I work in the behavioral health field here in Hawaii. Given my experience in the field, no one with an Axis I or II diagnoses should be allowed to own a firearm due to their mental health instability. Even if someone is high functioning and stable majority of them are highly dependent on their psychiatric medications to suppress their symptoms (i.e auditory/visual hallucinations, homicidal/suicidal ideations, mood stabilizers). I've seen cases who were stable for months to years, relapse on meds and within a week become unstable, impulsive and a threat to themselves and others. It takes a large amount of paperwork to legally deem someone 'mentally unstable'. You have to be caught in the act of being a danger to yourself/others. The event in question has to be documented in detail, accompanied with signatures from licensed mental health professionals (therapists, Psy.D etc.) in order for it to even be considered by a judge who has the final say. If it's a yes, they issue mental health warrant, take the individual into custody and transport them to the designated psychiatric facility.


Cheers

Hold on, that's a pretty broad statement (including all folks with an Axis I or II diagnosis to be prohibited from owning firearms). First, let's explain Axis I and II. Under the DSM (Diagnosis and Statistical Manual for Psychiatric Disorders) IV,  Axis I: This is the top-level of the DSM multiaxial system of diagnosis. It represents acute symptoms that need treatment; Axis I diagnoses are the most familiar and widely recognized (e.g., major depressive episode, schizophrenic episode, panic attack). Axis I terms are classified according to V-codes by the medical industry (primarily for billing and insurance purposes). That could include many different diagnoses with varying "severity" including Anxiety disorders, social phobias, PTSD, eating disorders, fetishism, and sexual and sleeping disorders. Using your suggestion would mean that any one experiencing PTSD and seeking treatment for it would be disbarred from firearms ownership. Are you suggesting this is an OK solution?

Axis II: Axis II is for assessing personality disorders and intellectual disabilities. These disorders are usually life-long problems that first arise in childhood, distinct from the clinical disorders of Axis I which are often symptomatic of Axis II. For example, a adult patient might have depression (an Axis I disorder) that is largely a result of a paranoid personality disorder (an Axis II disorder). And while you might assume this group of diagnoses might better represent those that should not own firearms, it includes, for example, dependent personality disorder, the oft mentioned "co-dependent" personality that frequently gets attention on afternoon talk shows.

To further complicate what you suggest would be a simple solution to the question posed about those with mental illness owning a firearm, the DSM V is collapsing  "...[A]xes I, II, and III into one axis that contains all psychiatric and general medical diagnoses."

So, the simple answer using Axes as the sole criteria isn't the panacea for this problem.   

LEO can MH-1 an individual who presents a danger to him/herself or others.

Similarly, mental health professionals can MH-2 an individual for the same reasons.

However, this is only a temporary, involuntary committment for psychiatric evaluation (assumimg the individual is MH-4'd by a physician, of course).

From my understanding, neither the MH-1 nor the MH-2 requires a pre-existing diagnosis or a demonstrated "history of violence/threatened violence/other crime," though such facts may factor into the physician's decision to sign-off on the MH-4.

... but we might be speaking about separate issues.

For those that aren't familiar with the documents/terminology being mentioned:

MH1 - "Involuntary Application for Mental Health Evaluation" - These "forms" used to be fillied out by LE when they thought individuals were a danger to themselves or others. These forms conveyed the authority for LE to involuntarily take the person into a facility for treatment. Now the police psychologist is responsible to make sure potential patients meet the inclusion criteria for involuntary evaluation. This is not an "arrest" per se but the patient can be handcuffed and transported via police vehicle

MH2 - "ex parte Order for Mental Health Examination" A judge, based on a petition can order a psychiatric evaluation. The petition can be from a mental health professional or care provider, but said petitioner cannot of their own authority commit or hospitalize the patient.

MH4 - "48 Hour Emergency Commitment" Generally done if a patient brought in for an examination under an MH1 or MH2 is felt to need continued hospitalization.

MH5 - Voluntary commitment

MH5a - Voluntary commitment of a minor

MH6c - Petition for involuntary commitment. Involves a court hearing. Maximum confinement is for 90 days and authorizes involuntary treatment.

In terms of limiting the ability to own firearms: An MH1 might not trigger such a prohibition as it is only for an involuntary evaluation and many times the patient is seen and released, especially if the involuntary examination was triggered by substance abuse (drunk). Same for an MH2. However, an MH4, MH5, MH5a, and MH6c would trigger a prohibition on firearms ownership.

It takes a large amount of paperwork to legally deem someone 'mentally unstable'. You have to be caught in the act of being a danger to yourself/others. The event in question has to be documented in detail, accompanied with signatures from licensed mental health professionals (therapists, Psy.D etc.) in order for it to even be considered by a judge who has the final say. If it's a yes, they issue mental health warrant, take the individual into custody and transport them to the designated psychiatric facility.

In my experience, it is not necessary to demonstrate any sort of danger or participate in any sort of physical event, in order for 'mental health professionals' to try to get you incarcerated.

You could be a student going to high school, state that you believe in the Second Amendment in a homework assignment, and the next day find yourself in the principal's and counselor's offices who then proceed to order you to undergo a psychiatric evaluation for your support of the Second Amendment.

You could be a student going to high school, state that you believe in the Second Amendment in a homework assignment, and the next day find yourself in the principal's and counselor's offices who then proceed to order you to undergo a psychiatric evaluation for your support of the Second Amendment.

I strongly believe that is just where the boosters of this sort of "pre-crime" sort of stuff want to see it carried to.

I understand not letting the defective handle sharp instruments, chainsaws and such. 

My issue is what it always has been: A massive distrust of authority.

Hold on, that's a pretty broad statement (including all folks with an Axis I or II diagnosis to be prohibited from owning firearms). First, let's explain Axis I and II. Under the DSM (Diagnosis and Statistical Manual for Psychiatric Disorders) IV,  Axis I: This is the top-level of the DSM multiaxial system of diagnosis. It represents acute symptoms that need treatment; Axis I diagnoses are the most familiar and widely recognized (e.g., major depressive episode, schizophrenic episode, panic attack). Axis I terms are classified according to V-codes by the medical industry (primarily for billing and insurance purposes). That could include many different diagnoses with varying "severity" including Anxiety disorders, social phobias, PTSD, eating disorders, fetishism, and sexual and sleeping disorders. Using your suggestion would mean that any one experiencing PTSD and seeking treatment for it would be disbarred from firearms ownership. Are you suggesting this is an OK solution?

Axis II: Axis II is for assessing personality disorders and intellectual disabilities. These disorders are usually life-long problems that first arise in childhood, distinct from the clinical disorders of Axis I which are often symptomatic of Axis II. For example, a adult patient might have depression (an Axis I disorder) that is largely a result of a paranoid personality disorder (an Axis II disorder). And while you might assume this group of diagnoses might better represent those that should not own firearms, it includes, for example, dependent personality disorder, the oft mentioned "co-dependent" personality that frequently gets attention on afternoon talk shows.

To further complicate what you suggest would be a simple solution to the question posed about those with mental illness owning a firearm, the DSM V is collapsing  "...[A]xes I, II, and III into one axis that contains all psychiatric and general medical diagnoses."

So, the simple answer using Axes as the sole criteria isn't the panacea for this problem.   

Awesome, I figured someone in here would break down the DSM V for everyone in the forum. Thanks for that.  You've made valid points to make me reconsider some of what I originally wrote. And it's great because that's why I enjoy participating in this forum. Great insight. It's a harsh reality but mental health illness are like cancer, potential remission but it does not go away. So as broad as my statement was I still believe that it is the right direction but it's definitely not the 'sole panacea'.

Hold on, that's a pretty broad statement (including all folks with an Axis I or II diagnosis to be prohibited from owning firearms). First, let's explain Axis I and II. Under the DSM (Diagnosis and Statistical Manual for Psychiatric Disorders) IV,  Axis I: This is the top-level of the DSM multiaxial system of diagnosis. It represents acute symptoms that need treatment; Axis I diagnoses are the most familiar and widely recognized (e.g., major depressive episode, schizophrenic episode, panic attack). Axis I terms are classified according to V-codes by the medical industry (primarily for billing and insurance purposes). That could include many different diagnoses with varying "severity" including Anxiety disorders, social phobias, PTSD, eating disorders, fetishism, and sexual and sleeping disorders. Using your suggestion would mean that any one experiencing PTSD and seeking treatment for it would be disbarred from firearms ownership. Are you suggesting this is an OK solution?

Axis II: Axis II is for assessing personality disorders and intellectual disabilities. These disorders are usually life-long problems that first arise in childhood, distinct from the clinical disorders of Axis I which are often symptomatic of Axis II. For example, a adult patient might have depression (an Axis I disorder) that is largely a result of a paranoid personality disorder (an Axis II disorder). And while you might assume this group of diagnoses might better represent those that should not own firearms, it includes, for example, dependent personality disorder, the oft mentioned "co-dependent" personality that frequently gets attention on afternoon talk shows.

To further complicate what you suggest would be a simple solution to the question posed about those with mental illness owning a firearm, the DSM V is collapsing  "...[A]xes I, II, and III into one axis that contains all psychiatric and general medical diagnoses."

So, the simple answer using Axes as the sole criteria isn't the panacea for this problem.   

It would seem then that the biggest question is not whether we should keep firearms out of the hands of the insane but whether it could be done, effectively, objectively and consistently without restricting the rights of people that it shouldn't.

It is a hard line to draw but I imagine that someone could come up with a scenario in which just about everyone would think a firearm should be denied to a particular person based on some very serious mental problem. I think we can all recognize that even though we all have our guaranteed rights that some situation could come up where a right is not absolute...
For example if someone were discovered to have Ebola (or whatever serious deadly disease) in Hawaii but refused treatment I think most would want an authority to be able to restrict that person's movements. Even though the individual had committed no crime cause might exist for the denial of a constitutionally guaranteed right. I am not sure if that would fall under an MH order or not since something like Ebola is not a mental illness.
I think another real issue of concern is not where a line can be drawn but that the public keeps the government accountable. If we get a system that restricts people with a certain level of mental illness from owning weapons then the public needs to make sure the system is not abused.

BTW, where did you get the break down on the axis diagnoses?

why would there be a diagnosis to begin with if they haven't committed a crime or an act of violence?  Hmmmmmm? 

In a school setting someone might be referred to a psychologist to diagnose potential disorders that could interfere with learning so that the student could get services to help him/her learn better. As for an adult I would suppose that a diagnosis would only come around if the adult by choice saw a doctor looking for help with a mental problem.

If you never watched the Robin Williams movie "Patch Adams," you should.
Not to spoil if, now that I told you to watch it ...   
Let's just say, it drives home the point that, even though we might notice signs of mental illness and instability, it's in our nature to want to try and fix that person.  The reality is, while symptoms can be controlled, the underlying disease is always there.
Do all mentally ill people turn to violence?  No.  So, as hard as it is to diagnose illness to begin with, it's even more difficult to predict the subsequent behavior -- ESPECIALLY when the patient is prescribed psychotropic meds.
I personally have been around a few people who had mental illnesses.  Most were very happy, easy to talk to souls with an obviously skewed view of reality.  One was very troubled, and she committed suicide after graduating HS, being married and having a daughter.  Others in high school knew she has issues, but I didn't know until after her death.  Another girl I dated once committed suicide just before her high school senior year. 

It's always after the event we sit back and try to second guess ourselves.  Could we have picked up on a clue that would have prevented a tragedy?  And, if we preemptively institutionalize a class of people because they might be dangerous, are we violating their human rights, or protecting the rights of the rest of society to not live among possibly dangerous people?


One thing we should strive for is to separate the gun issue from the mental illness issue.  We need to work on combating the underlying problem in ALL areas of our laws. 

Should the mentally ill be allowed to:
- drive
- use power tools
 - use knives
-  use guns
-  mange their own finances
-  enter into contracts
-  have or be around children unsupervised
-  live alone
and so on.  There are lots of laws on the books that protect the mentally incompetent from making contracts, etc.  But, there are no laws that say we can lock them up BEFORE they hurt themselves or someone else.  By then, it's too late.  Look at Susan Smith, Son of Sam,. Charles Manson, Jim Jones, Elliot Rodger (Cali Student who went on a killing spree) ...   Sometimes the person is just evil.  Other times, they are mentally ill and don't understand that what they are doing is irrational and morally wrong, or maybe the illness convinces them they have no other alternatives than to kill themselves or others..

Very good post on the overall picture of problems with mental illness and controlling those issues. People like to monday morning quarter back but sometimes things are unpredictable. Sometimes people see "signs" but ones that would not have justified the restriction of rights. For example, Adam Lanza was described as being odd, or weird, quiet, different etc. But none of these things would have justified extra restrictions on his access to weapons. Some speculated that he had autism, but that wouldn't have been justification for anything since people with autism are usually less violent.

My father adopted a child who has mild retardation. He won't let him go shooting because of not only some motor skill problems but because he is worried that his boy might do something bad. Keep in mind that this guy (my brother essentially) can hold down a job as a stock by so he still has functional capabilities. They live on the mainland so I don't have a whole lot of knowledge on the day to day things that brought my dad to that decision. It is tough issue.

As a child I was diagnosed with ADHD which got me into the special ed program even though I was not in any special ed classes. One day in high school I had to meet with a counselor/social worker who was just checking up on students in the program I guess and she was asking me basic questions like interests and future aspirations. I wasn't thrilled about the meeting so I sorta played a trick. When she asked about hobbies I mentioned shooting, when she asked about what i read I said gun magazines. When she asked about occupations I said I wanted to be a sniper. None of these things were lies per se, as I did shoot with my dad, had read a few gun magazines, and wanted to join the military but I knew it might get a reaction. Nothing happened to me as far as I know but I later found out she had nightmares or big fears about me doing something bad. Needless to say I did not go on a shooting rampage but who knows how that could have been turned against me with the citation of me having ADHD. A little scary I suppose but I am just offering that as my personal experience as someone with a "mental illness"

quote author=eyeeatingfish link=topic=16457.msg153931#msg153931 date=1412152340]
It would seem then that the biggest question is not whether we should keep firearms out of the hands of the insane but whether it could be done, effectively, objectively and consistently without restricting the rights of people that it shouldn't.

And that is the problem with using such broad measures or criteria. In the recent resident alien case that was deemed unconstitutional, the basis for that decision was that the prohibition (all legal resident aliens) was too broad. Or in the terms of strict scrutiny, not narrowly tailored to accomplish the goals of a compelling govenment interest. Not all Axis I diagnoses are debilitating or have a propensity to violence therefore to deny a core and fundamental Constitutional right based only on the fact that someone had a Axis I diagnosis is too broad, and therefore unconstitutional. I, for one, am not comfortable, given our government's history, of them doing anything "...effectively, objectively and consistently..." let alone ensuring that civil rights are respected.

It is a hard line to draw but I imagine that someone could come up with a scenario in which just about everyone would think a firearm should be denied to a particular person based on some very serious mental problem. I think we can all recognize that even though we all have our guaranteed rights that some situation could come up where a right is not absolute...

No right is absolute and is subject to restriction. On a case by case basis it would be easy to say Joe Smith shouldn't have a gun because of his severe mental illness. That is a lot different from saying everyone with a mental illness shouldn't have a gun

For example if someone were discovered to have Ebola (or whatever serious deadly disease) in Hawaii but refused treatment I think most would want an authority to be able to restrict that person's movements. Even though the individual had committed no crime cause might exist for the denial of a constitutionally guaranteed right. I am not sure if that would fall under an MH order or not since something like Ebola is not a mental illness.

We have public health laws that allow for quarantining individuals against their will. See HRS 128-129

I think another real issue of concern is not where a line can be drawn but that the public keeps the government accountable. If we get a system that restricts people with a certain level of mental illness from owning weapons then the public needs to make sure the system is not abused.

I disagree. Where the line is drawn is of the utmost importance. Keeping the government "accountable" is another issue, one that seems difficult on many fronts, such as Bengahzi, Fast and Furious, the prosecution of the Reese family......

BTW, where did you get the break down on the axis diagnoses?

Doesn't everyone have a copy of the DSM IV?

No right is absolute and is subject to restriction. On a case by case basis it would be easy to say Joe Smith shouldn't have a gun because of his severe mental illness. That is a lot different from saying everyone with a mental illness shouldn't have a gun

I think it would need to be done on a case by case basis not as a check box form that would automatically disqualify someone. Basically i think that if we thought "John Doe" shouldn't have a firearm then we should have to present that to a psychologist and a judge and get a ruling specifically for him. I think that should be the process when discussing taking away anyone's rights.

We have public health laws that allow for quarantining individuals against their will. See HRS 128-129

I have been trying to find an answer to that question, I will give it a read. I was going to call the health Dept today but got too busy.
UPDATE: I read through some of it and it appears to apply to situations when a state of emergency is declared. Having said that some of it sounds kind of scary in what laws the governor can suspend or create during an emergency. I can imagine the need for it but I can also imagine a worst case scenario of abusing it as well. "Compulsory immunization" can sound a bit scary.
I bet most cops have no idea what increase or decrease in laws they could enforce during a declared emergency.

It seems like chapter 325 is more applicable. It appears that the Dept of health has to petition the court for quarantine status unless the delay would be too dangerous.

I disagree. Where the line is drawn is of the utmost importance. Keeping the government "accountable" is another issue, one that seems difficult on many fronts, such as Bengahzi, Fast and Furious, the prosecution of the Reese family

I should have said that just as important as deciding where the line is drawn is keeping the government accountable. Where the line is drawn ends up being meaningless if the government crosses the line and no one fights back.

why should a psychologist and a judge have the right to take someone elses right away just because of their "opinion"?

why should a psychologist and a judge have the right to take someone elses right away just because of their "opinion"?

well, in california, it doesn't even take that for a "firearms restraining order"

well, in california, it doesn't even take that for a "firearms restraining order"

Oh yeah.  I read about that AB 1014 that was passed a couple days ago.  It's ridiculous.  This is probably why the government was doing social engineering experiments that researched on "civil unrest".

why should a psychologist and a judge have the right to take someone elses right away just because of their "opinion"?

A system would need to have a check an balance to it. Requiring that both a mental health doctor and a judge are involved would be one way to reduce abuses of the system.

Can you think of a better alternative? Is there someone else you would trust more to have that authority?  Who would you include/not include on giving the power to take away someone's rights?

The better alternative is to allow no one to arbitrarily take away one's firearm rights due to their subjective opinion on someone else's inner mental thought processes.

The only things which should be considered are physical actions (criminal record) and objective evaluations of mental and physical capacity (whether or not you can pass the written and practical tests in the firearm safety course).

The better alternative is to allow no one to arbitrarily take away one's firearm rights due to their subjective opinion on someone else's inner mental thought processes.

The only things which should be considered are physical actions (criminal record) and objective evaluations of mental and physical capacity (whether or not you can pass the written and practical tests in the firearm safety course).

And therein lays the problem. Most of what mental health professionals do is subjective, not objective. So creating some sort of system whereas the MH professionals would have to objectively evaluate a person without influencing the outcome by their personal bias (say against firearms) is a tremendously difficult task.

well, in california, it doesn't even take that for a "firearms restraining order"

The potential for abuse of that "firearms restraining order" is frightening. We already see the type of abuse in TRO cases so it isn't difficult to see how one pissed off family member could easily cause problems for an otherwise law abiding, gun-owning relative.....

The potential for abuse of that "firearms restraining order" is frightening. We already see the type of abuse in TRO cases so it isn't difficult to see how one pissed off family member could easily cause problems for an otherwise law abiding, gun-owning relative.....

Yup
It's very scary

The potential for abuse of that "firearms restraining order" is frightening. We already see the type of abuse in TRO cases so it isn't difficult to see how one pissed off family member could easily cause problems for an otherwise law abiding, gun-owning relative.....

It is meant to be abusive.

This law is nothing more than the progressive socialists running that state enabling their minions to impose their will upon those they consider "non believers".

The fact that more people are killed riding bicycles every year than have been killed by "mass" shootings in the last 14 years be damned. They will not be deterred by the facts or the evidence.

In fact, in the case they cite as the reason for this law, the murderer killed more people with a knife than with a firearm. Notice how they never mention that little tidbit of info.