Andrew Cuomo on reducing mass shootings: Let's have a federal mental health database

A solid sign that we’re in the midst of a panic is someone flinging “federal mental health database” onto the policy negotiating table. But there are at least three things working in Cuomo’s favor here:

1. None other than Wayne LaPierre has suggested the same idea. Jeryl Bier pointed me to this speech delivered by LaPierre in 2012 after the Sandy Hook massacre. So frantic was the NRA to steer the conversation away from gun regulations that it proposed having the feds keep tabs on America’s mental illnesses instead.

If righties attack Cuomo on grounds that his proposal is a gross invasion of privacy, he’s going to point them right to that speech.

2. How many Democratic presidential candidates have endorsed Medicare for All at this point? If the federal government is the country’s only health insurer then the federal government will have a very robust list indeed of who’s receiving medical care for mental health, coast to coast. It feels strange to ding Cuomo for wanting to keep a database of one specific aspect of Americans’ health with an eye to limiting mass shootings when Bernie Sanders and his fellow travelers are proposing a de facto comprehensive database of all aspects of Americans’ health — an idea that carries majority support within the Democratic Party at last check, do note.

3. New York State already does something like this under a 2014 law that was signed by — ta da — Andrew Cuomo. “The Safe Act,” as it’s called, has created predictable problems, per this NYT story from 2014:

A newly created database of New Yorkers deemed too mentally unstable to carry firearms has grown to roughly 34,500 names, a previously undisclosed figure that has raised concerns among some mental health advocates that too many people have been categorized as dangerous…

The way the law has played out, local officials said, frontline mental health workers feel compelled to routinely report mentally ill patients brought to an emergency room by the police or ambulances. County health officials are then supposed to vet each case before it is sent to Albany. But so many names are funneled to county health authorities through the system — about 500 per week statewide — that they have become, in effect, clerical workers, rubber-stamping the decisions, they said. From when the reporting requirement took effect on March 16, 2013 until Oct. 3, 41,427 reports have been made on people who have been flagged as potentially dangerous. Among these, 40,678 — all but a few hundred cases — were passed to Albany by county officials, according to the data obtained by The Times.

Makes sense. If you’ve been deputized by the state to report on mentally ill people who might conceivably be dangerous, odds are you’ll err on the side of reporting them. Same with federal no-fly lists: Why take any chances and then have to answer a difficult question later about why you didn’t file a report on someone who eventually went on a rampage? According to Cuomo’s own fact sheet on the Safe Act, more than 139,000 reports involving 98,000 people have been filed with the state since the law was passed. How many would end up in a federal mental health database? 500,000? A million?

And would they even know they were on it via an official notice from the government? Even if not, a perpetual worry with systems designed to keep tabs on the mentally ill is that the fear that they’re being monitored might discourage them from seeking help in the first place. Once the public knows that tabs are being kept on the mentally ill at the highest level of government, with at least one constitutional right at stake for those on the list, troubled minds may decide that it’s not worth the risk to find treatment. The promise of confidentiality feels less … firm, shall we say, when Uncle Sam’s in the room with you and the psychiatrist.

Exit question: Do we know for a fact that the El Paso shooter had mental health issues that might have placed him in a federal mental health database? The Dayton shooter certainly did, but offhand I don’t recall any major mental-health omens about the Las Vegas shooter either. Cuomo’s proposal may end up being both overinclusive in trying to stop mass shooters and underinclusive.