Mental Health & Firearms: June 20, 2017

The passage of Initiative 1491 in November 2016 made Washington one of just a handful of states in the country with an Extreme Risk Protection Order (ERPO) law. ERPOs are invaluable tools that prevent gun violence by removing access to firearms from individuals who pose a threat to themselves or others. But one of the challenges of passing and implementing this lifesaving law is avoiding stigmatizing mental illness.

The Alliance is dedicated to destigmatizing mental illness and supporting effective, data-driven policies and interventions where mental health issues meet firearm ownership. This effort led us to host a summit addressing the intersection of mental health and firearms in June 2017.

The day-long event brought together state and national gun violence and mental health experts to present the latest research on the intersection of mental health and gun violence. We also invited legislators to host a candid discussion about how to create effective policy without further stigmatization of those living with mental illness.

Josh Horwitz, Executive Director of the Educational Fund to Stop Gun Violence, delivered a powerful keynote presentation. A few key takeaways:

  • Suicide accounts for 75 percent of total firearms deaths in Washington, compared to 61 percent nationally.
  • Serious mental illness on its own contributes very little—just 4 percent—to overall violence towards others. However, between 47 and 74 percent of violence towards self is attributable to serious mental illness.
  • Case-control studies in the U.S. have found the presence of a firearm is a strong risk factor for suicide.
  • Success of policies to restrict firearm access to those in crisis work. For example, Connecticut’s Risk Warrant law of 1999, showed that for every 10-20 warrants issued, one life is saved.

Jessyca Dudley from the Joyce Foundation’s Gun Violence Prevention Program and Mamadou Nyiade from the Washington State Department of Health followed, presenting firearms fatality data from national and state perspectives.

Senator Patty Kuderer, from the 48th Legislative District, spoke to the immense challenges a divided legislature presents on gun violence prevention policy. Interestingly enough, Senator Kuderer pointed out, bringing mental illness and mental health into the discussion led her colleagues across the aisle to be more willing to engage in the conversation. Senator Kuderer was the Prime Sponsor of Senate Bill 5441, which would prohibit a person from possessing or purchasing a firearm for six months following a 72-hour involuntary hold. It received a hearing in the Senate, which represents a major step forward. And though it didn’t progress, Senator Kuderer plans to bring the bill back next legislative session.

Renee Hopkins, (CEO, Alliance for Gun Responsibility), Lauren Simonds, (ED, NAMI WA), Senator Patty Kuderer, and Representative Laurie Jinkins delivered a TED Talk- style discussion centered on how to create effective legislation without marginalizing those living with mental illness. Firearm ownership is a civil rights issue for those with mental health concerns—this reality has the potential to create conflict between mental health and gun violence prevention advocacy.

The group’s consensus was that the key to future legislative success is the messaging of “safety laws” that don’t further stigmatize those living with mental illness and make clear that prevention measures, such as Senate Bill 5441, are not about taking people’s guns away—they’re simply about removing access to firearms during a critical period.

A panel discussion featuring Josh Horwitz, (ED Educational Fund to Stop Gun Violence), Dr. Rebecca Hendrickson (Seattle VA Medical Center), Jessyca Dudley (Program Officer, Joyce Foundation Gun Violence Prevention Program) revolved around interventions at multiple levels.

The panel closed touching on Extreme Risk Protection Orders as a tool, which for the two clinicians on the panel, is a second order effect. Clinicians are obligated to report identifiable acute risk, creating an opportunity to ensure law enforcement is aware of ERPO. This second order effect of ERPO counseling also applies to families, as clinicians move to a more effective family support model.

During the second half of our day-long Summit, participants attended two of four breakout sessions offered:

  • Community Impact Of Mental Health And Gun Violence Intersection, The Clinician’s Perspective On Secondary Trauma. (Discussion)
  • From Policy To Practice And Practice To Policy: Use Of Extreme Risk Protection Orders, The Clinical And Legal Perspectives. (Presentation).
  • “Safety Assessments” For Individuals With Mental Health Diagnoses Including PTSD, Substance Use Disorders, Mood/Anxiety Or Psychotic Disorders In Populations With A Very High Rate Of Gun Ownership. (Discussion)
  • Trauma-informed Care: Real Risk Factors For Trauma And Resulting Interpersonal Violence. (Presentation)

Finally, a session on Extreme Risk Protection Orders took the audience through the complete process of filing a petition to the surrender of firearms. With a clinician co-leading the session, the presentation incorporated ERPOs as part of safety planning for at-risk individuals.

This summit attracted upwards of 60 mental health providers, public health employees and GVP advocates. It was a day of compassionate learning, breaking down barriers, and focusing on policies and programs that move the needle on gun violence.