Shrink Rap News

Update on New York’s mandate on reporting of patients


Almost 1 year ago, New York lawmakers passed some of the most stringent gun control measures in the country. One of the provisions of the New York Secure Ammunition and Firearms Enforcement, or SAFE Act, requires mental health professionals to report individuals they believe are likely to be dangerous to their director of community services, who then decides if patients are to be reported to the criminal justice system. The initial report, called a "9.46," goes through a website set up by the state. These patients may be investigated to determine if they have a firearms permit and whether that permit should be revoked.

The law is controversial. The federal Veterans Affairs Department said it would not comply because the law violates federal HIPAA requirements, and the New York State Psychiatric Association also registered objections, as did I – soon after it was passed. Of note, nothing in the law allows for a mental health professional to directly notify law enforcement officials to confiscate weapons from dangerous patients.

Now that it’s been a while since implementation, it’s time to start asking how it’s going. How many patients have been reported to the directors of community services through the website? How many of those have been investigated? How many guns have been confiscated or surrendered? And how much safer are New Yorkers? Are suicide and violent crime rates dropping? Are the agencies involved pleased with the results to date?

In June, The New York World posted a piece headlined "SAFE Act registry of mentally ill nets few gun permit holders" that read, in part:

"Of the 6,000 reports that have been filed, 11 have been acted upon, testified Jed Wolkenbreit, counsel to the New York State Conference of Local Mental Hygiene Directors, citing figures from the state Office of Mental Health.

His organization’s members are county directors of community services, who under the law must approve or dispute assessments made by mental health providers of the potential of their patients to cause harm.

The flood of SAFE Act reports, Mr. Wolkenbreit asserted, is taking time away from commissioners’ other responsibilities in running their counties’ mental health systems: 'The biggest problem is the amount of time and resources that the SAFE Act is diverting from all of the other duties of the DCS [directors of community services] for what we believe to be a minimal return.'

The law says that reports must be made by the mental health professional. Yet some reports, testified Mr. Wolkenbreit, are being filed by someone other than the mental health provider seeing the patient, and many appear to be computer generated, based on existing patient files. In many cases, mental health providers listed on the documents, when contacted by community services directors for review, either said that they had not filed the reports or that the patients they had seen did not meet the SAFE Act reporting criteria, according to Mr. Wolkenbreit."

That was back in June. In late October, I spoke with Mr. Wolkenbreit, who did not have up-to-date statistics. He noted that the original reports that patients were being reported erroneously was inaccurate, and the issue instead was that there had been confusion with people who had the same name and birth dates as those being reported.

Wait, so first it was stated that patients were reported in error but, in fact, that was a mistake?

"At the very beginning, there were problems with identification, and now we’re getting more information," Mr. Wolkenbreit said.

In April, WGRZ-TV in Buffalo reported on David Lewis, a college librarian in treatment for anxiety, who lost his pistol permit. Once the situation was clarified, his firearms were returned. Mr. Lewis, however, was not happy with the situation and made his story public.

WGRZ went on to discuss difficulties enacting the legislation and how the agencies involved were unclear about who was verifying information – the state police or the counties. In Rochester, the station reported, a county clerk was told to call the patient to verify that he was the subject of a report.

Mr. Wolkenbreit now estimates that 15,000 people statewide have been reported to the justice system.

"A high percentage of those are people who have been hospitalized, the next greatest number come from clinics, and a smaller number come from private practitioners. Most of the reports come from New York City."

He noted that those reporting must supply identifying information to confirm that the reporter is a legitimate mental health professional, and there needs to be a clinical reason; simply stating that a patient has suicidal ideation is not enough to trigger a report to the justice system.

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