Background: Gun violence is rapidly developing into a public health epidemic in the US. Many link firearm deaths with mental illness due to high-profile mass shootings, like that at Sandy Hook. In response to these types of mass shootings, some states have passed gun removal laws, like the SAFE Act in NYS. The law requires that mental health professionals report a patient who they consider is likely to engage in conduct that would result in serious harm to self/others. This reporting might result in surrender of any legally-owned firearms. Many mental health professionals and organizations have expressed concern regarding such laws fearing that they might prevent individuals from seeking mental health treatment. The purpose of this study was to assess whether knowledge of the SAFE Act impacts patients’ mental health treatment-seeking and symptom-reporting behaviors.

Methods: Patients at two mental health centers, one in upstate NY and the other in the Lower Hudson Valley, NY were asked to complete a questionnaire during 2014-2018. The independent variables used were gender, age, gun ownership and prior knowledge of the SAFE Act. After the key provisions of the law were described to participants, they were asked if they would be concerned about being reported to county government, their likelihood of seeking mental health treatment, and willingness to report mental health symptoms/behaviors.

Results: A total of 319 patients were approached to participate in the study and 228 (71.5% response rate) completed questionnaires. About 18% were concerned about being reported to county government as a result of the SAFE Act, 9% stated that they would be less likely to seek mental health treatment, and about 23% reported being less willing to report mental health symptoms/behaviors.

Conclusions: There has been much concern in the mental health community about the impact of gun removal laws. The findings of this study show that for most participants, knowledge of the SAFE Act’s provisions did not seem to impact their behaviors. There was however, a minority who did report concern and less willingness to report mental health symptoms/behaviors. As such laws are developed, it is important to consider patients’ perspectives.