Democratic Senator Touts Bill To Allow Patients Involuntarily Committed For Mental Illness To Purchase Guns

Sen. Mark Pryor (D-AR) hinted on Tuesday that he would oppose a Democratic initiative to expand background checks to all gun purchases, but reiterated his support for an NRA-backed measure that would permit individuals deemed mentally ill or incompetent to purchase firearms more freely. Pryor is part of small group of Democrats in red states who have not endorsed universal background checks, even though the measure is supported by a majority of residents.

“You know, I’m a Second Amendment guy, everybody knows that. People in our state are very strong believers in the Second Amendment and the right to gun ownership,” Pryor told “The Alice Stewart Show,” which airs on KHTE 96.5 The Voice. The conservative Democrat then highlighted his co-sponsorship of an NRA concocted proposal that would reduce the number of records in the existing background check system by removing prohibitions against individuals who were involuntarily committed to mental institutions.

Pryor emphasized removing records from the National Instant Criminal Background Check System, rather than broadening the requirement:

PRYOR: I do support improving the background check. I want to make sure that when we put data in the background check that we have the right kind of mental health data. We need integrity in that data to be in there and we also need a process where people can get their names out of there when the time is right. Either they got their name wrongly in the first place or they’ve gone through some issue or whatever and that’s behind them and they need to get their name out of the database. So I support a bipartisan bill on that, in fact I think it’s endorsed by the NRA, so I’m not like totally opposed to every single thing. I try to be reasonable on this.

Pryor, along with Sens. Lindsey Graham (R-SC), Mark Begich (R-AK), Dean Heller (R-NV), and Jeff Flake (R-AZ), has introduced the NICS Reporting Improvement Act (S. 480). The Act clarifies that mentally ill people are prevented from obtaining firearms but defines that term narrowly, so as to allow patients who had been treated for mental illness to pass a federal background check and purchase guns.

For instance, federal law prohibits people who are ordered by a court into involuntary treatment, found to pose a danger to themselves or others, or lack the mental capacity to enter into legal contracts from buying weapons — even though individuals can petition to have their rights restored in 22 states. The bipartisan NICS Reporting Improvement Act would allow these people to purchase weapons immediately after being released, unless it can be proven that they pose an “imminent” danger.

Since the shooting at Virginia Tech, the number of mental health records in NICS has grown from 200,000 to 1.2 million, though “millions of records identifying seriously mentally ill people and drug abusers as prohibited purchasers are missing from the federal background check database because of lax reporting by state agencies,” a report from Mayors Against Illegal Guns found. Pryor’s bill would keep even more mentally ill individuals out of the system.

“I doen’t listen to [New York City Mayor Michael Bloomberg] on these issues, I listen to Arkansas,” Pryor said. A recent poll found that 84 percent of Arkansans support expanding background checks to all firearm purchsases.

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ADHD’s Lasting Effects Prove That Mental Disorders Need To Be Treated Just Like Any Other Illness

When the bipartisan Wellstone-Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) was signed into law in 2008, mental health advocates hoped it would begin bridging the gap between the way that mental health treatments and more “traditional” medical services are provided — particularly by prohibiting different standards for one type of care over the other. Unfortunately, the evidence shows there’s still a long way to go when it comes to making the dream of medical parity a reality.

Time’s new Mayo clinic-sponsored report points out that ADHD, while being increasingly diagnosed and treated in children, has lingering long-term effects on adults and is a strong indicator of co-occurring mental illnesses for both children and adults. But lax insurance requirements, as well as a lack of awareness about the long-term effects of mental illness, have led to a dearth of research regarding the comprehensive effects of what medical professionals tend to dismiss as a childhood behavioral disorder:

It’s not that the condition isn’t being addressed adequately, or that doctors, parents and teachers are not aware of the condition: they certainly are, since education and awareness about ADHD has increased in recent decades, even contributing to a rise in diagnoses… [Dr. Barbaresi of Boston Children’s Hospital and Mayo Clinic] argues, however, that the legacy and long term implications of an ADHD diagnosis haven’t really been considered and studied adequately, since most doctors tend to think of the condition as one that primarily affects children that they tend to outgrow once they reach adulthood. The need for attention is even greater considering that the study also found a connection between ADHD and suicide. While the absolute number of deaths in the adults who still have ADHD is low, the statistical difference is significant: children with ADHD were nearly five times more likely to die from suicide than other people in the study group. [...]

In addition, data from this same group of study participants showed that more than 60% of kids with ADHD have a learning disability and develop at least one additional mental-health problem while they’re still children. Yet insurance companies are reluctant to authorize additional assessments that may detect and treat these conditions. “If a child gets diagnosed with ADHD, we want to do a comprehensive psychological assessment to see if the child has undiagnosed disorders because we know these kids are at risk,” says Barbaresi. “But insurance won’t pay.”

That’s in stark contrast to the way that children are evaluated for other medical conditions, such as diabetes. “We know they’re at risk for developing kidney and eye problems so they’re regularly assessed for those issues. We don’t wait until a child has renal failure or loses his eyesight,” says Barbaresi. “But with childhood ADHD, we can’t get authorization to do these assessments until it’s already happened.”

The Mayo study on ADHD underscores the practical hurdles of enacting true parity between the ways that mental health disorders and more “traditional” medical problems are diagnosed, treated, and even researched. Societal stigmas and decades of traditional medical practice have perpetuated a system in which mental health disorders are considered to be unique, individualistic medical problems — they are not — that ignores the interplay that mental disorders have with other medical conditions, not to mention the physical manifestations of such disorders.

Much of the focus on changing this unacceptable status quo has — justifiably — concentrated on funding and access to mental health care services. For instance, between the Wellstone-Domenici law and Obamacare’s requirement that statewide insurers include mental health coverage as an “essential health benefit,” millions of Americans are expected to gain access to mental services:

That is undoubtedly a step in the right direction. But the mental health benefits that states must provide under Obamacare are left largely to states’ discretion — and there is little reason to expect that states will impose strict requirements on insurers since mental health is still largely considered a form of “specialty” care culturally, if not legally, and private insurance doesn’t tend to cover patients’ out-of-pocket psychiatric costs. Bringing true parity between mental and physical health care necessitates a paradigm shift in the very culture of how such conditions are analyzed, approached, and treated, in addition to stricter insurer requirements for providing comprehensive care.

Armed with more data from longitudinal studies about the long-term effects and complex interactions of mental health problems — such as the Mayo ADHD study — health care professionals could substantially improve the lives of millions of Americans, and help eliminate a dangerous medical inequality and stigma in the process.

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Bradley Cooper On What ‘Silver Linings Playbook’ Can Teach Us About Mental Illness

David O. Russell’s Silver Linings Playbook, nominated for eight Oscars, is hardly the first movie to find critical acclaim with a searing portrait of the impact of mental illness. But unlike many films, which portray people who suffer from mental health issues as either saintly or pitiable, Silver Linings Playbook, about Pat Solitano (Bradley Cooper), a former high school teacher who is returning home from eight months at a mental hospital after he beat his wife’s lover and was diagnosed with bipolar disorder, is savagely funny and often disarmingly sweet. It’s also a subtle vehicle for larger ideas about mental health care in America, ranging from the damage done by late-in-life diagnoses of mental illnesses, to the fact that for some people, treatment comes only after they come into contact with the criminal justice system, to training about mental health that could help everyone from teachers to cops do their jobs better.

I spoke with Bradley Cooper, who was nominated for an Academy Award for Best Actor, and Dr. Barbara Van Dahlen, the president of Give An Hour, which coordinates with volunteer mental health providers to get free treatment to American veterans, about the stigma around mental illness, the intersection of mental health care and law enforcement, and what kinds of conversations they hope Silver Linings Playbook can start. Our conversation has been edited for clarity and length:

I wanted to ask you about the structural story of the movie, because the real tragedy of Silver Linings Playbook is that Pat’s biploar disorder doesn’t get diagnosed until it’s completely unmanageable. It’s awful that it gets to this point, but it’s also a way that he finally gets care, and that’s not a story we see very often.

Cooper: But reflective of what’s happening. I mean, that’s the whole point. Patrick Kennedy, he likens it to a diagnosis which happens at stage four of cancer. When that’s occurring, it’s a bleak horizon. The whole idea is to have it be diagnosed before he makes a plea bargain with the courts after he beat the hell out of a guy. That’s the only reason he even went to a hospital in the first place and was diagnosed there. But, if somebody recognized, or he had a venue when he was a teenager, to talk about the fact that his brain is working in such a way that make him feel like an outsider, like he’s not belonging, then maybe that would have been prevented, then maybe he wouldn’t have had to serve time and had a 500-yard restraining order out against him, and have no job.

At the same time, the movie treats the ongoing law enforcement involvement in Pat’s life—a local police officer is assigned to check up on him and respond to calls about him—as a good thing in Pat’s life. He doesn’t have a case worker, he has his therapist appointment once or twice a week, but the cops are actually doing a fairly good job of dealing with him.

Van Dahlen: That’s an unusual situation. The issue is having people in someone’s life who are consistent, who care. The police officer in this story was somebody who actually was willing to try when he could to be helpful, rather than just “Okay, I’m taking you back in.” And unfortunately, that’s not often the case in communities, nor is it the case that we’ve got teacher who have the knowledge, even though they care about the kids, they may not understand. So they’re not going to be the one that says “Maybe something else is going on here.” It’s educating all the way down the line in our communities so these folks are identified and have access and it’s part of our normal conversation. It should not be the case that someone has to keep feeling like “I’m going to try to keep it together, I’m going to try to keep it together.” We see this obviously with the service members, that whole culture, trying to keep it together when they can’t. Our society, unfortunately, puts a tremendous amount of pressure on people, and sometimes, they blow.

Cooper: The police officer for our story in the movie, he serves the same way that his friend Ronnie serves, his brother Jake and his parents, who say “You look great. Just adhere to the rules and you’ll be fine.” There’s no investigation into what’s going on. The cop doesn’t pull him aside at the movie theater and say “Explain to me what happens.” He goes “The restraining order. You want to go back to Baltimore?” Those aren’t ways of actually understanding the situation. And that’s the device we use in the movie to then introduce Tiffany Maxwell, who is Jennifer [Lawrence], and that’s the whole idea of somebody understanding him. And that’s where we can then use this movie in terms of spreading an awareness of people actually needing to investigate, and to inquire in what’s going on, so people feel free to share, instead of adhering to a set of rules, and that’s the way it is.

Van Dahlen: That’s a great point. It does a great job of showing, especially with young people, having both of those elements, the structure, like the psychiatrist said, “You’re going to have to figure this out.” That is a reality. We went through a phase in the mental health community where people got into navel-gazing, and it was all about understanding, and we do need to help people—

Cooper: A strategy. As he says in the diner.

Van Dahlen: Gotta have a strategy, gotta have a structure. And with that, have that understanding, so people can take that within that structure and have a healthy life.

I was struck by that element of the movie. Trying to find small victories, the silver linings, the idea that we can build up one step at a time has always seemed really important. It seems like Pat’s parents, not knowing very much about mental illness, don’t seem to understand that there’s a space in between him being in a mental hospital and him being completely well that is a good target for Pat to get to.

Van Dahlen: The other thing, too, and this happens to veterans, civilians, if you have something, as if we all don’t have something, is if you have something that becomes identified, bipolar, depression, everyone lumps all of your behavior into that. We’ll sit and talk to these veterans, and they’ll say “I got angry, and that’s my PTSD.” And I’ll say, “No, wait a second, it sounds to me like you had reasons to be angry.” And we have to do a better job with that element, too.

When it comes to the stigma around mental illness, I was struck by the intergenerational tension in the movie is interesting. It seems like Pat, Sr. has fairly serious undiagnosed issues, whether it’s OCD, he has the same kinds of tantrums that Pat has.

Cooper: He’s been banned from Vets Stadium.

Van Dahlen: It’s a pretty big tantrum.

It seems like a story about how we can brand getting treatment. The pills aren’t just going to turn you off. It can give you access to things that make you happy again.

Cooper: And also that it’s not the other. This is a regular guy. This is a sort of slice of life, looking at these people who are in the prime of their life. He’s a young guy, and this is what happened to him. You look at his neighbor, John Oritz, is talking about how he goes into his basement and smashes his fists against the wall to Metallica. He’s supposed to be the normal one. So it is sort of an attempt to show, let’s just not just judge, let’s look into ourselves.

Van Dahlen: Life events, if life delivered him a serious blow. It’s what happens to you that determines what others are going to call your behavior.

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