Firearm Laws: A Primer for Psychiatrists

Abstract

Persons with mental illness or substance abuse have been perceived by the public to pose an increased risk of violence to themselves and others. As a result, federal and state laws have restricted the right of certain categories of persons with mental illness or substance abuse to possess, register, license, retain, or carry a firearm. Clinicians should be familiar with the specific firearm statutes of their own states, which describe the disqualifying mental health/substance abuse history and the role and responsibility of the psychiatrist in the process. State statutes vary widely in terms of the definitions of, and reporting requirements relating to, prohibited persons with mental illness or substance abuse. States also vary in the duration of the prohibition and in the timing of the appeals process. Some of the statutes have specific provisions for the removal of a firearm when a prohibited person is identified. States may maintain a mental health database that is used to determine firearm eligibility and may forward information to the National Instant Criminal Background Check System. The National Instant Criminal Background Check System Improvement Amendments Act of 2007 will likely increase the number of persons identified as belonging to the prohibited class.

The role of serotonin in impulsive aggression, suicide, and homicide in adolescents and adults: a literature review

“…While mental illness alone is not predictive of violence without the co-occurrence of substance abuse, the onus of predicting violence, suicide, and homicide falls increasingly on the clinical psychiatrist, prompting further investigation into evaluating risk and temporizing violent behavior in our patients (1). Given the multifactorial biopsychosocial nature of violence, aggressive behavior is characterized in terms of the antecedents that lead to violence with one of the most intuitive approaches dividing aggression into impulsive or "reactive aggression" and premeditated or "instrumental aggression".…”

Biting the bullet: Fixing America’s quiet epidemic of gun suicide

“…The original Act (1968, 1220) included a provision to criminalise the sale of a firearm to any person who 'has been adjudicated as a mental defective or has been committed to any mental institution'. As such, the mentally unwell could be precluded from purchasing a gun today if evidence of their condition was found during a National Instant Criminal Background Check System (NICS) (Price & Norris, 2010). Unfortunately, the Health Insurance Portability and Accountability Act 1996 (HIPAA) has severely undermined the proficiency of the background check system to investigate the mental health of gun purchasers.…”

Trends in firearm safety—do they correlate with fewer injuries

“…Surely there would likely be few opponents to the general idea of keeping firearms out of the hands of people who intend to use them for malicious intent [16]. The ethical debate arises from whether or not it is right to restrict the purchase of guns for all individuals in an effort to protect innocent victims from harm at the hands of those few people who use firearms criminally [4].…”

“…While there may be a connection between states with higher incidences of gun ownership and deaths from firearmrelated homicides in those states [19], it is difficult to draw a far-reaching conclusion based on the current literature. One study found that making minimum purchasing and possession age laws did not reduce the rate of suicide in adults between the ages of 14 and 20 [16]. Another study found that adding laws that make the purchase of firearms more difficult did not substantially decrease the violent crime rate [8].…”

“…Seventy-five percent of the boys played with the real firearm, despite 75 % of the parents feeling sure that their child would not touch the real firearm and would play with the water gun only [1]. Another study looked at over 60,000 suicides among youth aged [14][15][16][17][18][19][20] and found that the CAP laws did not decrease the overall rates of suicide among the youth [7]. Yet, it does appear that CAP has a great effect on morbidity and mortality in states that have more strict penalties related to firearm possession and violence [10].…”