Thursday, January 17, 2013

The 2nd Amednment & The Problems Of Doctors Assessing Likelihood of Violence

I blogged below that the most troublesome aspect of Obama's new anti-gun push was the interplay between doctors' assessments of mental illness and 2nd Amendment Rights. A recent story by NPR shows how difficult it is for the mental health community to assess the likelihood of future violence. NPR does so in the context of addressing a recently enacted NY law that "says mental health professionals must report people they consider likely to do harm. It also gives law enforcement officials the power to take guns from these people " This from NPR:

States aren't likely to prevent many shootings by requiring mental health professionals to report potentially violent patients, psychiatrists and psychologists say.

The approach is part of a gun control law passed in New York yesterday in response to the Newtown, Conn., shooting a month ago. But it's unlikely to work because assessing the risk of violent behavior is difficult, error-prone and not something most mental health professionals are trained to do it, say specialists who deal with violence among the mentally ill.

"We're not likely to catch very many potentially violent people" with laws like the one in New York, says Barry Rosenfeld, a professor of psychology at Fordham University in The Bronx. . . .

Such laws "cast a very large net that will probably restrict a lot of people's behavior unnecessarily," Rosenfeld says. "Maybe we'll prevent an incident or two," he says. . . .

One of the biggest problems with laws like the one in New York is that it asks all mental health professionals to make assessments that are difficult for even those with years of special training, says Rosenfeld.

Rosenfeld says when he is called in to assess a person's risk of violence, "I typically have the benefit of a lengthy face-to-face interview, records on their criminal and mental health history, a tremendous amount of information at my disposal that the typical mental health professional on the fly simply doesn't have."

And even highly trained professionals with lots of information often get it wrong, research shows.

A study of experienced psychiatrists at a major urban psychiatric facility found that they were wrong about which patients would become violent about 30 percent of the time.

That's a much higher error rate than with most medical tests, says Alan Teo, a psychiatrist at the University of Michigan and an author of the study.

One reason even experienced psychiatrists are often wrong is that there are only a few clear signs that a person with a mental illness is likely to act violently, says Steven Hoge, a professor of psychiatry at Columbia University. These include a history of violence and a current threat to commit violence.

Without either of these, Hoge says, "an accurate assessment of the likelihood of future violence is virtually impossible."

"The biggest risk for gun violence is possession of a gun," says Hoge. "And there's no evidence that the mentally ill possess guns or commit gun violence at any greater rate than the normal population."

Obviously, using "mental illness" as a reason for denying 2nd Amendment rights is far more problematic than many of us non-shrinks initially thought.

1 comment:

Ex-Dissident said...

GW, Obama directing doctors to ask a patient if there are guns in the house is nothing new. I've been taught in medical school to ask about guns during a routine interview if the patient mentions or appears depressed.

If you want to write about something truly offensive, then focus on the NY State law passed without any deliberation. They outlawed clips that have more than 7 bullets...problem is that virtually every gun now made used a 10 or more bullet clip. What they really passed was a handgun ban.