It's also a judgement that the person cannot contract or manage their affairs.
27 CFR 555.11 - Meaning of terms.
Also, disturbingly, it does not require a judge.
Quote:
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A determination by a court, board, commission, or other lawful authority
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So a state could impanel three licensed social workers, call it a mental health board, and start deciding bi-polar, etc. folks off their meds are unable to contract or manage their affairs. I'm pretty sure organizations like the ACLU would parachute in like the 82nd Airborne if that happened though. However it also isn't unheard of for excessively... pro-active (to be polite) States to enact legislation like that. And if they work with an aggressive POTUS to get these folks adjudicated, and into the NICS database assembly line style to apply the prohibition to as many people as possible....