Here & Now

Assessing Firearm Risk for Mental Health Patients

Woman:

No more silence! End gun violence!

Marchers:

No more silence! End gun violence!

Zac Schultz:

Spurred by recent events and calls for action, a bipartisan group of senators earlier this week released details on a gun violence bill that could overcome a Republican filibuster and become law. One centerpiece of the compromise package is a red flag provision that would provide support for states to pass their own bills, creating a process to temporarily remove guns from people who are declared to be a threat to themselves or others. Joining us now to talk about a potential red flag law is Dr. Brad Burmeister, an emergency room doctor at Bellin Memorial Hospital in Green Bay. Thanks for your time today.

Brad Burmeister:

Thank you.

Zac Schultz:

Now, Wisconsin does not have a red flag law. But as an ER doctor, you can and do inquire about guns in the household if you believe someone is having mental health issues. How does that work?

Brad Burmeister:

You know, that’s a great question. So we have a diverse number of patients who present to the emergency department. And we know that there’s some patients who might be struggling with a psychiatric emergency who probably — it is not safe for them to have a gun in their home. Now, in Wisconsin, physicians do not have authority to remove guns from a house, so we’re stuck using it as a risk stratification tool to help understand what patients have a safe setting to return and who might need to be maintained in the emergency department or another psychiatric setting so we can help ensure their safety.

Zac Schultz:

Emergency detention is a process in which the legal system gets involved and can detain someone. A red flaw law is kind of the opposite. It would detain the guns from someone. Does one of those make more sense to you?

Brad Burmeister:

There are likely different applications for both scenarios. Certainly we know that if someone were able to return home who may be lower risk for harming themselves or others, if we can ensure there’s no firearms in their home, we may be able to help preserve the psychiatric services center for patients who might be at higher risk or may need more intensive treatment. You know, certainly having the ability to have a red flag law is something that our medical society — you know, we represent over 10,000 members in Wisconsin with diverse backgrounds, but in general, we have consensus on this matter that physicians think this is something we should have the ability to do in Wisconsin.

Zac Schultz:

For emergency detention, the standard often involves asking the patient if they’re homicidal or suicidal? How much sense does it make to rely on the answers of a person having a mental health crisis to determine that?

Brad Burmeister:

You know, that is a fantastic question. And something that different regions in Wisconsin really struggle with. In Wisconsin, whether or not someone is able to be detained, really is up to law enforcement. It’s not a decision that’s made by a physician in the emergency department or a commonly a psychiatrist, something that law enforcement needs to decide. You know, healthcare providers and law enforcement work hand in hand very often. But you know, it can be challenging and takes some medical expertise to really understand what sort of capacity somebody has to appropriately relay the information of what their thought process is. There’s some patients that may not be truthful when they’re saying they’re suicidal or potentially homicidal. So I think that is what’s the happening part, is how nuanced it is to really make that decision on who is safe to be members in our community both to themselves but also those people around them.

Zac Schultz:

Now, whenever we have a mass shooting like the recent examples in Buffalo or Uvalde, Texas, Democrats at the national level talk about gun control, Republicans usually talk about mental health. In in your profession, how often are you dealing with patients who have mental health problems and should we be conflating those two?

Brad Burmeister:

You know, in the emergency department, we see people who are struggling with either substance use or mental health challenges, you know on a daily basis. It makes up a relatively high volume comparatively of patients who present to the emergency department. You know, I think those two issues, you know, people’s rights to possess a firearm and mental health commonly run side by side with each another. But I think there’s probably opportunities on both ends of that spectrum to improve our regulation in this country by improving access to mental health care and substance use treatments, as well as also improving who exactly we allow to possess a firearm and to what capacity we allow that. You know, a recent study interestingly showed that states that expanded Medicaid actually had improved rates of suicide presumably due to increased access to mental health services.

Zac Schultz:

So are you hopeful that the national debate will actually lead to something substantive that can help you in your job or to prevent mass shootings?

Brad Burmeister:

Yeah. We are very optimistic at this point that for the first time in years or possibly decades, there are good earnest conversations about measures we can take as a nation to improve access to firearms. You know, of course, as physicians, we believe that we do have the constitution and we need to work within the constraints that document has provided to the American citizens. But at the same time, we know that there’s what we think are common sense approaches to limit access for people who it’s very likely it’s just not safe to have access to that weapon.

Zac Schultz:

Thanks for your time today.

Brad Burmeister:

Thank you.