Sunday, January 30, 2011

Should Government Have Access To Your Mental Health Records?

On The CBS show `Face The Nation' on January 16th 2011, Rudy Giuliani commenting on the Tucson shooting suggested that we need to catch those with mental illness earlier in the process in order to decrease incidents like Tucson from happening as often. He went on to infer that there needed to be a profiling process for mental illness and a way to access potential risks among the general public.
First, while many are suggesting that there needs to be a 'National Debate' around political discourse, gun laws and mental illness, I would suggest instead this needs to be a local debate between family members first, individuals in their local community and any legislation (I would tread carefully) should come out of the states and not as federal laws. Government becomes less effective, less accommodating, more costly and treads on individual liberties the further away from the people and closer to Washington DC into a centralized system.
Ex-Governor Giuliani's suggestion of monitoring mental illness in our society at face value seems reasonable but like any laws and controls on behavior there is the 'pebble in the water' ripple effect or Unintended Consequences'. To paraphrase Ludwig Von Mises, " Classical Economist of the early 20th Century, "A good economist not only considers what is seen and affects now, but also anticipates to the best of his knowledge that which he can't see and exists in the future." Mental Health, like Economics is an inexact science as it considers human social behavior in creating models and treatment therapies for the mentally ill; while assessing the mental health of one individual and the potential risk he might be to society is daunting, creating national formulas or profiles for all individuals is impossible.
The insurance industry has struggled in assessing risk for mental illness in their life and disability insurance policies for over a century. Most policies have an exclusion for suicide the first few years of the policy and underwriting the disease has been very difficult in general. Most insurance companies when underwriting for mental illness history will either decline the applicant or will put a rider on the policy to not cover the disease and could ask for higher annual premiums (money). Ironically, the most challenging class of people to underwrite for policies are those in the mental health profession, like Psychiatrists and Psychologists as they obviously believe in the service and will receive services as preemptive care or a general mental health checkup.
So what are the potential unintended consequences of the federal government creating a database for government officials and law enforcement to monitor the general public for security threats? One consequence might be fewer individuals turning to the mental health profession for answers. Fearing the possibility of ending up on a government watch list, many sufferers of the illness might choose to suffer in silence, some potentially deteriorating into a risk to their families or society. Another consequence is those of us who have already chosen to seek mental health services who could potentially wind up on a list somewhere in Washington, as your local mental health provider is forced to give up client file information in the creation of the national database. When federal laws are created they are administered by experts brought in by Washington, who decide what data is significant or not and how social and psychological models should be created. You could see the potential for real harm and abuse to individuals, the loss of privacy being the best outcome.
The tragedy of Tucson shouldn't turn into a double tragedy, the loss of precious lives and the taking away of the individual freedoms of those left behind. In order for that not to happen, we need to be led by the Constitution regarding the federal limitation to only make sure the 2nd Amendment is not tread upon by the states, and for states at their most local levels to have voluntary discussions about responsible gun ownership and the mental and spiritual health of their communities. Who knows maybe through private discourse and initiative, another Loughner family that has given up and closed its doors to its neighbors and society might with another knock on the door reconsider and find the help they need.

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