GPs’ role in gun ownership assessments expands

GPs in New South Wales can now conduct health risk assessments for the state’s firearms registry, provided they have at least five years of treatment history with the person they assess.
 
That is according to new guidance published by NSW Police this month, allowing GPs to do a task previously reserved for psychologists or psychiatrists.
 
Under those changes, GPs can now be responsible for assessing a person’s suitability to possess and use firearms, including queries about medical history, medications, the severity of any conditions, and whether the applicant has a history of suicide ideation or violence.
 
The new format has also expanded to assess conditions such as dementia and serious head injuries.
 
In a statement to newsGP, a NSW Police spokesperson said the new approach aims to ensure ‘a comprehensive assessment of all potential risks’.
 
They said the revised Mental Health Risk Assessment (MHRA) process now includes changes suggested by the NSW Chief Psychiatrist last year.
 
‘In Australia, suicide is the leading cause of firearm-related deaths,’ NSW Police said.  
 
‘The aim of the new health risk assessment framework is to ensure we have all relevant information necessary to make informed decisions about firearm safety; to ensure community safety and wellbeing.’
 
For RACGP NSW Chair Dr Rebekah Hoffman, the changes are positive.
 
‘It is a step forward that regulatory agencies such as this are acknowledging GPs for being the specialists we are,’ she told newsGP.
 
Firearms legislation has been carefully scrutinised in recent years following the Wieambilla attacks in Queensland in late 2022, which resulted in six deaths including two police constables. The perpetrators had previously been living in NSW.
 
A National Firearms Register is one recent upshot, while new stricter requirements have been introduced in Western Australia.
 
The shift in NSW, which means MHRAs can be completed by all registered health practitioners with sufficient treatment history, was flagged earlier this month by Sydney GP Dr Ken McCroary.
 
Dr McCroary discussed the changes in an interview with Janelle Ivankovic of the NSW Police Firearms Registry for the Sydney South West GP Link advocacy group.
 
In that interview, Ms Ivankovic said the changes are designed to streamline the process, increase access and cut costs for both health practitioners as well as people requiring the assessments.
 
She noted many gun owners are unlikely to have easy access to psychologists or psychiatrists, and that there is now more detailed guidance available.
 
Dr McCroary said he supported any measure with the potential to reduce the risk of suicide, but also expressed concerns about the possibility of extra work for GPs.
 
‘The changes are made with the great intent to protect the community and protect individuals,’ he told newsGP.
 
‘Significantly, the majority of deaths related to firearms are suicide, and suicide out here in outer-western metropolitan regions and throughout the country is still a major issue.
 
‘The difficulty is it’s another burden for general practice, which is a frustrating part of the bigger picture.’
 
For Dr Hoffman, any extra administration is likely to be worth the effort.
 
‘I do think any administrative burden is far outweighed by the importance of all people having a quality, longitudinal relationship with a GP,’ she said.
 
‘It is worth noting that as GPs, if we feel we are unable to complete these forms or do not feel we know the patients background and risk sufficiently, we can, as per usual practice, refer onto their psychologist or psychiatrist for review.’
 
In its statement, the NSW Police confirmed there is no obligation to carry out the assessment.
 
‘If a health practitioner is unable to complete a health assessment or feels it is not relevant for them to do so, they may refer the assessment to a psychiatrist, psychologist, or another registered health practitioner,’ they said.
 
However, they also said health practitioners should notify police if someone has threatened self-harm or harm to others and there ‘may be a risk to their own or public safety if in possession of a firearm or prohibited weapon’.
 
‘Section 79 of the Firearms Act 1996 and Section 38 of the Weapons Prohibition Act 1998 provide protection from civil or criminal liability that may otherwise arise, including a breach of any duty of confidentiality, when a health professional, including a medical practitioner, discloses information about a person they are treating to police,’ they said.
 
Completed health assessments are returned to the Firearms Registry by the GP or health practitioner who carried it out, with NSW Police saying assessors will be notified if a licence is issued following a risk assessment, including details of any conditions attached.
 
The changes in NSW will be subject to a 12-month review.
 
The new health risk assessment form is available here, while the NSW Police Force Firearms Registry has also issued the following guidelines for health practitioners.
 
If you or someone you know needs help, contact Lifeline on 13 11 14 or Beyond Blue on 1300 224 636.
 
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