Control yourself

Due in large part to the tragedy in Newtown where an obviously disturbed young man and some weapons massacred 20 children and six adults, there has been a great deal of debate regarding controlling access of such people from such weapons. Nevermind that other such tragedies over the last few years also involved persons equally unbalanced, with no such discussion subsequently. Nevermind the reality that people supposedly quite sane have been responsible for gun deaths that were just not of that scope.
The suggestion (and the actual law in New York now) is to require some sort of registry  for those who have been identified as "mentally ill." Similar to the existent lists of convicted pedophiles or other criminals, those on such a list would be prevented from obtaining a gun. But this is where it begins to get murky.
The biggest issue, of course, is confidentiality. There is already a major law on the books strictly protecting patient confidentiality. Without written consent, the clinician cannot even disclose the fact that someone is in treatment, even to another clinician. The only exemption is if a person discloses to a clinician that he or she is going to hurt him/herself or another person. Called the "Duty to Warn;" you gotta notify the authorities, call the person at risk, make arrangements for the client to be hospitalized. The trick is, if that same discloses that they have in the past  done that same whatever, that comes under confidentiality and cannot be disclosed!
And that doesn't even get into the area of discerning the reality of the risk. Most of the current debate seems to sweep all mentally ill people into the same pile; so seriously disturbed and so violent (or potentially violent) as to be dangerous to the populace at large. Of course, not all those who we might label "mentally ill" fit into this same Procrustean bed. They are on a vast spectrum that goes from passing depression or anxiety to those who require on-going supervision and restraint. Even there, thanks to psycho-pharmaceuticals (and the cut-backs on mental health hospitalization resources), many people who would have lived their lives in a locked mental ward are now striving to live as normal a life as possible in the world around us (assuming, of course, there is such a thing as"normal.")
There is another whole issue here, to be saved for another day, of the tension between requiring medical treatment of whatever sort, versus the freedom and autonomy of the person who, for whatever reason, refuses to take the medication or have the operation. (The New York law rolls it all into one, not only registering the "mentally ill," but penalizing them if they resist treatment.)
Of course, identifying the mentally ill is complex; can we make the distinction between the obvious (the bag lady wandering the streets mumbling) and the peripheral (the functional autistic person who does what needs to be done but just wants everyone to go the hell away!) and the everyday (the arrogant/narcissistic politician)? Can we rely on the insights of the therapist to distinguish between the expression of temporary despair and anger as against the real threat of dangerous action?
And we must recognize that, as important as it is to provide the help needed for those mentally disturbed, this should not be instead of addressing the gun issue.