New York State’s New Gun Law Shreds Patient Confidentiality, Trust
On Tuesday, New York became the first state to pass a tough new law on gun ownership. But not the kind of gun ownership that is actually responsible for most of the murders in the U.S. No, just one targeted at making tragedies like Newtown, CT a little more difficult in the future to pull off.
But in focusing on these one-off tragedies that subjectively seem epic (but objectively, are a drop in our national murder-rate bucket), the over-reaction of the lawmakers was predictable.
So lawmakers have decided to turn every physician, nurse, social worker, therapist and mental health professional in New York into a new kind of mandated reporter — people who turn into police officers when it comes to certain behaviors. In doing so, lawmakers in New York have single-handedly shred the foundation of confidentiality and trust in the doctor/patient and therapist/client relationship.
Is this a sensible reaction?
The New York Times notes the big change:
The most significant new proposal would require mental health professionals to report to local mental health officials when they believe that patients are likely to harm themselves or others. Law enforcement would then be authorized to confiscate any firearm owned by a dangerous patient; therapists would not be sanctioned for a failure to report such patients if they acted “in good faith.”
Currently in most states, mental health professionals already have an ethical duty to report certain kinds of behavior to authorities — active and ongoing abuse (whether child, partner, spousal, or elder), and certain threats of homicide or suicide. But the key difference is that the state has generally left this up to a professional’s experience and judgment to decide when to report, and when not to.
There may be many methods to helping someone in these situations, but most importantly, most of them do not involve immediately betraying the trust of the patient and reporting them to the authorities. From an ABC News article on the new law:
This flexibility allows a therapist to deal with a risk of violence without breaching confidentiality in all cases, he said. And even if those steps are enough to blunt the danger, the proposed law would still require that the patient be reported to mental health authorities, he noted.
“It undercuts the clinical approach to treating these impulses, and instead turns it into a public safety issue,” [said Dr. Paul Appelbaum at Columbia University.]
The new law, if health professionals follow it, completely throws away the therapeutic relationship with the patient, and breaches the patient’s trust and confidentiality. People with mental illness are being scapegoated, despite the lack of research demonstrating a conclusive link between mental illness and violence.
Worse, it encourages smart people to simply not admit to any such impulses of violence — even if they have little or no intent to carry them out. Patients are now encouraged — through the haphazard, quick passage of this law — to self-censor while talking to their therapist. Certain thoughts will be reported to the government otherwise.
If this doesn’t sound like Big Brother, I don’t know what does.
So while well-meaning, New York lawmakers have just managed to completely undermine the good, hard work that therapists do with citizens of that state. And state residents will learn to keep their mouths shut if they want to keep their Constitutional rights intact.
Grohol, J. (2013). New York State’s New Gun Law Shreds Patient Confidentiality, Trust. Psych Central. Retrieved on February 19, 2017, from https://psychcentral.com/blog/archives/2013/01/16/new-york-states-new-gun-law-shreds-patient-confidentiality-trust/