(C) Tennessee Lookout
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Zachary bill for involuntary psychiatric commitment is no solution for gun violence – Tennessee Lookout [1]
['More From Author', 'August', 'James Mckenzie']
Date: 2023-08-22
The Tennessee General Assembly convened Monday for a special session on public safety, and they will discuss what measures, if any, they are willing to take to stem gun violence. While some lawmakers have identified mental health care as the fix, I wish they would ask a psychiatrist for thoughts on the issue.
Before I became a psychiatrist, I learned about them from my brother, who was a patient. There were some doctors that he hated going to see, others he liked. I saw that the good ones were also the ones whose treatment helped him most. He died while I was in high school, and I decided to become a mental health professional myself. I studied psychology and medicine here in Tennessee, and moved to the Northeast and Midwest for my psychiatric training. I knew that one day I would move back to use my skills to help, but I didn’t realize how broken of a system I was coming to join.
Rep. Jason Zachary, R-Knoxville, has drafted House Bill 7008 , which lowers the threshold for involuntary psychiatric commitments. He writes that a mental health professional should report any “perceived” threat of violence to a person or group, and that we shall “predict” violent behavior. As someone who has been doing that job for years, I can say that this proposal would cause more harm than good.
If Zachary had asked, I would point out that we already inform officials and any targets of threats for violence made by our patients. This bill lowers the bar, from reporting threats made by someone who says they intend on following through, to reporting vaguely defined predictions or perceptions of danger.
Gun reform is needed, but using mental illness as a scapegoat is misunderstanding the problem or a bad faith argument. As someone who performs risk assessments and has been part of involuntary commitments, this drafted law is a fantasy. Predicting who will commit violence is an admirable goal, but all people, even doctors, are bad at it.
As someone who performs risk assessments and has been part of involuntary commitments, this drafted law is a fantasy. Predicting who will commit violence is an admirable goal, but all people, even doctors, are bad at it. Medicine works in probabilities and data, and using those to predict rare outcomes results in many wrong predictions.
The data shows that the leading cause of death in adolescents is firearms. Most homicides are committed with guns. Most suicides are completed by gun.
As a psychiatrist, I know that the only thing that’s higher risk for homicide and suicide than access to a gun is a history of violence or suicide attempts. Following Zachary’s logic, this proposal will have people locked in the hospital, in part because they own a gun, which will still be sitting there when they’re released.
Committing someone to a locked hospital unit against their will is a last report. It’s not a benign process: the person loses their freedom, their privacy, and their civil rights while they are in the hospital. This bill would create a new problem without fixing any of the ones we already have.
Gun reform is needed, but using mental illness as a scapegoat is misunderstanding the problem or a bad faith argument. This proposal won’t make us safer, but we can learn from other states about which ideas really work.
Gov. Bill Lee’s call for Emergency Risk Protection Orders is a start. Last session’s HB1580/SB1570, drafted by Rep. Justin Jones and Sen. Charlane Oliver, both Nashville Democrats, would have bolstered public safety and should be revived. The American Medical Association advocates for regulating ghost guns and warning labels on ammunition. Other proven methods include universal background checks and banning violent offenders from firearm purchases. All of these should be considered, because the health and safety of all Tennesseans is at stake.
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