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Comment & Response |

Firearm Access and Risk of Suicide—Reply

Jeffrey W. Swanson, PhD1; Richard J. Bonnie, LLB2; Paul S. Appelbaum, MD3
[+] Author Affiliations
1Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
2Institute of Law, Psychiatry and Public Policy, University of Virginia School of Law, Charlottesville
3Division of Law, Ethics, and Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York
JAMA. 2016;315(19):2124-2125. doi:10.1001/jama.2016.1071.
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In Reply Mr Kels highlights a confusing aspect of federal and state laws that disqualify certain people from accessing firearms. What types of involuntary mental health interventions result in a gun-prohibiting record that is reportable to the NICS? The question is difficult to answer because commitment practices vary substantially by state and locality.

Under federal law, individuals lose their firearm rights if they have been “committed to a mental institution.” In many states, commitment proceedings have 2 stages. The initial stage is a short period (eg, 3-5 days) of hospitalization for the purposes of providing emergency treatment and evaluation of whether patients meet commitment criteria; the second stage is a formal commitment hearing. These admissions are often authorized by an emergency medicine physician or mental health professional and in some states are ratified ex parte by a magistrate. These patients are discharged quite often before a formal hearing is required, so hospitalization never results in a commitment order.


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May 17, 2016
Charles G. Kels, JD
1Division of Legislative Counsel, American Medical Association, Washington, DC
JAMA. 2016;315(19):2124. doi:10.1001/jama.2016.1068.
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