Guns and Psychiatry

What comes to mind when you think of guns and psychiatry? Probably the Army psychiatrist at Fort Hood, or maybe the Virginia Tech student with psychiatric problems who went on a shooting rampage. Next you may think of the obligatory removal of access to firearms when you send home a patient at risk for self harm. Then there are the myths about violence and mentally illness.

But millions of Americans own firearms, so it should not surprise you that other considerations abound. How do you, the psychiatric provider, feel about the fact that a patient or family member might bring a concealed weapon into your office? Do you have a policy? signs on the waiting room wall? How many psychiatric providers themselves might keep firearms in the office? Would you ask a patient to leave if you discovered she had a revolver in her purse?

What about your patient with PTSD who has himself been a victim of violence and may want a weapon for protection? Would you argue against such a practice on principal? Maybe he's physically disabled as well, making him even more vulnerable.

Have you, the mental health practitioner, ever conducted a background check on a patient to determine whether there might be a history of criminal conviction? Possession of a permit to carry a concealed firearm can provide you with strong evidence that the individual has never been convicted of domestic violence or a felony in many states?

How important are leisure activities to a patient struggling with anxiety or depression? If your patient's favorite pastime relates to gun-smithing, collecting or hunting, do you want her to abandon an activity that contributes to self-esteem and possibly social connection during a time of crisis?

Most of us in the helping professions, especially medicine, are all too aware of the devastation wrought by violent death or serious injury, but do you want a patient who likes, owns, or even carries guns to feel judged by the very person to whom he has come for help?

Even if, like me, you do not believe in "transference," know where you stand with your feelings about people and firearms, and take care not to let them interfere with your work.