Mental illness dominating post-Parkland gun debate, but at what cost?

A familiar and polarizing tug of war over gun control and access to guns has re-emerged in the week since the massacre at Marjory Stoneman Douglas High School in Parkland, thrusting mental illness once again into the national conversation about mass shootings.

In Florida, that has led to discussion of the Baker Act, the state's law that allows for the involuntary examination of people believed to be a danger to themselves or others due to mental illness.

Gov. Rick Scott on Friday proposed a plan to make it "virtually impossible for anyone who has mental issues to use a gun" by strengthening gun purchase and possession restrictions.

"No one with mental issues should have access to a gun," Scott said. "It's common sense, and it is in their own best interest, not to mention the interest of our communities."

While some mental health professionals and experts agree tightening the relationship between the law and access to guns is a reasonable step, others question whether prevention should center on mental illness in the face of evidence that shows people who commit acts of violence are rarely mentally ill.

And, some added, lumping them together deepens an already-existing stigma against mental health conditions that, by the Centers for Disease Control and Prevention's count, one in five Americans will experience in their lifetimes.

"I 100 percent believe we need to have stricter laws, protocols, procedures for the purchasing and owning of guns when somebody is exhibiting unsafe behaviors and/or bizarre behaviors," said April Lott, CEO of Directions for Living, a social services organization. "I just think that's a separate issue from mental illness."

There were about 194,000 involuntary examinations under the Baker Act in fiscal year 2015-16, according to the University of South Florida's Baker Act Reporting Center.

Not many of those resulted in gun restrictions.

An exam is initiated, usually by law enforcement or a mental health professional, if there is reason to believe a person is a threat to themselves or others due to a mental illness. A doctor, typically a psychiatrist at a receiving facility or hospital, determines if the person meets that criteria.

Those who don't are released into the community with their gun rights unaffected while those who do are kept for up to 72 hours for the evaluation.

It is when a person needs to be kept longer and continues to be imminently dangerous that gun rights come into play, said Martha Lenderman, a statewide Baker Act consultant.

At that point, the person can either voluntarily participate if he or she is deemed mentally competent, or a court can force treatment if the person doesn't volunteer. Both paths can lead to someone's name being added to the federal list of people barred from buying guns, but several factors must line up to get to that point, Lenderman said. And the list applies only to the future purchase of firearms, not to guns already owned.

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In the week and a half since the Parkland shooting, officials have floated several ideas to further gun restrictions. During a CNN town hall this week, Broward County Sheriff Scott Israel floated the idea of expanding the law to seize guns from those who aren't only an imminent threat but who present a "totality of circumstances" that indicate a person is mentally ill.

In the Tampa Bay area, Pinellas County Sheriff Bob Gualtieri has proposed a so-called temporary "cooling off" period for those who pose a threat to others to lose access to possessing and buying guns, even if they don't meet criteria for further treatment.

"You can have someone Baker Acted last night, released today and goes down to a gun store and buys a gun," Gualtieri said, "or goes back to the house where they were Baker Acted and pick up the gun they were Baker Acted for."

Scott proposed a period of at least 60 days for those involuntarily committed to lose access to buying and possessing guns.

Parkland shooter Nikolas Cruz was not taken into custody under the Baker Act, but authorities had encountered him before. The Broward County Sheriff's Office dealt with 23 calls related to him and his family in the last decade, including one report in which he "planned to shoot up a school," according to the agency.

There was significant missed opportunity with Cruz, said Arthur Lurigio, a professor of psychology and criminology at Loyola University Chicago. But the fact is, he said, "most people who are mentally ill are not dangerous, and most dangerous people are not mentally ill."

It's understandable why the public would draw the association, he said. Mental illness is easier to grasp than the reality, which is that everyone has different motivations. The Las Vegas shooter, for example, showed no signs leading up to the most deadly mass shooting in U.S. history, he said.

Mental illness can be a risk factor, said Alisa LaPolt, executive director for the Florida chapter of the National Alliance on Mental Illness. But there are many others, including drug and alcohol abuse, being young and male, and untreated childhood trauma.

Solutions to those issues are more elusive. A cooling off period such as the one Gualtieri suggested is a "first step," said Joe Rutherford, CEO of Gracepoint, a Baker Act receiving facility in Hillsborough. But it would likely come at a cost of furthering misconceptions about mental illness and isolating those who have it from treatment.

"There's such a stigma for people to receive mental health services," he said.

Lott, the Directions CEO, said she would rather see Florida mirror states with "red flag laws," or court orders that allow the temporary seizure of guns from people deemed dangerous, because it releases the link to mental illness included in the Baker Act. During Friday's news conference, Scott proposed a "violent threat restraining order" that has a similar framework.

Another mental health professional pointed to a broader societal problem. While it's tough to avoid feelings of frustration or resentment, you can learn to cope, said Kristin Mathre, chief operating officer of the Suncoast Center, a behavioral health nonprofit.

"If we don't (focus on the larger picture of emotional wellness)," she said, "we're just building more walls, more separation, more us them, more of all the things that make it worse."

Senior staff researcher Caryn Baird contributed to this report. Contact Kathryn Varn at kvarn@tampabay.com or (727) 893-8913. Follow @kathrynvarn.