A Handy List of Everything Wrong with Creating a Database of People with Mental Illnesses

It’s not like anyone expected the NRA to say anything intelligent during its long-awaited press conference on Friday, so I’m not exactly disappointed by what they said. I am, however, completely appalled at the NRA’s ignorance of mental illness and insensitivity to those affected by it.

Along with a few other laughable suggestions, like putting armed security guards in elementary schools, Wayne LaPierre, the NRA’s Executive Vice President, said this:

“How many more copycats are waiting in the wings for their moment of fame from a national media machine that rewards them with wall-to-wall attention and a sense of identity that they crave, while provoking others to try to make their mark.

A dozen more killers, a hundred more? How can we possibly even guess how many, given our nation’s refusal to create an active national database of the mentally ill?”

Now, I’m not sure to what extent LaPierre actually believes that this is a realistic and ethical goal as opposed to a throwaway remark intended to deflect responsibility from his organization and the products it defends. It’s also unclear how much the NRA’s leadership has discussed and promoted this idea.

However, I think it’s still worth using this example to show how ignorant these people are about mental illness, because I’m quite certain that they are not alone.

So, here’s everything I can think of that’s wrong with the idea of creating a national database of people with mental illnesses.

1. It’s redundant.

As Kate explains on Ashley Miller’s blog, mental health professionals are already required to break confidentiality and report when patients pose a clear threat to themselves or others. Rather than putting this in some sort of “database,” they report it to the people who know best how to use this information–the police. I’m not sure if LaPierre is suggesting that we create a public database of people with mental illnesses so that armed vigilantes can take matters into their own hands or what, but I think most reasonable people agree that dealing with people who have expressed the intent to harm others is best left to the police.

Furthermore, as Sarah Kliff writes in the Washington Post, 38 states already require or allow the use of mental health records in background checks for people trying to purchase guns, and the Gun Control Act of 1969 bans the sale of guns to people who have been committed to a mental institution in the past. However, that act is difficult to enforce because state reporting laws vary so much, and unfortunately for LaPierre, it is unconstitutional for the federal government to require states to report mental health records for a national database.

2. It violates existing laws.

As Kate also mentions, HIPAA (the Health Insurance Portability and Accountability Act) requires that people’s medical records be kept private. (So strict are medical confidentiality rules that when I saw a psychiatrist as a 19-year-old dependent on my parents’ medical insurance, the psychiatrist had to ask for my consent before she explained to my mom why she thought I needed antidepressants.) Creating a national database of people with mental illnesses would mean repealing or amending this law. Can the NRA summon up enough support in Congress for that?

If LaPierre intends to use this database to restrict the ability of people with mental illnesses to access to resources they need, such as jobs and schools, that would also violate the ADA (Americans with Disabilities Act), which bans discrimination on the bases of mental and physical disability. And, regardless, as mentioned in #1, creating a national database would probably not be constitutional because the federal government would have to force states to report mental health data.

3. It’s probably impossible to determine which diagnoses should be included.

Repealing or amending HIPAA would also mean deciding which diagnoses would suddenly not be subject to confidentiality. People like LaPierre seem to think that schizophrenia and bipolar disorder are the most “dangerous,” but what about substance addiction, which is highly correlated with violence? Would every alcoholic have to be registered? What about autism, which many people falsely associate with violence? And, if yes, then what about Asperger’s Syndrome, now considered a “mild” version of autism that’s on the low end of the spectrum? What about depression, which can sometimes involve psychosis?

Or, since LaPierre simply called it a “national database of the mentally ill,” should we include everybody with mild depression, social anxiety, a phobia of elevators, an eating disorder? Should we include people whose mental symptoms are caused entirely by another, purely medical illness? Should we include people who develop depression as a result of, say, cancer?

4. The list of ethical ways to use this database is very short.

Seriously, what would you do with it? Deny these people access to employment, education, and housing? Then you’d have to repeal the ADA. Surveil them? That’s a violation of civil liberties (not that our government’s great about that). Bar them from purchasing guns? As mentioned above, that’s already going on in the majority of states, and it’s one of the reasons “liberals” are trying to pass stricter gun regulations. But this is where the common argument against such regulations–that criminals will find a way to get guns anyway–can be turned right back on those who tend to spew it. It’s worth noting that Adam Lanza did not purchase his guns; he got them from his mother, who bought them legally and is not reported to have had any mental illness.

5. Most people with mental illnesses do not get treatment.

And you can’t register them in a database unless they do, obviously. One study suggests that over 60 percent of people with serious mental illnesses, such as schizophrenia or bipolar disorder, do not receive consistent treatment. This means that a majority of the people who should be in the database wouldn’t be in it, anyway.

Although the association between mental illness and violence is tiny, people with untreated mental illnesses are more likely to be violent than those whose illnesses are being treated properly (although the link between mental illness and violence is still very small). This means that the people who would be on this database are the ones who are least likely to cause anyone any harm.

In any case, the percentage of people who don’t get the treatment they need would probably go up, because:

6. It would discourage people from seeking treatment.

The stigma of mental illness and treatment already keeps many people from reaching out for help. If you know that going to see a therapist or psychiatrist could put your name on a national registry of people to be feared, stigmatized, and discriminated against, why would you do it?

Even if most of what I’ve said above about misuses of this database turns out to be a huge strawman–which I don’t know, because LaPierre hasn’t specified how he wants this database to be used and it’s important to consider the potentially dangerous ramifications–people will still worry. Even if the only purpose of the database is to prevent people with mental illnesses from purchasing guns, people will still be worried about that information falling into the wrong hands.

This, of course, is the final nail in the coffin of LaPierre’s idea. Even if nothing else that I’ve said about it were true, this point would be reason enough not to do it. Anything that prevents people from getting treatment is, by default, the wrong solution.

I already know many people who refuse to seek treatment for a mental illness because they are worried about being discriminated against if the wrong person finds out. Although the ADA supposedly protects them, it is difficult if not impossible to prove that discrimination has occurred. Those fears could grow much more urgent if simply going to a doctor and receiving a diagnosis puts your name and medical information into a national database accessible to god-knows-who.

This is what tells me that not only is LaPierre scapegoating people with mental illnesses to divert opprobrium from his own organization, but he also completely misses the point and fails to understand the first thing about mental health and treatment.

He gives away his views on people with mental illnesses when he says this: “The truth is, that our society is populated by an unknown number of genuine monsters. People that are so deranged, so evil, so possessed by voices and driven by demons, that no sane person can every possibly comprehend them.”

We are “genuine monsters” to him.

He’s wrong, of course. There are plenty of “sane” people who comprehend those with mental illnesses–researchers, therapists, psychiatrists, social workers, friends and family of those affected, and people who have recovered from those illnesses. That LaPierre personally fails to understand them says more about his own lack of both empathy and research in the field than about the supposed need to stick them all in a national database for the perusal of bigots.

It is also worth noting that in this emotionally charged statement, LaPierre fails to distinguish between people who commit acts of violence because of an illness they cannot control without proper treatment–which LaPierre wants to make it even harder for them to get–and people who commit acts of violence because they have no respect for human life and are seeking to make a political point, get personal revenge, and so on. Although violence and death, especially of children, is tragic regardless of the cause, that doesn’t mean that all violence is caused by the same type of person.

If I could make a suggestion to LaPierre, I would tell him to talk less, read and listen more. There’s reasonable disagreement to be had about how to prevent further mass shootings, but his suggestion was not reasonable. It was ignorant, offensive, and probably dishonest.

A Handy List of Everything Wrong with Creating a Database of People with Mental Illnesses

25 thoughts on “A Handy List of Everything Wrong with Creating a Database of People with Mental Illnesses

  1. 1

    Excellent post.

    The point of Wayne LaPierre’s speech was to create a climate of fear, so more people will buy guns. He was using stereotypes of the mentally ill to promote that fear.

    If we have to monitor people, and turn public spaces into prisons, then maybe it’s time to rethink our approach towards guns.

  2. 2

    Keep in mind I’m just being a jackass here, but how about the argument that constitutional rights shouldn’t be denied to people just because of a mental health hospitalization? If the right to keep and bear arms is really so fundamental, than why are they so ready to throw a significant segment of the population under the bus to deny them constitutional rights, without trial or due process?

    It just goes to show the real issue here with the gun lobby is protecting the profits of gun manufacturers. It’s not about rights, if they were a civil rights organization, they should defend everybody’s right to own a gun. Just because you’re crazy doesn’t mean you can be denied the right to free speech (hence LaPierre’s career), or habeus corpus, or any other fundamental freedom.

    Maybe to way to avoid letting them scapegoat the mentally ill is to insist they deserve the same constitutional rights as everybody else under the equal protection clause. What LaPierre is asking for here, is a brutal anti-civil rights power grab against a disadvantaged group with no due process. How dare he!

  3. 3

    I quite agree with most of this. I’d like to say to LaPierre, “as with gun registration and databases, so to with mental health registration and databases.” Likewise “as with alcohol prohibition, so to with gun prohibition” to people on the left who want to maintain gun databases or prohibit guns.

    Better access to mental health treatment – including lowering the barriers of stigmatization and fear of coercive treatment or hospitalization without due process – would IMO be a great help to reducing violent acts by the mentally ill. Which accounts for 1 to 3 % of violence, but never mind. A proscriptive registry or database (which we already have via the NICS system) is a great way to dissuade people from seeking help or admitting they have a problem.

  4. 4

    Thank you for posting this, Miriam. I almost couldn’t believe LaPierre’s statement when I read it, and I still don’t understand why more people aren’t coming out and condemning this. It’s simply a horrific idea.

  5. 5

    Yup. All of this. I would also add (probably as 3a): How long does he think people should be on this registry? If you were treated for mild depression in college, or had a drug abuse problem from which you’ve now been recovered for years… should you still be on this dumbass registry?

    The very notion of this registry assumes, along with all the many other fucked-up things it assumes about mental illness, that mental illness never gets better. It assumes that people with mental illnesses never recover from them. An assumption which, of course, adds to the stigma around it — and keeps people from seeking help for it. I know that I resisted seeking help for my depression because I felt that, once I got that diagnosis, it was going to hang over my head for the rest of my life: not only in other people’s minds, but in my own.

    1. 5.1

      We already, kind of, have such a registry. It’s called the NICS system. And it’s easier for felons to get their name taken off the “prohibited” list for gun purchases, than it is for people who’ve been treated for mental illness. It does indeed assume that the mentally ill never recover.

      LaPierre’s organization has long campaigned against a national database or registry of gun owners. It’s hypocritical to fight one sort of Orwellian registry while endorsing another.

      1. As for it being unconstitutional for the federal government to require state reporting of mental health treatment – HR 2460, the NICS improvement act, that the NRA supported, does in fact mandate reporting of mental health issues to the NICS system, and penalizes states for not reporting. It was passed after the VA Tech. shooting.
        A person with mental illness can be institutionalized with much less due process than a criminal.

  6. 6

    Okay, look, I’m probably with you on 99% of this, but I haven’t read a good 90% of it because you said this:

    Rather than putting this in some sort of “database,” they report it to the people who know best how to use this information–the police

    This is so wrong it’s ridiculous. The police are seriously unprepared to deal with mentally ill people and escalate instead of de-escalate all the time… and then shoot the threat that they created. Tell Jose Mejia Poot that the police are the best people to deal with the mentally ill. There are just so many examples it’s ridiculous. I’ll come back and read the rest of your post later, but it would be nice if you would think about articles such as this one and then respond.

  7. 7

    In addition to everything the OP says, this is also a really disturbing sort of attribution error. Whenever someone does something flamboyantly horrible like the recent school shooting, a whole lot of people rush out to call the perpetrator “crazy” or “sick” or whatever word they can think of to ascribe to them some kind of innate property, a kindergardener-murdering quality which, presumably, the rest of us don’t have. Thus we are falsely reassured, that no combination of extreme emotion and false premises could ever cause us to do evil. No, not us. We’re the good guys.

    It’s cowardly. Not more cowardly than average, for the human race, but cowardly.

  8. 9

    Just for fun, let’s carry the NRA logic to a possibly-absurd conclusion here. What if it were decided that the act of acquiring a semi-automatic or automatic long gun for no good reason (i.e., if you’re not in the military) was evidence of mental illness. Then all such gun owners would need to be included in this database.
    Well, why don’t we just save a step and start with that database, just of gun owners? No need to decide if it is even a mental illness. Just make a list of everyone who has such a gun, and distribute it to all law enforcement agencies, and require them to keep these lists permanently (instead of for only 48 hours). And require new owners to report updates to the police just like when one sells a car. That way, if Humphrey Bogart needs the authorities to “round up all of the usual suspects,” they have a logical place to start. Don’t get mad at me for this idea — I’m just quoting and applying the NRA’s suggestion in the most logical way possible.
    Of course, my suggestion would never be implemented. But at least it would help the NRA to visualize why making lists of people is not always such a good idea.

  9. 10

    The conventional rationale is that more people having guns will help prevent or interrupt these kinds of mass shootings. (I actually agree with that idea myself.) Now, based on that, it is the students that should be having the guns, rather than some group of security guards. Now, I don’t think the students should be having the guns either, but even that would be preferable to putting in some group of armed security guards.

  10. 11

    Nobody ever states the obvious. The “database” of mentally ill is already available. It’s called the Roster of Members of the NRA.

    1. Nobody with mental health problems should be allowed access to firearms.

    2. Anybody who wants access to firearms has serious mental health problems.

    3. Tax the gunowners – every year, more and more until they are happy to give them up willingly.

    1. 11.1

      Linda K–your belief that anyone who wants to access a firearm for any reason has “serious mental health problems” is one of the most ridiculous things I’ve ever read and clear evidence of your own lack of grip on reality.

    2. 11.2

      Anybody who wants access to firearms has serious mental health problems

      To me that sounds like it’s just name-calling. It’s meant to offend gun owners, but really it’s offensive to people with genuine mental illness, who deserve sympathy and support because what happened to them wasn’t a choice. Buying a gun is.

      Similarly, calling LaPierre crazy isn’t getting anywhere. We can’t fight the stigma of mental illness while using it to attack people, and he certainly doesn’t deserve the attention and concern that should be how we react to mental illness.

      1. Why can’t all the gunowners skip the middleman and just kill themselves without taking others with them?

        The original mental health problem that led them to want to acquire guns seems just the first symptom in a degenerative mental illness that compels them to kill others before themselves. Perhaps the realization that they won’t be missed much by others so they make sure they will have an impact by taking away somebody who will be missed.

        Gunowners should just commit suicide and not homicide.

        1. It’s dishonest and unfair to speak of “all the gun owners” as killing others. Just as mass shooters represent a vanishingly small percentage of people with mental illness, they also represent a vanishingly small percentage of gun owners. There are responsible law abiding gun owners. Stigmatizing all gun owners in the wake of a mass shooting is just as unfair – and unhelpful – as stigmatizing all mentally ill people in the wake of a mass shooting.

    3. Bob

      I only agree with part of this. Some firearms owners are simply hunters and given that there are species that require thinning in certain areas (white tailed deer in the east) they should be accommodated, unless we want to reintroduce top predators (wolves and cougars). All those who believe that it is their right to acquire an assault weapon, or currently have an assault weapon (more than 6 shots without reloading, hand gun or long gun) should be considered suspect in the mental health category. If you are suspect you should be required to pass an annual mental health review administered by the local organization most opposed to guns. You are never after the first time not a mental health suspect.

      All gun owners should be held responsible for any use of their weapons, whether or not they approved or authorized the use.

  11. 13

    Because placing people who may have severe paranoia as part of their disease on a government watchlist is a good idea. What about people like myself who have a pretty “severe” diagnosis (e.g, Schizophrenia, Chonic Paranoid Type) but have had several years of remission and thankfully haven’t been hospitalized? Also, I propose a law stating that any and all citizens may lawfully carry on their personage a sword of their choice, concealed or not. After all, right to bear arms, right?

  12. 14

    Another point: The “list” assumes that those who are “dangerous” will have prior acts of violence.

    Those who commit violent outburst aren’t like serial killers who have a long path of escalation (arson, killing animals, etc.). Some mass shooters have zero history of mental disorders or criminal activity. Some (One L. Goh, Kip Kinkel) have histories as victims of abuse, but that is not a predictor of being violent.

    Adam Lanza had no history of violence (or, the media did not mention any) nor did Jeffrey Lee Michael, the Hollidayburg shooter. A friend described Michael as “withdrawn”, a hard core christian and believer in the “end of the world” on 12/21. But Michael (reportedly) displayed no anti-social tendencies before he acted out.

    I would bet this is true of other shooters.

  13. 16

    Commenting on an old one, but I had to weigh in. Nobody chooses to mentally ill. Given that mental illness is something out of a person’s control, treating someone like a second-class (or perhaps close to third class) citizen owing to a condition which they have no control over (and which I don’t really see any evidence that mentally ill people pose more of a threat of violence than anyone else) is a blatant violation of any concept of human rights.

    However, people choose to own guns. If you want to own a gun, jump through some hoops the same way you have to jump through some hoops to drive a car, operate a business that serves alcohol or any other activity that has potential to put others at risk. Mental illness is not a choice and people should not be treated like pariahs for something they have no control over, but if you choose to own a gun, prove to the rest of us that you’re responsible.

    All said, Wayne LaPierre must have a pretty stone-age conception of mental illness, especially with buzzwords like ‘deranged’ ‘voices’ and ‘demons.’ .Does he realize that about 1/4 of the population has been treated for depression? Nice to know that he thinks pissing and shitting on people with disabilities is a better thing to do than to ask his (probably mostly white) fan base to fill out a few more form, or limit themselves to guns that can’t fire more than 10 shots before re-loading.

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