In their fervor to take action against gun violence after the shooting in Newtown, Conn., a growing number of state and national politicians are promoting a focus on mental illness as a way to help prevent further killings.
Matthew Staver for The New York Times
Gov. John W. Hickenlooper of Colorado, a Democrat, has proposed a broad overhaul of the state's mental health system.
Legislation to revise existing mental health laws is under consideration in at least a half-dozen states, including Colorado, Oregon and Ohio. A New York bill requiring mental health practitioners to warn the authorities about potentially dangerous patients was signed into law on Jan. 15. In Washington, President Obama has ordered "a national dialogue" on mental health, and a variety of bills addressing mental health issues are percolating on Capitol Hill.
But critics say that this focus unfairly singles out people with serious mental illness, who studies indicate are involved in only about 4 percent of violent crimes and are 11 or more times as likely than the general population to be the victims of violent crime.
And many proposals — they include strengthening mental health services, lowering the threshold for involuntary commitment and increasing requirements for reporting worrisome patients to the authorities — are rushed in execution and unlikely to repair a broken mental health system, some experts say.
"Good intentions without thought make for bad laws, and I think we have a risk of that," said J. Reid Meloy, a forensic psychologist and clinical professor at the University of California, San Diego, who has studied rampage killers.
Moreover, the push for additional mental health laws is often driven by political expediency, some critics say. Mental health proposals draw support from both Democrats and Republicans, in part because, unlike bans on semiautomatic weapons or high-capacity magazines — like the one proposed in the Senate last week — they do not involve confrontation with gun rights groups like the National Rifle Association.
"The N.R.A. is far more formidable as a political foe than the advocacy groups for the mentally ill," said Dr. Jeffrey A. Lieberman, chairman of psychiatry at Columbia University and president-elect of the American Psychiatric Association.
Indeed, the N.R.A. itself, in response to the massacre in Newtown, argued that mental illness, and not the guns themselves, was at the root of recent shooting sprees. The group called for a national registry of people with mental illness — an alternative that legal experts agree would raise at least as many constitutional alarms as the banning of gun ownership.
For mental health groups, the proposals under consideration are tantalizing: By increasing services for those with mental illness, they raise the possibility of restoring some of the billions of dollars cut from mental health programs in recent years as budgets tightened in the financial downturn. The measures also hold out hope for improvement of a mental health system that many experts say is fragmented and drastically inadequate. And some proposals — those to revise commitment laws, for example — have the support of some mental health organizations.
But some mental health and legal experts say that politicians' efforts might be better spent making the process of involuntary psychiatric commitment — and the criteria for restricting firearms access once someone has been forcibly committed — consistent from state to state. And some proposals have caused concern, raising questions about doctor-patient confidentiality, the rights of people with psychiatric disabilities and the integrity of clinical judgment.
Especially troublesome to some mental health advocates are provisions like New York's, which expand the duty of practitioners to report worrisome patients — a model likely to be emulated by other states. New York's law, part of a comprehensive package to address gun violence, requires reporting to the local authorities any patient "likely to engage in conduct that would result in serious harm to self or others." Law enforcement officials would then be authorized to confiscate any firearm owned by such a patient.
John Monahan, a psychologist and professor of law at the University of Virginia, said that such laws are often superfluous.
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