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The challenge of preventing mass shootings through mental health records

In the aftermath of the school shooting in Florida, there's been discussion of addressing those with mental and emotional problems. But preventing violence by using mental health records is more complicated than many realize. What systems are already in place and what are the challenges? Judy Woodruff gets perspective from Jeffrey Swanson of Duke University School of Medicine.

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  • Judy Woodruff:

    In the aftermath of the school shooting in Florida, there has been discussion about a number of ways to prevent a repeat of these tragedies, from arming teachers, to stricter gun laws, and addressing people with mental and emotional problems.

    But preventing violence by using mental health records is more complicated than many realize. For example, posting a disturbing message on social media doesn't necessarily mean an individual has a mental health concern, and someone treated and diagnosed for a specific illness may never turn up in the federal background check system.

    To help us lay this out and look at some of the challenges, I'm joined by Dr. Jeffrey Swanson. He's a professor of psychiatry and behavioral sciences at Duke University.

    Professor Swanson, thank you for joining us again on the "NewsHour."

    Just to — I want to clarify something going in. You were just reminding us that the vast majority of people who have mental and emotional challenges don't turn out to be violent. Is that right?

  • Dr. Jeffrey Swanson:

    That's right, Judy. There are probably over 40 million people in the United States who would meet criteria for a diagnosable mental health condition, 10 million with a serious disorder such as schizophrenia or bipolar disorder or major depression.

    And the overwhelming majority are not violent towards other people, and never will be.

  • Judy Woodruff:

    So, right now, just tell us generally what do the laws say about preventing somebody from — banning somebody from getting a gun if they have some kind of mental or emotional problem?

  • Dr. Jeffrey Swanson:


    Well, the federal law goes back to the 1968 Gun Control Act, and, basically, the law identified a couple of categories of people who would be prohibited from purchases or possessing firearms, most importantly people with a felony criminal conviction.

    But with respect to people with mental health records, it's really about an adjudication, so people who have been involuntarily committed to a mental hospital, people who have been found in a court to be incompetent to manage their own affairs and have a mental illness, people who, on the criminal side, have been found not guilty by reason of insanity or incompetent to stand trial.

    So there's been a legal determination, and most of those categories have something to do with dangerousness, and there's also been some due process, which actually is important when you think about the fact that people are going to be deprived of a constitutional right.

  • Judy Woodruff:

    So, given that, what has to happen for there to be information in the national criminal background check system on someone?

  • Dr. Jeffrey Swanson:

    So, the information in the National Instant Criminal Background Check System is reported by states typically, and the background check, as regulated by the Brady law, is only as good as the information that's there.

    So, sometimes, the state courts report the information. Sometimes, it comes from a mental health authority in the state. There are records of involuntary commitment that are submitted. And — but a lot of people might not be reported, even though they have been involuntarily detained and evaluated during a mental health crisis, because they're only there for a short period of time, say 72 hours.

    After that, they may sign into the hospital voluntarily, if they're able to do that and willing, or they may be discharged. And if it doesn't progress to a gun-disqualifying involuntary commitment hearing with a judge and the opportunity for the person to be represented by counsel, then that record is not going to be in the national instant check system.

    I think, as a result, the records that are there, they are kind of spotty, and also, when we look at the criteria, they're probably too narrow and too broad at the same time. There are lots of people who have been involuntarily committed who are not violent towards others or themselves, and there are lots of people who actually do pose a risk.

    Maybe they're just really angry, disturbed people, and are never going to have a gun-disqualifying involuntary commitment record or maybe not even a felony conviction.

  • Judy Woodruff:

    So is there a better way?

    I mean, I know mental health professionals like you talk about this, look at this, research this all the time. Is there a better way? Are there things that could be done to catch more of these people who could be potentially dangerous?

  • Dr. Jeffrey Swanson:

    Well, I think so.

    If you wanted to focus first on that point of sale that — when people come in to purchase a firearm from a federally licensed dealer, we could have better criteria. We could, for example, do, as about half the states do, and say let's restrict firearms, at least temporarily, from people who have been detained in a short-term involuntary hold.

    We could say let's prohibit people who have a misdemeanor violent crime conviction, because we know that violence escalates. And today's fist and black eye could become tomorrow's gun and dead body.

    But we could also say, look at all the people out there who already have a number of firearms and don't have a disqualifying record. And so what if we put into the hands of police officers the clear legal authority to intervene upstream and remove firearms from people where there is clear evidence that they pose a risk, and also allow family members to initiate that process?

    If they know someone's at risk — and often they have that information very specifically about people — give them an avenue to remove the firearms, at least for a period of time.

    And I think that's a solution that is getting some traction. It's called extreme risk protection orders or gun violence restraining orders. In Connecticut, the pioneering state, called it a risk warrant law.

    I think that is another solution, because it doesn't require that the person have this record. And it also solves the problem that if you just stop someone from buying a new gun, and they already have 10 or 12 or 15 at home, it might not deter them.

  • Judy Woodruff:

    But you are suggesting clearly that a number of these methods have been tried, and they just — they're not passing, they're not — they don't gain the support that they need in so many states.

  • Dr. Jeffrey Swanson:

    Well, that's right.

    For one thing, the number of states that have enacted a risk warrant law is very small and, until recently, just a couple of states. But, also, as with any public health law or policy, you need to do more than just passing the law. There has to be a very systematic effort to implement it and to make sure that people who are in a position to use it, the actors around it, actually know about it, whether it's law enforcement or others.

    And so I think that's an important part of the message as well.

  • Judy Woodruff:

    And do I hear you saying, Jeff Swanson, that what is needed is action at the federal level, that it really isn't enough to have some states pass these kinds of regulations?

  • Dr. Jeffrey Swanson:

    I think the federal and the state laws can work together.

    For example, there are a lot of state-level measures that would work better if we had comprehensive background checks required at the federal level, so that — you know, if you stop someone with a good state law, they can't just go next door to a neighboring state with weaker gun laws, and maybe doesn't have a requirement for a background check.

    So, you know, I think the answer is both. But even federal measures often have to be implemented at the state level. And the restriction with respect to involuntary commitment is a good example. That's a federal law, but commitment statutes and practices vary a lot from state to state.

    And some states use it a great deal, and others don't. So the chance that the same person with the same mental health crisis will be prohibited may depend on what state they're living in. So, I think we need to have a comprehensive solution, but also an on-the-ground, state-level implementation.

  • Judy Woodruff:

    Well, it is no question — no question this is complicated, but it is also clear that progress has been made, and there's some impetus now to be trying to make more progress as we go forward.

    Professor Jeff Swanson of Duke University, thank you very much.

  • Dr. Jeffrey Swanson:

    Thank you so much.

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