ignored. The mass murderer's pull the trigger on their guns. Social injustice causes the rage and hopelessness that locks and loads that fire arm. In the 1960's we could take a 22 to school on a school bus to go home with a friend and hunt at their house. What changed? The guns? The people? The social acceptance of public persecution? Seething anger by some in segregation states because they lost their privilege to deny other human beings their Constitutional Rights and Protections?

 

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