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Firearms, mental illness, dementia and the clinician
Anne P F Wand1, Carmelle Peisah2, Julie-Anne Strukovski3
1Older Persons Mental Health Service, St George Hospital, Sydney, NSW, Australia. a.wand@unsw.edu.au.
Insights
Clinicians should screen patients for firearm access, especially those with dementia, to prevent harm. A combined assessment approach is proposed to ensure firearm license safety.
Area of Science:
- Medical Ethics
- Public Health
- Neurology
Background:
- Clinicians must report patient risks of harm involving firearms to authorities.
- Dementia is an under-recognized condition potentially increasing firearm violence risk.
- Current firearm licensing relies on self-declaration of medical conditions by license holders.
Purpose of the Study:
- To highlight the need for clinician screening of patients with firearm access.
- To address the under-recognition of dementia as a risk factor for firearm violence.
- To propose a new framework for assessing firearm license fitness.
Main Methods:
- Review of current clinical obligations regarding patient safety and firearm access.
- Analysis of dementia's impact on risk assessment for firearm injury.
- Proposal for a combined capacity and risk assessment model for clinicians.
Main Results:
- Lack of specific guidelines for clinicians on mandatory firearm access screening.
- Dementia poses an under-recognized risk in patients with firearm access.
- Current system places the onus on firearm license holders to disclose medical conditions.
Conclusions:
- Clinicians should proactively screen patients for firearm possession.
- A comprehensive assessment integrating capacity and risk is needed for firearm licensing.
- Implementing these measures can enhance public safety by mitigating firearm-related risks.
Abstract:
Clinicians have an obligation to report to state or territory police any concerns about risk of harm from patients with access to firearms. Dementia is an under-recognised medical problem which may increase the risk of firearm injury or violence in those with such access. There are no guidelines for clinicians regarding mandatory screening for access to firearms, and currently the onus is on the firearm licence holder to declare any relevant medical conditions. We propose that clinicians should screen patients for firearm possession and use a combined capacity and risk assessment approach to evaluating fitness for firearm licences.