Mental Health Background Checks Won’t Solve Gun Violence

Every time there’s a mass shooting deemed worthy of attention, a predictable pattern follows in society and the media: expressions of outrage, shock and surprise; a flurry of “we are all [site of the incident]” banners; and calls for more controls over mentally ill people in the name of public safety.

Despite the fact that mental health is not necessarily a factor in mass shootings, and that mental health is a very complex and diverse subject, many members of the public seem to feel that things like mental health background checks would prevent gun violence.

Would that they could, but alas, life is not that simple. Mental illness is a huge social and political category, with an estimated 50% of people in the United States experiencing symptoms of mental illness at some point during their lives. That ranges from depression for teens to severe mental illnesses emerging in the early 20s to psychosis in older adults, with everything imaginable in between. How feasible would mental health background checks be to implement, politically, socially, and ethically? And would they really prevent gun violence?

Mental illnesses have historically been heavily associated with stigma, and the idea that mental health background checks will make the country safer adds to that stigma. It reinforces the idea that mentally ill people are dangerous, and sets up an “us versus them” mentality with the proposal of policies that would be very difficult to enforce on practical as well as legal grounds.

In fact, mentally ill people are much more likely to be the victims than perpetrators of violence — if anything, the mentally ill community should fear the “sane” community.

What Would Background Checks Include?

Advocates for background checks are arguing first of all that private medical information be released to the government databases used for conducting background checks. This is something that should concern anyone worried about privacy and medical records, not just mentally ill people, because once the precedent is set, it’s difficult to revoke those privileges.

What other material might be released, and to which agencies? Will patients even be aware of what kind of information about them is being circulated? How will authorities determine who should be permitted to purchase firearms and who should not, without the benefit of training in psychology and individualized sessions to assess risks with a buyer? Even psychiatrists and other mental health professionals routinely get it wrong when it comes to patient risk assessments; how can a layperson hope to do any better? These are important questions to consider in any potential legislation.

There are also proposals that anyone who has ever complained of symptoms of mental illness should be barred from owning a weapon, something that collides with the Second Amendment (under at least some interpretations of it). According to proposed legislation, many mental health background checks would be focused on expanding reporting under the background check systems, mandating states to submit mental health records for people deemed “incompetent” by experienced judges and mental health officials. While reporting is already mandated, many states refuse to participate because of privacy concerns, or have incomplete reporting systems in place.

State by state, reporting rules are a bit more complicated. New York State, for example, now has aggressive mandatory reporting lawsthat can actually jeopardize doctor-patient relationships. Many reporting laws rely on the idea that outbursts of violence against others can be reliably predicted and stopped by limiting access to firearms, but is it that easy?

Curiously, many gun advocates are actually the ones pushing for mental health checks, but they don’t appear to be thinking the implications of such policies through; the gun lobby is in the peculiar position of proposing a ban on gun ownership for a potentially large U.S. population as it attempts to relieve manufacturers of the responsibility for gun violence.

What is the Effect of These Proposals?

This is encouraging mentally ill people to push themselves deeper underground. Many people are already hesitant to seek attention for mental health issues. That’s only going to get worse if they know that their medical status may be recorded and shared with other persons and organizations, in defiance of the supposed privacy of medical records. Anyone who works in government agencies or wants to work for the government, for example, would think twice before going to a doctor to get treatment for a mental health condition, because a history of mental health problems can become an obstacle to getting a security clearance or promotion, regardless of the patient’s current status.

Where would the line be drawn when it comes to mental health conditions and gun ownership? Who would decide? Who would enforce it? These are all important issues that are not being explored in all the discussion of pushes for background checks. Should this hasty legislation be pushed through, it might rebound on gun rights advocates once they realize the full implications, and the disability community will no doubt take offense as well — the United States would likely see a host of lawsuits as people attempted to defend medical privacy, fight mental health-based discrimination, and protect their right to bear arms.

Many people also appear to be reluctant to name the other issue: what about all the killers who weren’t mentally ill and had no history of mental health conditions?

It’s clear that the United States needs more functional and sustainable gun control, and more effective gun policies, because it has been subject to an epidemic of gun violence in the last few years. What’s less clear is what mental health background checks would contribute in terms of keeping guns out of the hands of people who want to commit violence with them. Instead of focusing on buyers, the government might want to look on the other side of the coin, restricting manufacturers, limiting the types of guns that can be sold to the public, increasing penalties for owning illegal firearms, requiring more safety training for gun owners, and intervening directly in communities where gun violence is an ongoing issue.

The frustrating conflation between mental illness and gun violence means that the huge problems with the mental health care system in the US tend to only come up in the wake of horrific events. It’s time to separate these two conversations and address them on different footing, because the United States also needs better mental health care, but that’s a completely different issue than gun control. Much as we don’t link, for example, the Farm Bill and head injuries in the NFL, we should stop connecting two things that don’t go together and focus on addressing both of these pressing issues on their own so they get the attention they deserve.