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Mental Health Assessments for Gun Ownership?


The United States has by far the most firearms, both absolute and per capita, in the world. The statistics of the impact of guns in the United States are stark.

The recent tragic incidents in Uvalde, Texas and Buffalo, New York have again put mass shootings in the news. The question of whether mental health assessments should be a prerequisite to gun purchases has been renewed. Public outcry has prompted the US Congress to pass a bill that would expand background checks for prospective gun buyers between 18 and 21. The new process would incentivize states to provide access to previously sealed juvenile records and could add several days to the waiting period before a purchase can be completed.

Could pre-purchase mental health assessments also help reduce the carnage?

Would This Prerequisite Work?

Currently, federal US law prohibits possession or receipt of firearms and ammunition if the firearms or ammunition were transported across state lines at any time and the person falls under any of the conditions below:

  • Is a convicted felon (or awaiting trial on felony charges) or fugitive from justice

  • Is a drug user or addict as defined in section 102 of the Controlled Substances Act

  • Has been judged in court as being “a mental defective” or has been committed to a mental institution

  • Immigrants who are not permanent residents, i.e., “green card” holders or visa holders with a special waiver from the US Attorney General

  • Is subject to a domestic restraining order

  • Has a prior conviction for domestic violence

  • Was dishonorably discharged from the military

  • Has renounced US citizenship

Sales of firearms between private parties within a state who are not dealers with a Federal Firearms License (FFL) are not subject to background checks. Thus it’s primarily up to state and local governments to decide how (if at all) to limit access to firearms further.

Many states have statutes on the books preventing some from possessing guns, but most parallel the federal restrictions:

  • Persons who have been acquitted of crimes by reason of insanity

  • Persons found incompetent to stand trial because of mental disorder

  • Persons who have been committed to a mental hospital/institution or addiction treatment center

Making a mental health assessment mandatory could well screen out some who would pose a danger to themselves or others if they obtained a gun.

Consider the fact that of the 45,027 gun-related deaths in 2021, over 24,000 of these were by suicide. This number represents roughly half of all suicides committed, a grim toll. If mental health assessments could prevent a number of these, it would be a meaningful outcome.

Would it be Supported?

Support can be found for enacting a federal law requiring pre-purchase mental health assessments. A survey of 1.250 adult Americans found the following:

  • 49% of all Americans say mental health assessments should be required for gun ownership.

  • 4 in 10 Republicans support mental health tests before any gun purchases.

  • 1 in 2 gun owners support annual mental health assessments for gun ownership.

  • Mass shooters having a history of mental illness is the #1 reason why Americans say mental health assessments are necessary for gun ownership.

  • 45% of people who object to mental health assessments cite the 2nd Amendment violation.

There is also concern from mental health practitioners that the cost of malpractice insurance could increase—maybe substantially.

How Would it Work?

With the help of advanced technology, an interactive, standardized test could be developed as a starting point for the evaluation. Yet, a psychologist would still need to further evaluate a candidate for gun ownership.

The Federal Bureau of Investigation (FBI) already maintains the National Instant Criminal Background Check System (NICS) database, established through the Brady Handgun Violence Prevention Act in 1993. The NICS is used when FFL dealers submit prospective buyers’ information as a prerequisite to a gun purchase. The NICS database might conceivably be adjusted to include individuals who have been assessed by a mental health professional and flagged.

Much work would have to be done to establish standards for excluding those who should not purchase firearms. Also, gun rights advocates and defenders of the 2nd Amendment would surely work hard to prevent such protocols from being established. The process would be laborious, but establishing a screening system would help avoid needless gun deaths.


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