Gun violence prevention initiatives and implications for practitioners

APA Practice provides advocacy and resources as federal and state officials take action to reduce gun violence

By Legal and Regulatory Affairs staff

Jan. 31, 2013—In response to recent tragic shootings, including the killing last month of 20 children and 6 adults at an elementary school in Newtown, Conn., federal and state officials are taking action to reduce gun violence. Several aspects of these initiatives, such as efforts to improve mental health services and to restrict access to firearms by individuals with mental illness who are deemed to be potentially dangerous, may directly affect practicing psychologists and their patients.

Earlier this month, President Obama released a plan titled “Now is the Time: The President’s Plan to Protect Our Children and Our Communities by Reducing Gun Violence" (PDF, 193KB). The plan has four main components: closing background check loopholes; banning assault weapons and high-capacity ammunition magazines; making schools safer; and increasing access to mental health services. 

APA Chief Executive Officer Norman B. Anderson, PhD, met with administration officials and provided input on President Obama’s plan. Since its release, APA has expressed strong support for key elements of the president’s plan.

In addition to initiatives that enhance access to psychological services and improve mental health care, President Obama’s plan includes several provisions that potentially impact the practices of psychologists and other health care professionals. For example, the plan clarifies that the Affordable Care Act (ACA), the federal health care reform law, does not prohibit health care professionals from talking with their patients about guns and gun safety.

For psychologists, asking about firearms may be an important component of assessments for danger to self or others. Possible ACA restrictions on the collection of data on gun ownership seem to be limited to specified situations, such as in certain types of wellness and prevention programs, or when data is submitted directly to the Department of Health and Human Services.

President Obama’s plan also clarifies that no federal law prevents health care professionals from warning law enforcement authorities about potential violence. However, state law varies regarding psychologists’ duty to protect or warn, so it is important to understand the law in your jurisdiction. (A list of references that summarize these state laws appears at the end of this article.)

The president’s proposals to strengthen the National Instant Criminal Background Check System include broad language about increased access to relevant mental health data and records. Possession of firearms by individuals with mental illness is already regulated by federal and state law, but many states have not yet made the relevant data fully available to the background check system. Federal law prohibits the sale of firearms or ammunition to “any person knowing or having reasonable cause to believe that such person… has been adjudicated as a mental defective or has been committed to any mental institution” (18 U.S.C. § 922(d)).

In addition, many states currently prohibit the possession of guns by individuals who have been involuntarily hospitalized for mental illness or found by a court to be mentally ill or incompetent. Information on specific state laws is available from the National Conference of State Legislatures.

New York recently passed the NY Secure Ammunition and Firearms (NY SAFE) Act, a comprehensive gun control law that, among other things, bans assault weapons and high-capacity magazines. In addition, the law requires mental health professionals, including psychologists, to report to local mental health officials when they determine that a patient “is likely to engage in conduct that would result in serious harm to self or others.” This information will then be cross-checked against the gun registration database and, if the patient possesses a gun, the license will be suspended and law enforcement will be authorized to remove the patient's firearm.

The NY SAFE provision requiring reporting by mental health professionals does allow for the use of reasonable professional judgment in determining potential for harm, does not require reporting if the professional believes that doing so would increase the danger, and provides immunity for decisions to disclose or not disclose made reasonably and in good faith. Nonetheless, the reporting requirement in the NY SAFE law has raised concerns about how it will be implemented and potential unintended consequences, such as patients being more reluctant to seek help or to reveal violent thoughts to their therapists. Importantly, the NY SAFE reporting requirement supplements other legal, ethical and clinical responsibilities (for example, to hospitalize a suicidal patient) and would not directly protect against imminent violence, but rather limits a patient’s access to guns.

The APA Practice Directorate anticipates that other states are likely to pursue stricter gun control laws that may affect the duties of licensed psychologists. We will continue to work with state psychological associations to monitor proposed gun control legislation and address the potential impact on confidentiality, the duty to warn, stigma and patients’ willingness to seek help.

APA recommends a combination of education, training, access to mental health treatment, program funding and research to reduce the impact of gun-related violence. Additional APA resources and information on gun violence prevention are available in the Gun Violence Prevention section on the APA website.

Summaries of state duty to warn laws

Benjamin, G.A., Kent, L., & Sirikantraporn, S. (2009). A review of duty-to-protect statutes, cases, and procedures for positive practice. In J.L. Werth., E.R. Welfel, & G.A.H. Benjamin (Eds.) The duty to protect: Ethical, legal and professional considerations for mental health professionals. Washington, D.C.: American Psychological Association.

Edwards, G.S. (2010). Database of state Tarasoff laws.

National Conference of State Legislatures, Mental health professionals’ duty to protect/warn.

Sonne, J. (2012). PsychEssentials A pocket resource for mental health practitioners (pp. 151-161). Washington, D.C.: American Psychological Association.

For more information, contact the Legal and Regulatory Affairs department by email or by phone at (202) 336-5886.

Note: Legal issues are complex and highly fact specific and require legal expertise that cannot be provided by any single article. In addition, laws change over time and vary by jurisdiction. The information in this article does not constitute legal advice and should not be used as a substitute for obtaining personal legal advice and consultation prior to making decisions regarding individual circumstances.