I’m a shrink [flame away, yawn], and have often worked with fairly heavy-duty illness in both voluntary, involuntary and forensic settings for a quarter century.
I’ve often been faced with actively suicidal or homicidal patients, and it varies whether there is any therapeutic alliance, ie “trust,” between me and a patient in the first place in these sorts of extreme situations.
Most, but not all, patients, even when quite ill, can be reasoned with to a certain degree, and can understand the basic concept, which I state to them directly, that “What’s important here is that nobody gets hurt.” That’s my professional, therapeutic and personal foundation, and almost everybody, no matter their mental state, gets it.
Most of the time, when a firearm at home or in the car presents even a hint of a significant situation, I discuss with the patient whether there are any friends or relatives we can contact who might be willing to keep the gun(s) in safekeeping until the person is safe to possess them again, and almost always this can be worked out so that the authorities are left out of it.
If I meet any hesitation at all, I simply reiterate - “What’s important here is that nobody gets hurt,” a bottom line we can both usually agree on. If necessary I will sometimes back that up with a matter of fact statement that I am obliged under the law to do what I can to make sure that nobody gets hurt, but that I’d prefer that he/she works with me to leave the authorities out of it.
Despite the acuity of the patients I often deal with, there are relatively few times I have had to involve the authorities. Never has a patient of mine gone on the use a firearm to kill themselves or anyone else, that I know of - knock on wood. And a handful of patients have - either then, or at a later point - thanked me for handling the matter in this way.
“Despite the acuity of the patients I often deal with, there are relatively few times I have had to involve the authorities. Never has a patient of mine gone on the use a firearm to kill themselves or anyone else, that I know of - knock on wood. And a handful of patients have - either then, or at a later point - thanked me for handling the matter in this way.”
The difference is that you’re on this site, which means you’re predisposed to protect people’s privacy and right. I doubt that’s the case with most people in the shrink world, at least if the psych majors that I went to school with at ESU are any indication - they were radical as hell.
So I do think that most of the advice on this thread holds, unless the person is lucky enough to be seeing you, or manages to find someone similar.
Thanks for having the courage to post a comment here. I commend you for stating that you work hard not to violate patient confidentiality by involving police authorities in situations like this.
But, I hope that you realize that not everyone in your profession may rise to that standard, and instead give in to their misguided and prejudiced notion that they can “make the world a better place” by doing any thing they can to rid anyone of “evil guns”.
I strongly recommend that you make every effort to bring this topic up for discussion within your profession ranks at all possible levels; that it is extremely *unprofessional* to allow personal prejudices and/or biases to violate patient confidentiality.