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VA says it won't follow New York gun law
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ALBANY, N.Y. (AP) — The federal Department of Veterans Affairs said Monday its mental health professionals won't comply with a new gun law in New York that requires reporting the names of patients they believe likely to hurt themselves or others.

That provision is set to take effect Saturday. Several veterans and their advocates warned it would deter many from seeking counseling and medications to deal with post-traumatic stress disorder or other psychological issues. Veterans fear their rights would be taken away.

Under the law pushed by Gov. Andrew Cuomo, the information would be used by state officials to determine whether someone should give up a gun license or weapon.

VA Spokesman Mark Ballesteros said Monday that federal protections of veterans' treatment records take precedence. The agency's lawyers had been studying the New York statute, which passed in January.

"Federal laws safeguarding the confidentiality of veterans' treatment records do not authorize VA mental-health professionals to comply with this New York State law," Ballesteros said in a prepared statement. "Under the Supremacy Clause of the U.S. Constitution, federal laws take precedence over conflicting state and local laws."

Cuomo, addressing reporters Monday, acknowledged limits to the law, which he advocated in part to keep guns away from the mentally ill and avert mass shootings like the killing of 26 children and adults last year in Newtown, Conn.

"Depending on the institution or the organization, they have pre-existing legal parameters," Cuomo said. "Some organizations just say at the beginning of the day, 'All communications are confidential,' period, 'all information is confidential,' period. So it's going to have to be viewed in light of their legal structure in the first place. It's up to them."

Paul Rieckhoff, founder of the 200,000-member Iraq and Afghanistan Veterans of America, based in New York City, said New York's gun law has been a topic among veterans in New York and across the country. He said it would definitely have had a chilling effect on them seeking or continuing treatment because of confidentiality and overcoming the stigma of getting treatment for mental injuries.

"We're already struggling to get folks to come out and get help," said Rieckhoff, an Iraq vet, citing just a 52 percent utilization rate at the VA. He said the issue is even more complicated for veterans because they have been trained to use guns, which in some places are an important part of their culture.

Robert Green, a 64-year-old Vietnam combat veteran, who has joined protests in Albany against a state law he also regards as an infringement on his Second Amendment rights, agreed it would have deterred veterans from seeking help. He noted none of the mass shootings involved vets.

He would not say whether he had any issues connected to his service for the same reason he thought others would, explaining, "It could be used against me."

New York's law also sets a seven-bullet limit on magazines, tightens the definition of illegal "assault weapons" and requires owners of formerly legal semi-automatic guns to register them.

Derek Coy, a 28-year-old Marine Corps veteran now living in New York, who was in Iraq in 2005-2006 and diagnosed with PTSD in 2009, said he has gotten counseling and medication for symptoms including feeling numb and "crippling anxiety." He said that it is hard enough for vets to admit they have a problem and get help, and that New York's law threatened to put up another obstacle.

"I never had feelings to harm anyone else. I have had suicidal ideations," he said. "I own guns. I like to hunt. ... This will deter people from being honest and open."

At the Mental Health Association of New York State, chief executive Glenn Liebman said the concern is not just veterans who won't get treatment for fear of the stigma of being listed in the state database or who will hide serious issues from their therapists.

"We think it has been a mistake to equate mental illness and violence. There are so many other predictors that are so much more significant," Liebman said. "Clearly, with regard to PTSD, the rates are much higher among veterans than the general population. ... But there's so much stigma associated with mental illness in general, and it's very difficult for veterans to come forward."

In February, a VA report said that in 2010 about 22 veterans committed suicide each day, at rates higher than the general population and higher still among women vets. That was based on 27,062 suicides by those with U.S. military service among 147,763 suicides total in 21 states.

The VA's National Center for PTSD said experts think that 11 to 20 percent of Iraq and Afghanistan war veterans — the number clicks up to 30 percent among Vietnam veterans — will experience that disorder.

The New York State Psychiatric Association, representing more than 4,000 practicing psychiatrists, said confidentiality is a core guiding principal in medicine, particularly in psychiatry, where patients' disclosure of thoughts and feelings, including anger, hostility and resentment, is often essential to treatment.

According to the association, psychiatrists already have a duty to notify police when they conclude a patient presents "an imminent risk of harm to self or others," but the new law contains no such time distinction. Richard Gallo, the group's lobbyist, said "imminent risk" occurs when a patient reaches "a crisis stage," and the association has proposed an amendment to say that.

Cuomo said Monday, "The law says it's totally up to the health provider if they come forward or not; it's totally up to them."

However, the statute says mental health professionals, absent laws to the contrary, "shall be required to report, as soon as practicable," the names of patients who, in their judgment, are "likely to engage in conduct that would result in serious harm to self or others." There is an exception when physicians, psychologists, clinical social workers or registered nurses believe reporting will endanger them or increase the danger to potential victims.