Sunday, October 19, 2014
Mental Health Issues Put 34,500 on New York’s No-Guns List
A newly created database of× Yorkers deemed too mentally unstable to carry firearms has grown to roughly 34,500 names, a previously undisclosed figure that has raised concerns among some mental health advocates that too many people have been categorized as dangerous.
The database, established in the aftermath of the mass shooting in 2012 at the Sandy Hook Elementary School in Newtown, Conn., and maintained by the state× Division of Criminal Justice Services, is the result of the× Act. It is an expansive package of gun control measures pushed through by the administration of× Gov. Andrew M. Cuomo. The law, better known for its ban on assault weapons, compels licensed mental health professionals in× York to report to the authorities any patient “likely to engage in conduct that would result in serious harm to self or others.”
But the number of entries in the database highlights the difficulty of× America’s complicated balancing act between public safety and the right to bear arms when it comes to people with mental health issues. “That seems extraordinarily high to me,” said Sam Tsemberis, a former director of× City’s involuntary hospitalization program for homeless and dangerous people, now the chief executive of× Pathways to Housing, which provides housing to the mentally ill. “Assumed dangerousness is a far cry from actual dangerousness.”
Similar laws in other states have raised the ire of gun rights proponents, who worry that people who posed no threat at all would have their rights infringed. Mental health advocates have also argued that the laws unnecessarily stigmatized people with mental illnesses.
Because the names in× York’s database and the circumstances of their cases are private, it is impossible to independently determine whether the people in it are truly dangerous.
The database figures were obtained by The New York Times through a Freedom of× Law request.
Gun control supporters argue a wide net is appropriate, given the potentially dire consequences.
Even if just one dangerous person had a gun taken away, “that’s a good thing,” said× Malte, senior national policy director of the Brady Campaign To Prevent Gun Violence. The National Rifle Association of× America favors a separate “process of adjudication” to make sure that “these decisions are not being made capriciously and maliciously,” Andrew Arulanandam, a spokesman, said.
John Tauriello, deputy commissioner and counsel for the state× Office of Mental Health, said the figure must be evaluated in the context of the magnitude of× York’s mental health system, to which 144,000 people were admitted in 2012 for treatment in community hospitals, private psychiatric hospitals or state-operated psychiatric centers.
“It sounds really reasonable if you know the size of the system,” Mr. Tauriello said.
Mental health professionals and advocates point out, however, the vast majority of people with mental illnesses are not violent. Accurately predicting whether someone will be violent, they said, is also a highly fraught process.
Under the 2013 law, the reports prepared by doctors, psychologists, nurses and social workers are first sent to county officials. If they agree with the assessments, the officials then input the names into the state database. The information is retained for five years. If the authorities find a person in the database has a gun permit — necessary to purchase a handgun in New York — they are required to revoke the license and seize any guns. The people in the database are barred from obtaining a permit until their names are purged.
Among the people named in the database, fewer than 300 were found to have a permit. State officials said they did not know how many guns were subsequently seized from them.
Under the 2013 law,× York is one of the most restrictive states in the country in terms of mental health and firearms.
Under federal and most state laws, people with serious mental illnesses lose their gun rights only if they have been involuntarily committed to a mental health center, or have been legally designated as mentally ill or incompetent; both relatively rare occurrences. A small number of states, including California, Connecticut, Illinois, Maryland and× York, have stricter criteria for people with serious mental health issues to purchase and possess firearms.
New York’s law gives county officials the responsibility of reviewing the reports from mental health workers, ostensibly providing an added layer of oversight. But several said in interviews that they had little capacity to independently confirm whether the finding that a patient was dangerous was justified.
The way the law has played out, local officials said, frontline mental health workers feel compelled to routinely report mentally ill patients brought to an emergency room by the police or ambulances. County health officials are then supposed to vet each case before it is sent to× Albany. But so many names are funneled to county health authorities through the system — about 500 per week statewide — that they have become, in effect, clerical workers, rubber-stamping the decisions, they said. From when the reporting requirement took effect on March 16, 2013 until× Oct. 3, 41,427 reports have been made on people who have been flagged as potentially dangerous. Among these, 40,678 — all but a few hundred cases — were passed to× Albany by county officials, according to the data obtained by The Times.
As of Saturday, the state updated the database to 42,900 reports, and said that roughly 34,500 of those were unique individuals. The rest of the names were duplicates because people had been reported more than once.
Kenneth M. Glatt, commissioner of mental hygiene for Dutchess County, said that at first, he had carefully scrutinized every name sent to him through the Safe Act. But then he realized that he was just “a middleman,” and that it was unlikely he would ever meet or examine any of the patients. So he began simply checking off the online boxes, sometimes without even reviewing the narrative about a patient.
“Every so often I read one just to be sure,” Dr. Glatt, a psychologist, said. “I am not going to second guess. I don’t see the patient. I don’t know the patient.” He said it would be more efficient — and more honest — for therapists to report names directly to the Division of Criminal Justice Services, which checks them against gun permit applications.
On a recent Wednesday, Dr. Glatt logged into the system and up popped the names of people being reported — 16 since he last looked three days before.
Among the newest cases was a patient who had threatened to kill his partner. “Becomes aggressive and unpredictable, has history of noncompliance with medications,” the narrative said.
Two patients had attempted suicide with guns. Another “is exhibiting manic behavior,” the note said. It added that the patient was “not sleeping in the past few days, throwing lit cigarettes and matches around the house,” and had “a history of fire setting.”
Still one more involved a man who had threatened a housing office worker if he was not helped immediately and was so agitated that it took six police officers to bring him into the emergency room.
After the names are entered into the database, they are compared against gun permit records. Since the law went into effect, state officials have found 278 matches, with the largest number, 36, in Monroe County, followed by 17 in Westchester, 16 in Suffolk and 14 in Dutchess.
Several mental health experts said the data obtained by The Times renewed their fears that the reporting requirement would discourage patients from seeking help.
“The threshold for reporting is so low that it essentially advertises that psychiatrists are mandatory reporters for anybody who expresses any kind of dangerousness,” said Dr. Mark J. Russ, director of acute care psychiatry at Zucker Hillside Hospital in Glen Oaks, Queens, which has filed many reports to the state.
Another concern is the possibility that the database might be used for other purposes or could contain a mistaken identity. State officials, however, emphasized that only a small number of programmers and administrators have access to the entire database, while others, like law enforcement or licensing officers, see only what they need to make sure the identifications match individual gun permit applications.
The Cuomo administration initially refused The Times’s request for data on the program and rebuffed a public records request, turning over limited information only after an appeal process.
The overwhelming majority of reports from mental health professionals are coming from hospitals — often community hospitals — with an emergency room and inpatient psychiatric services, according to several county officials. Relatively few came from either outpatient mental health clinics or private therapists, they said. The typical diagnoses are schizophrenia, psychosis or major depression.
In interviews last week, state officials said they believed the law had focused on the right group of people. The approach prescribed in the law “is common sense and saves lives,” Melissa DeRosa, a spokeswoman for the governor, said.
While the county-level review of the names might not be a perfect system, state officials said, it at least provided a check against flagrantly undocumented referrals to the database. Not only that, they said, but county officials in smaller upstate communities might know the people being reported and be able to make informed judgments about them.
Despite the breadth of the law, significant loopholes remain. Outside of New York City, permits are not required to buy long guns, so nothing would stop someone in the database from buying a shotgun, for example, after being released from a hospital. Also, it is unclear exactly how the process for confiscating someone’s guns is enforced. And law enforcement officials may not even be aware of all of the guns someone owns.
Patients can challenge the revocations of their gun permits in court, and at least one has: a man in Otsego County, in central New York, who lost his gun license after being admitted to a hospital because he had threatened to harm himself, according to court papers. He also said he had accidentally exposed himself to a young girl and was racked with guilt. The county judge ruled the license could be revoked.