Submission to the Home Affairs Committee - Possession of handguns report
Royal College of Psychiatrists
United Kingdom
22 April 1996
(SSAA comment in orange)
The question has been raised as to whether psychiatrists and/or clinical psychologists have a part to play in the assessment of people for their suitability to hold firearms licenses.
There is no direct evidence for an association between the misuse of firearms and psychiatric disorder per se, and the assumed link must be between the misuse of firearms and shotguns, and previous associated (violent) behaviour. The main thrust of our response is therefore that it is not appropriate to medicalise the issuing of firearms licenses when this is largely an issue of politics and social policy.
From a purely practical point of view the number of licenses issued - some 409,000 for firearms (rifles, pistols and handguns) and more than 1,296,000 shotgun certificates [note: these figures are not correct, actually 175,000 firearm and 740,000 shotgun certificates] at any one time - would require that any psychiatric risk assessment be only for a highly selected group who had passed through a filtering system of different levels of concern. The manpower required for adequate assessment of risk at the different levels would be great and would involve considerable expense and require professional resources that are in short supply anyway, i.e., psychiatrists and clinical psychologists well-trained in risk assessment. Furthermore, risk assessment is an ongoing process and re-assessments would need to be carried out at least each year, compared with the current policy of five years duration before the renewal of licenses.
As background, it is the case that only a minority of homicides involve shotguns (9 per cent in 1994- and this includes death by the use of the gun as a blunt instrument rather than shooting). Furthermore, there has been no increase in homicides using shotguns according to criminal statistics in recent years up until 1994.
There are, of course, some individual instances in which a particular person may be considered an inappropriate recipient of a firearms or shotgun license. Individuals who abuse alcohol and drugs or suffer from organic brain disorder or a major functional mental illness may fall within this category. Any doctor asked to sign a character reference for license purposes would obviously be well advised to ensure that he or she is fully informed about any such conditions as well as any previous history of violent or anti-social behaviour.
At the present time it is possible for a doctor to inform the police if a person is known to have a weapon which the doctor has cause to think may be misused and/or be dangerous to others. This is addressed in the GMC document on guidelines on confidentiality and is an admirable provision since it involves individual selectivity and not generalised assumptions of the misuse of firearms by any one grouping, e.g. those with a psychiatric history - for which there is no evidence. However, there is some question about whether this process of informing the police works in practice, since anecdotally it is said that the police frequently do not wish to accept and act upon such information. Education of agencies, such as the police, who might receive the information from a doctor, is clearly indicated.
The following suggestions have been discussed within the College:
(1) Would it be possible to have a questionnaire devised which would filter out those with personality characteristics that would be likely to lead to the misuse of firearms? This is rejected on the grounds that false answers could be provided and that the shooting lobby could educate people who wanted a gun license into giving the "right" answers.
(2) Could general practitioners be required by law to provide certain information that would contribute to an assessment of the suitability of granting firearm licenses? There are problems with this; for instance, what sort of information - except the most obvious - would be relevant? Previous depressive illness, for example, would be relevant to suicide risk, certainly, but depression is very common and a blanket ban on all people having suffered previous depression would not be acceptable to most people. There are also serious reservations for general practitioners in giving information in such circumstances, even if they are aware of which information would be considered relevant.
(3) In the case of the issuing of driving licenses by the DVLC (Swansea), a confidential "hot-line" is provided whereby doctor can talk to doctor about worrying cases, for example, epilepsy and consequent fitness to hold a driving license. Such a system could be adapted for the confidential relaying of information with regard to firearms certificates. This would seem to be worth exploring.
In short, apart from known cases who are referred for a full psychiatric risk assessment, which must be comprehensive, there is little place for psychiatrists or clinical psychologists in routine screening for the granting of firearms licenses.
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