141st APHA Annual Meeting

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280499
Do firearms restrictions prevent suicide and violence in people with mental illness? new research evidence from New York

Monday, November 4, 2013 : 3:30 PM - 3:50 PM

Jeffrey Swanson, PhD , Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Duke University, Durham, NC
Allison G. Robertson, PhD, MPH , Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
Paul Appelbaum, MD , Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY
Li-wen Lee, MD , Division of Forensic Services, New York State Office of Mental Health (OMH)
Marvin S. Swartz, MD , Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
Research evidence has been lacking to evaluate the public safety effects of firearms restrictions on people with serious mental illness. A recent study in Connecticut found evidence suggesting that the state's policy of reporting gun-disqualifying mental health records to the federal gun background check database significantly reduced risk of a first violent crime in people with serious mental illness. However, that study was limited by its lack of a direct measure of firearms involvement in crime, and could not examine firearm-related suicide as an outcome. The current study from New York addresses both limitations of previous research. New York began reporting mental health records to the National Instant Check System (NICS) in 2009, depositing a large number of records at a single time and thus providing an opportunity for a powerful natural experiment. A sample of over 75,000 persons with schizophrenia, bipolar disorder, or major depression was selected from state mental health services recipient records over the decade from 2003-2012. Matching administrative records from the state mental health, criminal justice, and vital records agencies were obtained to identify gun-disqualifying mental health adjudications, arrests (with all statutory arresting charges, including specific firearms violations), hospitalizations, incarcerations, and deaths (by cause of death.) Effects of gun laws will be estimated by comparing trends in firearms violence and suicide for persons disqualified vs. not disqualified from gun purchase due to mental health history, for the periods before and after the state's implementation of reporting to the NICS. Policy implications of findings will be explored.

Learning Areas:
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Public health or related research

Learning Objectives:
Describe new evidence for the effectiveness of firearms restrictions on people with serious mental illness in reducing the risk of firearms-related suicide and gun violence toward others. Assess the strength and limitations of the new evidence, and will understand the implications of the evidence for policies and laws to reduce gun injury and morality.

Keywords: Firearms, Mental Illness

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Jeffrey Swanson, PhD,* is Professor in Psychiatry and Behavioral Sciences at Duke University School of Medicine. Dr. Swanson is a medical sociologist with expertise in mental health law and policy studies. He PI of a multi-site study on firearms laws, mental illness and prevention of violence, co-sponsored by the NSF and the RWJF Program on Public Health Law Research. Dr. Swanson received the 2011 Carl Taube Award from the American Public Health Association.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.