Wednesday, August 20, 2014

Continuation of the Discussion about Disarming Depressed People

From the Robin Williams post

TS wrote: 

MikeB: “…are you OK with folks who have been involuntarily committed to mental hospitals being disarmed?”

Yes, but that’s existing law, and not what we’re talking about here.
Because it's existing law that makes it ok for you? That doesn't sound right.

You're concerned that too many people suffer from depression and so few of them end up committing suicide, well so what. I say the first thing we do is change the way we look at the 2nd Amendment - either that or repeal it.  Then we institute proper gun control which includes licensing for gun ownership. People who suffer from depression don't qualify. Simple.

The determination can be made by a physical and psychological examination prior to granting the gun owner's license. It wouldn't be 100% perfect but urinalysis and blood tests, part of any good physical, would reveal those on medication and the psyche exam would pick up some of the others.

No need to violate anyone's private relationship with their health care providers.


  1. MikeB: “Because it's existing law that makes it ok for you? That doesn't sound right.”

    I’m ok with it, and it happens to be existing law. It’s not the reason why I am ok with it. Obviously there are lots of existing laws I am not ok with. And yes, there are some new ideas that I am ok with as well.

    MikeB: “No need to violate anyone's private relationship with their health care providers.”

    Instead what you want to do is require a new government relationship with a different health care provider that isn’t private. And to assure that all you non-gun owners don’t have your privacy violated, you tie it to your licensing scheme only. I get it. I guess that would be too much to ask you guys to sacrifice something to “save lives”.

    But again, what you keep revealing is that you favor disarmament over treatment. Millions if not tens of millions of mental health care man hours diverted from treatment of the ill to screening of gun owners, and you think treating sick people less is going to help? I favor treatment. Frequent commentator, Steve, once said that means “job creation”. Never mind the naivety in that statement, but again, I favor treatment. If we ever do find ourselves with an influx of qualified mental health professionals, those resources would still be better used treating people who need help, not interviewing perfectly sane people who just want to buy a gun. It’s not like the mentally ill are currently receiving enough or too much care. Most everyone in the community would agree that the mentally ill do not currently receive adequate care.

    Then there is this idea you have that professionals can screen out people from a simple interview. I’ve talked about this in the past, how useless cold interviews would be even when screening for deep psychoses (unless they happen to have an episode). But you even think this would work for a neurosis like depression. If a patient doesn’t want their therapist to know they are depressed, they just have to say “I’m happy” and smile. It’s a neurosis, not a psychosis. That means they have control of their faculties, can function in normal day to day activities, and can hide it well. In the Robin Williams case, how many times have you heard someone say “I had no idea”? He was a comedian for Pete’s sake. Mental health professionals are not blessed with psychic powers. They are not mind readers. They need cooperation from patients in order to get somewhere.

    But at least you acknowledge that the Second Amendment would not allow your desires. You need to destroy the right first.

    1. Thanks for clarifying that you're not ok with something just because it's existing law. And for finally going on record as accepting as good policy the disarming of those who have been involuntarily committed. But you're adamantly opposed to raising the bar even a little. That's odd because for sure among those who have been involuntarily committed at some point in their lives there are some who could safely and responsibly own firearms today. They're being "punished" unfairly, to use one of your favorite ways to describe gun restrictions.

      On the other side of the argument, it's also odd that you won't budge about raising the bar on gun ownership. If done carefully, as I've outlined and others have suggested, it would save lives and keep the unfair applications to a minimum, just like the formerly committed folks who are now well.

    2. You can't "raise the bar a little" without breaking privacy barriers. That's the difference between being involuntarily committed where the law has already been involved.

    3. Privacy barriers are already broken for some. Again your rationale is that " the law has already been involved." Yet you denied that had anything to do with it when I asked before.

      The bar needs to be raised as to who can own guns.

    4. Privacy barriers are broken for extreme cases of imminent danger at the doctor's discretion. If you want to lower their standards, take it up with the doctors, not gun rights advocates.

      What I said about the law already being involved for involuntary commitments is that it went through courts and due process. This mostly gets triggered by someone committing a crime. You want to expand disarmament to people who haven't done anything wrong, and who have not been deemed an immediate threat to self or others. Big difference.

    5. That's a pretty loose interpretation of what I've been saying.

      " You want to expand disarmament to people who haven't done anything wrong, and who have not been deemed an immediate threat to self or others."

      Where did you get the idea that I say disarm those "who have not been deemed an immediate threat to self or others?" This entire discussion has been about those who ARE deemed a danger to themselves and others.

      Is this another example of your slick attempts at changing what I say so the better to argue against it?

    6. No, this entire discussion is how you want to disarm everyone who suffers from depression, which is tens of millions of people of which which a small fraction are a danger to themselves, and a smaller fraction still has been deemed a danger to themselves by a professional. Look, you just called for a pee test where it reveals the person took an antidepressant should have their rights denied. How is that deemed a danger to themselves?

    7. Sorry, TS, but your doing that twisting thing again. The idea is that anyone suffering from depression to the point of needing medication cannot qualify for gun ownership. The reason is that they are a danger to themselves and others if armed. Does that mean the every one of them will commit murder or suicide? No, of course not. But the fact that most of them don't do those extreme things doesn't mean that they are safe and responsible enough to own guns.

    8. Being prescribed medication does not mean you are a danger to yourself. That's you conflating. A doctor deeming that a patient is a danger to themselves or others has real meaning. It would be awfully irresponsible of a doctor to only send a dangerous person to CVS with a piece of paper and hope they take their meds.

    9. Have it your way. But I say gun ownership is ONLY for the truly qualified.

  2. Again, TS is simply being irrational. He believes that, somehow, the Govt will find out from his MD that he's depressed and--voila--black helicopters will be circling his bunker looking for guns.

    In reality, it would probably work like this: an MD upon examining a patient makes a determination said patient represents a danger to himself and/or others. This would be passed onto the legal system for removal of firearms, There'd subsequently be an appeals process if warranted.

    Think of how many lives would be saved. Probably several thousand suicides each year and almost as many gun murders.

    NRA gunloons like to say to say we ought not count suicides because people who want to commit suicide will find a way to do it. As always, the facts don't support them. Statistics show that 90% of those who attempt suicide and fail--never try again. This shows several things: 1. suicide is almost always an impulsive and fleeting act; and 2.) the vast majority of suicides can be prevented. Given this fact, a gun is perhaps the most certain way to kill yourself is with a gun which is about 95% fatal.

    1. "In reality, it would probably work like this: an MD upon examining a patient makes a determination said patient represents a danger to himself and/or others. This would be passed onto the legal system for removal of firearms, There'd subsequently be an appeals process if warranted."

      I didn't get what you are saying from Mike's post Jade. I got this,

      "The determination can be made by a physical and psychological examination prior to granting the gun owner's license. It wouldn't be 100% perfect but urinalysis and blood tests, part of any good physical, would reveal those on medication and the psyche exam would pick up some of the others."

      It sounds more like what he would want mandated as a precondition towards a citizen qualifying for the gun license that Mike feels should be mandatory. And I'm guessing that another test would be required in order to renew that same license.
      This would ensure that not only would people stop taking meds that might be quite successfully be treating a condition, but would also act as something which would drive people away from even seeking out care in the first place.
      As for the claim regarding the claim of doctor patient priviledge being upheld, that would work right up till the first person made use of the "loophole" available by simply no longer taking meds and not mentioning any treatment.

    2. Jade: “He believes that, somehow, the Govt will find out from his MD that he's depressed and--voila--black helicopters will be circling his bunker looking for guns.”

      Jade, just because I am arguing against the ridiculous proposals you guys make, doesn’t mean I believe it is going to happen. You guys won’t get what you want on this. Ever. So no, I don’t believe that your exaggerated example with black helicopters is going to happen either.

      Jade: “In reality, it would probably work like this: an MD upon examining a patient makes a determination said patient represents a danger to himself and/or others. This would be passed onto the legal system for removal of firearms, There'd subsequently be an appeals process if warranted.”

      Which is what we have right now. If any doctor decides that their patient presents an immediate danger to themselves or others the oath they took allows for authorities to be called. Note they don’t do this too often, because they value privacy and trust a hell of a lot more than you do. It is very typical of people on the gun control side to not understand what current policy is.

      Twice now you have said that depression wouldn’t result in loss of gun rights, and even made up some mocking story about my paranoia, but then you end your post implying about how many lives would be saved if suicidal people didn’t have guns. Will you stick to a position?

    3. TS, again, you make no distinction between depression and being suicidal/homicidal. Why?

      My position has been steadfast; you're the one claiming there's no difference between someone who gets down from time to time or has anxiety and someone who is suicidal/homicidal. It's a little akin to making no distinction between bronchitis and ebola.

    4. Less than 1 in 1000 depressed people go on to commit suicide. And no, it’s not so easy to tell which ones are going to do it. What are you saying- disarm only the depressed people who are going to commit suicide? How do you know which ones they are? Especially without massive violations of privacy rights (same for knowing who is depressed in the first place). Remember, Mike’s position in this thread is clearly stated: No guns for depressed people, so I am responding to that. You say it’s ok for depressed people to own guns, but not suicidal people. So why don’t you enlighten us on your plan on how the government finds out who is suicidal. Is it anything like Mike’s plan:

      1) Repeal the right to keep and bear arms.
      2) Institute a licensing program for gun ownership.
      3) Make part of the process for obtaining a license an interview with a mental health professional.
      4) Anyone who answers “yes” to the question “are you depressed?” will not get their license.
      5) Anyone who has taken anti-depression medication recently enough to show up in their pee test will not get their license.

      Except maybe you would replace the question in 4 to be “do you want to kill yourself?”, and skip number 5. Is that about right? Earlier you said it should be up to the doctors to call the authorities on patients who they feel are a danger to themselves or others, so maybe you are ok with current policy, but I somehow doubt that. What it is that you want, Jade? How do you want to prevent people from killing themselves with guns?

    5. Jade: “again, you make no distinction between depression and being suicidal/homicidal. Why?”

      The DSM-5 doesn’t.

    6. Another thing TS is feigning to be concerned about is the idea that mental health professionals would be removed from their important and vital work places in order to do simple screening of gun license applications.

      Do I even have to explain how silly that is?

    7. Yes you do have to explain. There are tens of millions of gun owners who would need to be screened. You somehow think that's not a lot of work?

    8. Well, first of all we wouldn't have to screen all of the tens of millions right away. We could start gradually and start with new gun owners and over ten or twenty years try to get all the rest regularized. Secondly, like many fields of work these days, there are more mental health professionals graduating from college than there are jobs to accommodate them. Some of them are working as waiters and cab drivers for crying out loud.

      Your over simplification that such a program would take mental health professionals away from their important work is more self justifying bullshit on your part.

  3. SS: You;re confused. My comment refers to people who already have access to guns and may have developed or progressed in mental illness.

    I fully support licensing (and insurance). I really question why gunloons--most of whom claim to know everything that ever was and ever will be about guns--don't endorse codification of their expertise.

  4. There are all sorts of qualifying tests for all sorts of government services and rights. Why should guns be any different?

  5. Mike,

    You're living in Italy.

    There won't be any blood tests or urinalyses to buy a gun here stateside. Given the digitization of medical records and the instant access to said without much of any supervision or oversight, I don't think it is going to be much of a secret for very much longer, despite of HIPPA and all of its supposed privacy protections, just who has sought out psychiatric help or medication for pretty much the last forty years.

    Get real.

    I'm going out on a limb here. Depression mostly has to do with people being unhappy. Lots of people are unhappy. Fuck the mental health police.

    Thank God you don't hold office. Can't sad people have a need for a gun as much as anybody else? I mean, surely there is some justification for killing criminals and attackers?!? Do I have to be happy to earn the right to kill someone?

    I am going on record right here, right now. I promise never to kill any person for any reason. That's mostly because I am lucky and I live in a prosperous part of California that takes care of its widows, wounded and dispossessed. We don't like killing other people.

    Personally, I think that it would be extremely helpful for a private citizen who wishes to kill another person to be at least a little bit off of their rocking horse.

    1. FJ, first of all I'm talking about what should be, the ideal, as I see it. I'm not talking about what I expect will come to pass in the near future.

      Secondly, as Jadegold explained above there's a big difference between the mildly or occasionally depressed, or as you put it, the unhappy, and the seriously depressed and suicidal. Those folks need to be disarmed.

    2. Mike, are you going to be able to identify them? Is anyone? Will anyone in the head evaluation profession be willing to go out on that limb and face lawsuits because of misdiagnosing someone?

      There are also that snap at whatever and commit suicide without any signs of ever having depression or suicide indications ever. What about them, huh?

      Are you willing to condemn hundreds of millions of people because of a few thousand nut jobs? Do you want to put yourself in that position? Would you want to be in the position of having to prove your not one of those nut jobs because someones opinion says that you are and need to be locked up?

      If you do, then you really are one of those nut jobs and seriously need to be evaluated.

    3. Health care professionals are able to identify some of them.When someone tells their therapist about plans to commit a murder. the therapist is required by law to report it to the police. In the same way when someone indicates to the therapist that they are dangerous to themselves or others the therapist could be required to report that so the ill person can be disarmed BEFORE an incident. Privacy concerns must take a back seat to safety concerns. And a policy like this would not affect the tens of millions who are depressed, but only the worst cases.

    4. This is current policy. You're not happy with the status quo. You've made that clear. You want millions and millions of more people disarmed, not limiting it to "worst cases". You just said in this thread how you want the tens of millions of depressed people disarmed.

      But you are asking for a different interview from someone's private therapist for the express purpose of buying a gun. You think when someone knows they have to pass a screening to buy a gun they are just going to blurt out how they want to kill a bunch of people or themselves?

    5. That's why I said the worst of the worst. Most people could fool the interviewer, but not the worst of them. Think about Holmes and Laughner and Lanza. Guys like them, the worst of the worst wouldn't be able to fool anyone.

      But you refuse to even consider it. Their privacy might be damaged.

    6. Ok, so you're backtracking on the idea of disarming all the depressed people? Those guys you mentioned were not simply depressed, though you underestimate the ability of psychotics to fool people too (the problem is psychotic episodes are temporary, most of the time psychotics can function normally). But depressed people can function normally all the time, and they can fool whomever they want by just not telling then how they really feel.

      The point if this thread has been about depression. You keep conflating it up to homicidal maniacs. Is it because you've conceded that the idea of disarming tens of millions of people with depression and using interviews to do so is preposterous?

    7. Remember in the case of the Tucson shooter, a team of psychiatrists spent months to determine he was unfit to stand trial. And this was after he shot up a parking lot. But you think one person could do that job in a half hour or so as a cold interview with no behavior history and mixed in with thousands of other interviews of perfectly sane people.

    8. The urine and blood tests will screen out those on medication. The others will be subject to a psyche exam and interview. As you say, some will fool the examiner but not all. That's the best we can do.

    9. Every single depressed person can fool an examiner. Depression is not a psychosis. Do you understand the difference between a psychosis and a neurosis?

    10. Are you kidding? EVERY one? Some people with depression are in such bad shape they cannot get out of bed in the morning. In some it actually affects their physical appearance and voice.

      "Every single depressed person can fool an examiner." Do you want to rephrase that ridiculous statement?

    11. So, you want therapists to deny people because their hair is messy or because they talk like Eeyore? Yes, every single depressed person can smile when they have to. They can lie about how they feel. They all lie to somebody about it, if not most people. Again, you seem to think that when a therapist graduates from the Hogwarts school of psychology that they are bestowed with magical mind reading powers. In order for a therapist to work with or identify depression, the patient must be cooperative in expressing their feelings to them.

    12. Actually TS, well trained people are pretty good at detecting mental problems from mild depression to severe personality disorders. No process is 100%, but that's no reason to use it as a tool. .

    13. How about giving me one example where a doctor diagnosed depression in an uncooperative patient. Sure, they can diagnose depression if the patient wants to be helped, but Mike is talking about a cold interview with a therapist expressly for the purpose of obtaining a gun license where the applicant knows they must convince the administrator that they are not depressed. Look, here's an excerpt from the Mayo Clinic regarding diagnosing depression:

      Psychological evaluation. To check for signs of depression, your doctor or mental health provider asks about your symptoms, thoughts, feelings and behavior patterns. Your doctor may have you fill out a questionnaire to help answer these questions.

      So what's the doctor going to do if the interviewee doesn't answer the questions honestly, doesn't express their true feelings, and lies on the questionnaire?

    14. And I'm not demanding 100%. Any process must be evaluated for cost and benefit. I'm saying the benefit will effectively be zero, and the cost will be huge. Unless you're considering long waits and high expenses slowing gun sales way down to be a "benefit". I put that on the "cost" side, plus the neglect of actual patients that need that time the therapists are wasting.

    15. The benefit would not be zero and the cost is the cost just as other government mandated services are.

    16. " In order for a therapist to work with or identify depression, the patient must be cooperative in expressing their feelings to them."

      And would not some of them do just that? Some? Even one out of the tens of millions?

      I see in your follow up comment you've backpedaled to what would be cost effective. Slick.

    17. I'm not back peddling from it being useless, I'm saying the cost will also be high (and not just monetarily).

      Mike, this interview is specifically to get a gun. If they didn't want a gun, why would they be there. If they want to get help for depression, they can go see a private therapist, which you conceded as being important to remain private.

    18. Mike, the reason why I brought up cost performance is to address comments like your "not one in ten million?" question. One in ten million is effectively zero. Scale matters. And cost must be a factor. How much did it cost to find that one person? And did you really save a life, or will he/she just go buy a rope? Was that person really suicidal? Were they actually going to go through with it if they bought that gun? And by "cost" I don't mean just money. If we direct that time and resources to something more effective, how many lives could have been saved? Wasting time and money in the wrong place costs lives. That's why cost analysis is always important.

    19. "I'm not back peddling from it being useless" I didn't accuse you of that. The useless idea came later, after I called you on this amazing remark: "Every single depressed person can fool an examiner."

      Do you have so little integrity in the argument that you can't admit when you made a stupid and wrong statement?

      Then you try to seize on my one in ten million remark, which as you fucking well know, was only to disprove your first wrong statement. It was not to suggest that the ones who cannot fool the interviewer would be that few, not by a long shot.

    20. What’s stupid and wrong about that statement? All they have to do is say they are not depressed. How hard is that? I said they can fool an examiner, as in they are all capable of doing so. If they don’t want to fool the examiner, that’s a different story, which is the case you just brought up where “some” people might just admit they are depressed. But why would they do that? Why would they go through the hassle and expense of gun licensing that you want to subject them to, make an appointment with a “psycho gun screener”, only to show up there and tell the therapist “yes, I shouldn’t be allowed to have a gun- I’m depressed”? If they want help, they would just go see a private therapist. Your idea isn’t going to help them anyway- they just won’t approve them to buy a gun and send them on their way.

      I even pasted a link here for psychological evaluation of Major Depressive Disorder (which is more severe than simple depression). What makes you think this information can be pulled from someone who wants to hide their feelings so they can buy a gun? That’s why I asked you if you know the difference between a neurosis and a psychosis. You seem to have this sciolistic view of mental health where it’s just a bunch of crazy people going around acting crazy.

      Also, you don’t have to be hung up on the “one in ten million” comment. The point is cost analysis and using resources efficiently- whatever the number ends up as. In any kind of program desiring a certain result, you have to look at the cost it takes to get that result. And then you have to weigh that against the costs and results of other programs. This is just like how you want to devote a bunch of law enforcement recourses to looking at gun serial numbers all day long because you demand every gun in the nation to have its serial number looked at in person by a cop every year. Is that the best use of law enforcement? Of course not. Even I’ll admit that the most likely reason for the modern drop in crime isn’t expansion of gun rights, but use of advanced policing that uses resources more efficiently. If you have them do something less efficient, crime goes up, lives are lost.

      And why they hell can’t depressed people have the best means of self-protection anyway? If a woman’s marriage dissolves and the psycho-ex-husband turns into a stalker threatening to kill her- that might just make her a little sad. Maybe even depressed. That doesn’t mean she is going to kill herself (you admit only a small percentage do), but she is more likely to be murdered. You never think about the good side of guns.

    21. The fact that you equate sad with depression proves you have no clue what you are talking about. You can't just hide real depression, but an examination would have to be more than a couple of questions.

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  6. Oh, so you knew Robin Williams was depressed? You can identify the 1 in 10 people in your life who are depressed? I guess they should hire you to do all the gun screening.

    And I didn't equate sad with depression. I added "maybe even depressed" as it could lead to something more severe.

    1. Yes, I knew Robin Williams had depression.