HF 240 whose short description was listed as "Mental health screening improved for persons applying for firearm permits" was introduced last week by freshman Rep. Dan Schoen (DFL-St. Paul Park) and eight other DFL colleagues. There is no Senate companion at this point. If passed into law, it would require primary care physicians and mental health professionals to read the minds of their patients and become fortune tellers as to whether at some time in the future someone might act out violently. Here is the relevent language:
(b) When the applicant has had past police contacts that indicate dangerous or violent
2.18behavior, chemical dependency, serious mental illness, or a physical condition involving
2.19mental incompetence, the chief of police or sheriff, as a condition of granting the permit,
2.20may require that the applicant obtain a letter from a state licensed primary care physician
2.21or state certified mental health professional, or both, affirming that, in the person's
2.22professional opinion, the applicant is not seriously mentally ill or chemically dependent,
2.23and does not have a physical condition involving mental incompetence such that the person
2.24would be likely to be violent or a danger to self or others. The chief of police or sheriff must
2.25take the letter under consideration but is not required to treat the letter as determinative
2.26or conclusive in the decision to issue or deny the permit. Any such requirement by the
2.27chief of police or sheriff suspends the count on the waiting period beginning at the time
2.28the requirement is determined until the required letter or letters are provided.
The physician board chairman of the Minnesota Medical Association, Dr. Dave Thoreson, was on Morning Edition with Cathy Wurzer (audio available here) on February 6th. He made no bones about how difficult this was for both primary care physicians and psychiatrists. He mentioned that regular physicians may not have access to mental health records due to HIPAA and that both physical and mental conditions can change rapidly. When pressed by Wurzer, he also admitted that even psychiatrists are unable to predict the future actions of mentally and emotionally troubled patients.
One major reason that even these vaunted physicians of the mind are not able to predict the potential future actions of their patients is that they know that when people look under their pseudoscientific veneer, their diagnoses in the present are highly subjective. For example, Dr. Dilip Jeste, president of the American Psychiatric Association, in a statement on the completion of the new edition of the bible of psychiatric diagnosis, the Diagnositc and Statistical Manual (DSM-V), said last December:
At present, most psychiatric disorders lack validated diagnostic biomarkers, and although considerable advances are being made in the arena of neurobiology, psychiatric diagnoses are still mostly based on clinician assessment.
In plain English, that means that all psychiatric diagnosis is an educated guess. Dr. Allen Frances, chief editor of the previous edition of the DSM put it much more bluntly in a 2010 interview:
“…there is no definition of a mental disorder. It’s bull****. I mean, you just can’t define it.”
The other big reason that doctors don't want to be responsible for having their opinion required about a person's future mental status is that then they might have to be accountable for the prescribing decisions they make. Sadly, either they don't know or won't admit that the psychiatric medications they prescribe, especially the SSRI antidepressants like Prozac, have been linked to violence, including mass violence like Newtown, and suicide since the 1950s. There are at least two reports that have not been discredited from the Washington Post and from 60 Minutes that Adam Lanza was on some type of medication for treatment of Asperger's Syndrome. According to the International Society for Ethical Psychiatry and Psychology (ISEPP), on whose board I just recently served, in their Statement on the Connection Between Psychotropic Drugs and Mass Murder, they said:
This connection between psychotropic drugs and mass murder is not coincidental. There is enough evidence that antidepressants cause increased risk of suicide and violence for the U.S. Food and Drug Administration and its Canadian counterpart to require that drug companies include a “black box” warning to that effect on their packages. Our first knowledge of this association between psychotropic drugs and violence came from studies completed in the early 1950s, (8).
This was supported by research completed on antidepressants in the mid-1970s, (9).
More recent studies have corroborated this association between antidepressants and homicide/suicide, (10, 17).
Antidepressants, specifically Paxil, appear to more than double the risk of hostility events in adult and pediatric placebo-controlled trials (11).
All of the classes of psychiatric drugs can cause violent, irrational, and/or manic behavior. Among other effects, these drugs cause a neurological condition called “akathesia,” which means that persons who take them can’t sit still and feel like they are jumping out of their skin. They behave in an agitated manner which they cannot control and experience unbearable rage, delusions, and disassociation. For a detailed explanation of the neurology, chemistry, and physiology of akathesia, see Rethinking Psychiatric Drugs: A Guide to Informed Consent by Dr. Grace Jackson (8).
Psychotropic drugs – antidepressants, antipsychotics, mood stabilizers – impair the ability of people to accurately and effectively process emotions. They take away caring. They dull conscience. In his book Listening to Prozac, psychiatrist Peter Kramer reported that his patients on Prozac didn’t care as much. They lost some of their conscience. This made it easier for them to do things that were hurtful to other people (12).
In his book Medication Madness, psychiatrist Peter Breggin presents evidence of how psychotropic drugs cause people to lose awareness of how they are behaving and to lose control over their behavior. Such people are at greatly increased risk of committing acts of crime and violence (13).
During the packed and highly charged House hearings held in the House Public Safety Policy & Finance Committee on February 5th, chaired by Rep. Michael Paymar (DFL-St. Paul), there was testimony against the bill from several mental health professionals. One, Patty Bittney-Stark, president of the Mental Health Consumer Survivor Network, spoke of her concerns about how veterans who have honorably served their country but are struggling with PTSD might not seek help because of fears of losing their second amendment rights. (Audio available here in second story.) This is especially concerning because many veterans are prescribed these dangerous psychiatric drugs. It is quite likely that the disturbed veteran, Eddie Routh, that shot fellow veterans Chris Kyle and Chad Littlefield at a shooting range was on one or more of these medications given reports that he was in a mental hospital twice in the five months before the shooting. It is a rare patient indeed that leaves one of these facilities without psychiatric medication.
Instead of ending the second amendment rights of people, especially our veterans, struggling with emotional difficulties or mentally screening children in schools with subjective screening tools, patients, physicians, law enforcement, and the public need to be made aware of psychiatry's dirty little secret - that psychiatric medications are very toxic and can be a contributing factor in these kinds of horrific and violent events. I agree with ISEPP when they say:
We understand that many factors are involved in acts of mass murder. We are not suggesting that psychotropic drugs are the only or the major factor. But we do know there have been 22 international drug regulatory warnings about the impact of psychotropic drugs on suicidal and homicidal ideation, mania, violence and hostility (15). We do believe that there is enough evidence of the association between psychotropic drugs and mass murder to warrant an inquiry. And we believe that psychological autopsy and complete review of all medical records should be standard operating procedure in the investigations of these tragedies.
Finally, in light of the Kyle shooting and other military/veteran related killings, I would really suggest that veterans be very wary of using medications to deal with PTSD. I hope their advocacy organizations will join experts like Dr. Paul Caplan, author of When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans, and non-profits like the Wounded Warrior Project or FITCO Cares started by Chris Kyle to work with the VA to change the way our brave veterans are cared for when they return from battle.