Psychiatric Commitment Data Question

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Doc Nonverbal

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Hello all,

The way I understand the ATF Form 4473 restrictions related to being "mentally defective", if a person is committed to an institution for being a danger to self, danger to others, or gravely disabled, that individual is forbidden from purchasing firearms.

My question is whether the person is still entered into the NICS database if he/she signs into the facility on a voluntary basis.

I used to work as a Behavioral Healthcare Clinical Case Manager for a Blue Cross / Blue Shield plan. It was the policy of the company that they would not pay for court-ordered treatment. This applied to court-ordered domestic violence anger-management and parenting training and also to psychiatric commitments.

Psychiatric facilities had a vested interest in getting patients to sign in on a voluntary basis so they could bill the patient's insurance company. This was with the understanding that if the patient left AMA that the attending Psychiatrist could re-commit them and potentially ship them off to the State hospital to serve their time there.

My thought is that if a person is committed, regardless of whether they sign into a facility on a voluntary basis, they should have their information submitted to NICS. This otherwise sounds (at least to me) like a "loophole" in the mental health system reporting.

Does anyone know how this works?

Thanks,


David
 
All I can say for sure is that HIPAA does not preclude it. As for whether or not the NICS "holes" you described are attributable to incomplete reporting is a question best left for someone with more knowledge and experience in the healthcare field than me. :)

I do believe I know where you're coming from, though, and I agree that not passing this information on to the NICS system is doing the public a disservice. I would go one step further and say that physicians who prescribe psychotropic medication should also inform NICS that their patients are undergoing treatment without going into specifics unless necessary.
 
"I would go one step further and say that physicians who prescribe psychotropic medication should also inform NICS that their patients are undergoing treatment without going into specifics unless necessary."

To what end -???? Denial of firearms? You do realize that your talking of 10s of millions

As to the previous question about vol. commitment - my understanding is involuntary only - do you think many people would volunteer if it was automatic ban for life as it would be?
 
darmtn1917 said:
To what end -???? Denial of firearms?
Click to expand...

Yes, that's precisely what I'm getting at. There's a well established causal link between SSRIs and suicides/mass shootings.

darmtn1917 said:
You do realize that your talking of 10s of millions
Click to expand...

Would you please elaborate on how the NICS would be overburderned from the influx of this new information?

darmtn1917 said:
As to the previous question about vol. commitment - my understanding is involuntary only - do you think many people would volunteer if it was automatic ban for life as it would be?
Click to expand...

No, but do you also believe that everyone who's disturbed or mentally ill will police themselves and have the restraint to keep themselves from purchasing a firearm through legal avenues?

ladder13 said:
I'm not down with the drug thing. Some take Zyban for smoking cessation. These drugs today, your BP or statin drug tomorrow. No, he'll no.
Click to expand...

Zyban has an FDA "black box" warning just like SSRIs. Painting blood pressure and/or cholesterol medication with the same brush is just silly.
 
What about someone who actually did voluntarily admit themselves for a drug addiction or alcoholic rehab of 30 days some 20 years ago and changed their life around. Do you believe these people should be reported to the NICS and denied the right to purchase firearms for the rest of their life???
 
bilmc said:
What about someone who actually did voluntarily admit themselves for a drug addiction or alcoholic rehab of 30 days some 20 years ago and changed their life around. Do you believe these people should be reported to the NICS and denied the right to purchase firearms for the rest of their life???
Click to expand...

Short answer: Reported at the time of the commitment, yes. Denied later in life, no. The process to remedy that situation is called expungement, and it's rarely granted for unsound reasons.
 
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"Yes, that's precisely what I'm getting at. There's a well established causal link between SSRIs and suicides/mass shootings."

Please supply legitimate study of "causal link" ( not from the LDS)- coincidence is not a causal link

"Would you please elaborate on how the NICS would be overburderned from the influx of this new information?"

Most "psychotropic medication" such as for depression, anxiety, etc. are prescribed by "family practice MDs" for short periods. The idea that millions of people should lose the rights because they sought treatment is ludicrous.What 1 out of ??? millions are actually homicidal

"No, but do you also believe that everyone who's disturbed or mentally ill will police themselves and have the restraint to keep themselves from purchasing a firearm through legal avenues?"

By your tone you don't seem to believe that persons should be adjudicated a threat before they lose a right. That someone should just decide that "they" feel the person maybe a danger and thats it
The best comparison I see is many vets suffer from PTSD - by your logic all of them should be barred from owning guns for life because a very few commit suicide/commit crimes.
Or we "know" that a lot of murder occurs while people are drinking/drunk so EVERYONE that consume alcohol should be prohibited persons?

That exclusion was placed in the law so people will seek treatment - if they appear to be that dangerous while there a psychiatrist can take them to court for commitment and they would be added to NCIC as a prohibited person

"disturbed or mentally ill" covers a good amount of the population when you consider what a broad brush that is those terms cover in life
 
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The Lautenberg Amendment did something similar in 1996 for a misdemeanor, was retroactive, and has no provision for removing the restriction on the RKBA. That still has not been overturned.

Is it too much to imagine this issue being the next "Lautenberg Amendment?"
 
CoMF said:
Zyban has an FDA "black box" warning just like SSRIs. Painting blood pressure and/or cholesterol medication with the same brush is just silly.
Click to expand...

Really, silly ? Ever read the side effects for widely prescribed meds? Dizziness,lightheaded,etc. ....not very hard for someone to link side effects to gun ops.
 
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Just to clarify the whole commitment issue: When I worked psych assessment and admissions in a private psychiatric hospital, I was advised on several occasions that the commitment process works something like this:

If a person expresses a plan and intent to harm him/her self, the person is first given the option to do a voluntary admission into a psychiatric facility. There isn't a need to do a 72 hour hold if the patient is willing to do this.

Persons who are gravely disabled (meaning that they can't take care of their basic needs due to a psychiatric disorder) are generally committed for their own safety. From the way I understand it, if they're not cognitively with-it enough to take care of their basic needs, then they cannot voluntarily sign themselves into a facility of their own volition.

So if a person voluntarily admits him/herself into a facility, it shouldn't go to NICS.

Someone please correct me if I'm wrong on this.
 
CoMF,

Quote: "The process to remedy that situation is called expungement"

What is this "expungement" process of which you speak? How is that accomplished?

Myron
 
I was questioning medical records - a bit different from a criminal process.
Medical records are a whole different can of worms. Once they are created, there is about zero chance they could be changed.
If medical history is to be used for background checks, that opens up a nightmare for anyone ever treated for something as simple as post partum depression or nerves.
Any veteran treated for PTSD would be automatically screened out by the NICS check.
This is a very slippery slope!

Myron
 
As I have mentioned before in another thread. This is a topic that must tread upon carefully because it can be a two edged sword. The field of psychiatry is not an exact science. I have some experience because of a family member and I have seen the good and the bad of it. I think the bottom line for entering someone's name on the background check list if the person is deemed truly a danger to themselves or others by at least two maybe three qualified psychiatrists.

I myself have little faith in the practice of psychiatry due having a family member that required help with his mental problems. I think psychiatrists for the most part can determine if someone is truly a danger to themselves or others but little else can be counted on as far as my family was concerned. My family was responsible enough to know that one member of the family was not to have access of or be trained in the use of firearms.
 
This is probably the most dangerous aspect of the ongoing campaign. I'm holding my breath to see what "expanded background search" will look like.
With prescriptions computerized by now, Mr. President can enter "Prozac", cross reference it with guns purchased with plastic cards, and get the exact number of people he can make felons due to their mental imperfection. You can bet your house it will be retroactive.
 
My question is whether the person is still entered into the NICS database if he/she signs into the facility on a voluntary basis.
Click to expand...
Not according to current law. It's solely a private medical issue.
Voluntary treatment where an individual is not deemed mentally defective is not reportable as per federal law.

When an individual is adjudicated by the court as a mental defective (Is a danger to himself or to others) or has been involuntarily committed to a mental institution (formally committed to a to a mental institution by a court due to severe mental illness, drug addiction etc.) the institution or health care professional is required by law to send a report to the federal NICS system.

It should be noted that this is done under the protections of due process of law; the right to legal counsel contesting the determination.

"The field of psychiatry is not an exact science."
Click to expand...
And just as important is the breadth of interpretation that is used by health care professionals, courts and laymen for determining prohibitions based on mental illness.

Will the Presidents EOs be used to harass and prohibit legitimate, law abiding gun owners such as a veteran diagnosed with mild PTSD; individuals prescribed psychotropic drugs; someone depressed/despondent over the recent loss of a loved one who sought out professional psychological intervention and treated with medication?

What may be at issue is the unintended consequences that could result due to possible future reinterpretations or legal changes to the legal definition of “mental defective” and those that subsequently may be affected and deemed prohibited persons.

Will gun owners with minor psychological issues be reluctant to voluntarily seek professional help because of concerns about being incriminated as mental defective, delaying treatment until it becomes a bona fide and serious mental disorder?

It's all open to speculation at the moment.
 
After reading many of the responses, it becomes apparent to me that this really is a complex issue with lots of variables and no simple solutions.

Sorry if I seemed a little hard-hearted.
 
If someone uses words that are interpreted by the attending as "being a danger to ones self or others" the attending is required by law/regulation to detain and "investigate". I have painful personal experiences with this related to my daughter and ex-wife.

This whole thing is way up there on the difficult chart so the Politicians won't touch it. Guns are inanimate objects (except in the eyes of certain groups of loons) so the Pols will work on guns. Guns are easy, mental health is tough.

While everybody who needs help should get it but stepping over that line and asking for help then getting it means you are pretty much screwed for life. Having that on your record even if the treatment was successful still means you will have a hard time getting a job, may never get a security clearance (if you are in that field), life insurance rates are higher, gun ownership questionable, etc.

So you have people who are going through a hard time and could use some help but are still in control of their thinking to the point where they evaluate the pros and cons and decide to do things without help.

Real difficult topic....so focus on guns because they are easy.

BTW: if you need alcohol/drug treatment call AA or NA locally. Non institutional assistance with a very long history of success. No records kept and first names only are used.
 
This whole issue has been made more complicated and less private by the passage of Obamacare. On one hand having online medical records might make attending psychiatrists more likely to report the very dangerous to the NCIC rather than hide behind their lawyers and HIPPA misconceptions. On the other hand given the green light the admin has given to doctors to pry into your life by asking whether you have firearms or not, those same digitalized medical records could prevent you from obtaining or even keeping your firearms.

As I wrote in another post. I was treated very unfairly by a physician that specializes in women's anatomy because I told him that my owning firearms is none of his business after he asked me directly. He then proceeded to write in MY medical records that I was a troublemaker and firearms owner. The doctor I went to see after I dropped that arrogant jerk read that in my records that were sent to her from the other doctor's office. I explained to her that I wouldn't tolerate such behavior from a physician but I was treated like I was on probation until I had seen her for a few months. That was over 10 years ago before any of the current admin malfeasance had been initiated.

This is how it happens with psychiatrists and the mental health community except multiply the effects on person's life that's caught up in that circle of arrogance and professional misconduct by a thousand times. As I mentioned I had a family member that had problems but those problems were exacerbated by the so called mental health professionals. They want to be constantly meddling in places they have no business meddling in and they believe drugs are the cure all, be all, do all.

Tread with extreme caution with getting the mental health community involved in the gun control debate, that is a loaded firearm that can be pointed in the wrong direction easily. It's got to be kept to the narrowest of definitions of "immediate danger to themselves or others". Work extenuating circumstances out with careful and intelligent negotiations. If that's at all possible in this current climate of hysteria of "strike now while the iron is hot" mentality coming from the gun grabbers.:mad:
 
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Wow....just wow. Force multiplier using empowerment of physicians who despite their education truly don't have a clue. Your writing about your experiences picked the scab off some long forgotten sores (sorry about the visual).

Jennifer, keep posting please!
 
Thanks Scott, I truly believe that psychiatric terms and definitions can easily be used against anyone that they want. The mental health community can be used as weapon and it has been in the past. In the past if you were someone that stood in the way or could expose a politician's corruption you could easily be branded mentally ill and institutionalized. Once those people brand you it's very difficult if not impossible to shake that.

The courts closed down huge numbers of mental institutions during the 1970's and 80's. They let people out onto the street that couldn't take care of themselves. The people that were supposed to be responsible for taking care of these unfortunate people abused them and tortured them and completely ignored the public trust in them to take care of those unfortunate individuals.

None of those in the mental health community that were responsible for those abuses were ever held to answer for that. The courts closed those places down and opened the doors and let those poor people out onto the street to fend for themselves.

To now let those same mental health professionals into the firearms debate would be a huge mistake. Please don't be calling in an entity that has proved itself time and time again over the years to be just as dangerous as the disease it's supposed to cure.

Don't believe for one second when the gun grabbers see the potential in the abuse of that weapon they won't use it. They have in the past and will do it again if they think it will work.
 
I absolutely agree that the potential for abuse of mental health commitments could have an extremely detrimental impact upon legal gun owners. For example, if they extend the definition of "commitment" from a 72 hour hold (which can only be initiated by a professional) to a 24 hour hold (which can be initiated by anyone), I could see people defining the presence of a firearm as being a danger to others.

For example, I once did an assessment on a patient who was placed on a 72 hour commitment by her psychiatrist because she missed too many appointments (no SI/HI/Grave disability). It's a mad, mad, mad world.

Now with Obamacare, Physicians are going to be asking about guns in the home. It's already standard procedure for Pediatricians, which is patently absurd given that firearm accidents are in miniscule proportion to things like falling down stairs, falling out of bed, etc.
 
Doc Nonverbal,
Quote:

"For example, I once did an assessment on a patient who was placed on a 72 hour commitment by her psychiatrist because she missed too many appointments...."

Is there any way to get a record of that kind removed, or is the person permanently saddled with it?

Also, these records are not "court" records are they unless they were used in some court proceeding?

What I am getting at is the general assumption that a person has to be declared "unfit" or committed by a court order before it would show up in a NICS check.

Myron
 
mountaingun629 said:
Doc Nonverbal,
Quote:

"For example, I once did an assessment on a patient who was placed on a 72 hour commitment by her psychiatrist because she missed too many appointments...."

Is there any way to get a record of that kind removed, or is the person permanently saddled with it?

Also, these records are not "court" records are they unless they were used in some court proceeding?

What I am getting at is the general assumption that a person has to be declared "unfit" or committed by a court order before it would show up in a NICS check.

Myron
Click to expand...

Hi Myron,

I'm not sure what it would take to get records like that removed. The way I understand it, criminal records can be expunged and the records of minors can be sealed, but we're stuck with our medical records.

In that particular case, I called the on-call Psychiatrist, explained the situation, and the patient was free to go.

You bring up an excellent question though: Would the commitment have been reported to NICS regardless of the disposition of the patient? I'd like to learn more about who does the reporting to NICS for mental health, what criteria are used, and how consistently those criteria are applied from State to State.


David
 
David,
I have read repeatedly that a court finding of incompetence is supposed to show up in the NICS checks, but what about the Medical Privacy act aspect of it? I doubt many of these have actually been reported at all.

And is a 72 hour hold even reported to the court system at all?

Myron
 
You can almost paint the picture coming up. A person who owns more that <insert a number here> guns and/or more than <insert a number> rounds of ammunition is suffering from a mental disorder and would be subject to rejection of further applications for gun ownership
 
We saw something similar in the old Soviet Union. Anyone who expressed any displeasure with their "workers' paradise" was obviously in need of psychiatric treatment. Essentially, psychiatric hospitals were used to confine political prisoners.

The operative issues arise in the wording of the question on the Form 4473, which asks whether or not a person has ever been adjudicated mentally incompetent. This requires a judicial process, not a medical decision. The open-ended question arises after the commitment has been lifted, the person restored to sufficient sanity that he no longer poses a threat to self or others, however appears to be barred from acquiring firearms due to the fact of the adjudication commencing the confinement and treatment.

RE: PTSD in veterans, it is my understanding that our VA has been reporting all of those treated for PTSD, resulting in denials during the background investigation process. As I understand it, this resulted from an executive order by former President Clinton during the 1990's.
 
im in law enforcemenet as well as mental health field laws are alrteady non the books if a person has been committed into a mental ward which means past the hearing there considered committed and can no longer own or buy guns.
there needs to be a link between the committments and the back ground checks which as of right now nothing shows up on there i do not think a vol admittance for help would count
 
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