President’s Plans To Prevent Gun Violence Involve Health Care Providers, Research

On January 16, 2013, President Barack Obama rolled out a multifaceted plan to prevent gun violence, using a combination of executive action and proposed legislation. In addition to proposing a reinstatement of the bans on assault weapons and ammunition clips containing more than ten rounds, the plan calls for increased access and referrals to mental health services and new research, reporting and education about gun violence as a public health issue.

A Presidential Memorandum directs the HHS Secretary, through the Centers for Disease Control, to conduct or sponsor public health research into the causes and prevention of gun violence. Secretary Sebelius is to begin by identifying “the most pressing public health questions with the greatest potential public health impact” and assessing the public health interventions currently being used to prevent gun violence in the United States. The President contends that the research is essential to an informed approach and does not violate statutory prohibitions on the use of CDC funds to advocate gun control.

President Obama also directed HHS to issue guidance to clarify the relationship between patients’ right to privacy of their mental health treatment records and health care providers’ legal authority to report credible, direct threats of violence to law enforcement authorities. The guidance states that no federal law prohibits health care providers from reporting threats to the authorities.

In addition, the administration takes the position that nothing in the Patient Protection and Affordable Care Act (PPACA) (P.L. 111-148) restricts the authority of health care providers to discuss issues of gun safety with patients and families. Providers must be free to ask whether guns are present in the home and how they are stored in order to address safe storage and security, especially where the household includes young children or anyone who may show signs of mental illness.

Because 75 percent of mental illnesses develop in patients by the age of 24, President Obama’s plan calls for training of teachers and others to recognize the signs of developing mental illness and provide “mental health first aid,” in the form of intervention and referrals. Additional programs would: (1) provide support for individuals between 16 and 25 with identified needs for mental health services; (2) provide services in the schools to address the mental health needs of individuals who have been exposed to gun violence; and (3) train more mental health professionals. Finally, the administration also will enforce the 2008 laws requiring parity in coverage of mental health and substance abuse treatment.