Ethical Issues in Mental Health Background Checks for Firearm Ownership

Federal law has prohibited the purchase and possession of firearms on the basis of mental health for nearly 50 years. The current background check system is limited by its vague policies, nonmandatory reporting standards, and low cooperation of individual states with the national background check registry. In January 2013, the Obama administration began an effort to reduce gun violence, which included proposed reform to mental health reporting standards and to the national background check system. However, there is much debate over whether people with mental illness should be included in background check databases or if their inclusion is counterproductive to the treatment of mental illness and the prevention of gun violence. The literature suggests that mental illness is not a reliable predictor of violence, rather a history of violence and current threats of violence are the best predictors of future violence. This article discusses the ethical considerations of mental health background checks for firearm ownership, with particular regard to the differing confidentiality policies of mental health professionals across states and the potential ramifications of a national mental health registry on patients' well-being. We propose that gun control regulations should implement empirically supported predictors of violence and that national inconsistencies in policies regarding confidentiality and "duty to warn" should be resolved.