The fevered debate about who should and should not possess firearms often turns much more volatile when the aspect of mental fitness enters the picture. And background checks, always a contentious issue, are a critical — and often misunderstood — facet of this conversation.

According to Dr. Gianni Pirelli of Pirelli Clinical and Forensic Psychology, “leading contemporary mental health experts recognize the need to focus on prevention rather than prediction efforts when it comes to mass shootings because they are very low-base rate events that cannot be predicted with any real accuracy.”

Gianni Pirelli, Ph.D. presenting at NJ SAFE Conference on July 30th 2016

Background checks “have their place in the process, but the reality is that most mass shooters either passed a background check or they would have if they had been subjected to one. Background checks in this context represent a screening measure; they may raise a flag, but if (those screened) are not excluded outright they will still need to be evaluated.”

Politicians and journalists who focus on background checks and mental health treatment “bypass the critical second step: the comprehensive, firearm-specific forensic evaluation that is needed once someone is flagged. As for treatment, I am certainly a proponent of increased access to mental health services. But when packaged into firearm laws and procedures, it has a stigmatizing rather than beneficial effect. Unless we are discussing treatment for the restoration of gun rights — such as for those with mental health histories — discussions of mental health treatment lack utility when presented within firearm-related legislative initiatives and media accounts.”

The most pressing mental health issues

Three mental health issues have particular relevance to firearms ownership in New Jersey, he explains, especially for those pursuing a new or reinstated Firearms Purchaser Identification Card:

Mass-shooting myopia and hyper-reaction: “The mentally ill shooter with an ‘assault rifle’ is often the image put forth by politicians and media outlets to sensationalize the ‘gun epidemic’ in this country, he says. “However, only about 3 to 5 percent of those diagnosed with serious mental illnesses engage in violence at all, and an even smaller proportion engage in firearm-involved violence.”

The bigger concern is firearm-involved suicides, he explains: “Some groups, such as law enforcement and correctional officers, have disproportionately higher rates of such compared to their same-aged (civilian) peers. Despite these statistical facts, uncommon yet high-impact events such as school shootings often prompt highly reactive legislative and media responses – usually in the form of overly burdensome and restrictive legislation in conjunction with negative media attention. These effects are particularly salient in states like New Jersey.

Red flags without reasons: More and more firearms applicants are flagged in one or more “prohibitor” areas upon being subjected to a labyrinthine system of policies, laws and more intrusive background checks. But “the relevant gatekeepers and decision-makers (detectives, police chiefs, etc.) are often not privy to any detailed information related to the flagged issue,” Pirelli notes. Even if they were, “it is unlikely they would be able to interpret those related to mental health properly.

“For example, an applicant may have been hospitalized 17 years ago at a facility that is now closed or from which the records are no longer available. Now what? Even in the case of a more recent problematic record or a revocation, if the main issue is mental health related — such as a diagnostic concern or one that pertains to violence or suicide risk, substance abuse or the like – it will need to be assessed by a forensic mental health professional with expertise in firearm-specific issues and evaluations.”

Lack of expert forensic evaluators: “There are very few doctors who conduct legal or administrative forensic evaluations,” Pirelli says, “and there are virtually none trained to conduct firearm-specific evaluations.” New applicants or those who had an FID card revoked have a hard time finding the specialists they need.

“They may seek ‘a letter’ from a general clinician, medical doctor or treating therapist as opposed to a comprehensive firearm-specific evaluation conducted by a forensic evaluator,” Pirelli cautions. “Some may be told that they only need a letter from ‘any doctor,’ and that can be very appealing because it is quicker and less expensive. But it may very well prove to be a temporary fix — if it even addresses the issue sufficiently.”

Failure to undergo a comprehensive, firearm-specific evaluation by a forensic evaluator trained on these issues “may prove to be a problem in the future because of ever-changing policies and laws, and the fact that gun owners must re-apply at various points in their life” — for example, if they move or seek permission for additional handguns.

This shortage of specialists imperils potentially workable legislation, he says.

“It would be impossible to conduct meaningful firearm-specific evaluations on all FID applicants in New Jersey,” he asserts. “There are simply too many applicants and too few properly trained professionals to appropriately do so.” And “most doctors do not engage in psychological evaluations; a much lower number engage in forensic evaluations. Even fewer have any training or education on firearm-related issues at any level, nevermind firearm-specific evaluations. Any volume of evaluations required in this regard in the foreseeable future would likely be very brief in duration, rather than comprehensive, and conducted by professionals who might very well lack competence in this area.”

The role of education

Further complicating the issue is the fact that many gun owners, prospective applicants — and even lawyers, judges, politicians and medical professionals — “are largely unaware that firearm evaluations are a specialized type of forensic assessment. My colleagues and I continue to publish articles and present talks and trainings to educate on this issue, as well as those related to mental health and firearms generally.”

Evan Nappen, Esq.

Part of Pirelli’s educational process occurs Sept. 22, the day before the third-annual NJ Safe Conference in Princeton, when he conducts a four-hour class on firearms and mental health along with renowned weapons rights attorney Evan Nappen.

Having given a presentation at last year’s NJ SAFE (in the dark thanks to a power outage in the second half of the event), his more focused class is aimed more toward a legal audience — but all are welcome. “The core aspects of the course are based on my publications and other courses I have held, such as those at Gun for Hire and those that I run directly out of my private practice.”

Pirelli praises NJ SAFE as “an excellent conference … based on education and camaraderie. All the speakers have different perspectives on the issues at hand,” making for “a very interesting and thought-provoking experience. There are different types of education and practice. Some take place in the range, but others take place in classrooms and at conferences. In an age of information, why settle for being one-dimensional? We can and should all learn from each other.”

The worst cases

For his part, Pirelli can impart plenty of first-hand knowledge of how New Jersey firearms policies can ensnare gun owners — even some of the best-qualified applicants — at any time.

“It is always most surprising to me when law enforcement, correctional and military personnel are flagged on a very old issue when they seek out a new personal firearm,” he explains, “but they can maintain their service guns and continue to work without question. My disbelief is usually not that they are still allowed to work, but rather, that these have been some of the most well-trained firearm owners and operators I have ever seen — not to mention that they are responsible for protecting us with their service weapons. Yet, their ability to have a ‘personal’ firearm is in question.”

Even worse, he recalls, are cases of clinicians making “improper diagnoses, inferences or even reports, which is usually reflective of their lack of training and education on firearms combined with their low threshold and tolerance of guns and those who own and/or operate them.” To combat this, Pirelli and his peers publish “guidelines on developing and maintaining cultural competence of firearm subcultures for medical and mental health professionals.” But “it will be a very long time before this type of education and training gains widespread reach. Until then, prospective applicants and gun owners need to be diligent in seeking professionals to work with who have a high level of professional and cultural competence relevant to firearms.”

Register for Pirelli’s course on firearms and mental health at the NJ SAFE registration page; cost of the four-hour course is $150.

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