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Old January 26, 2016, 06:46 PM   #1
turkeestalker
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USPSTF recommends depression screening for all adults....

... color me a bit paranoid in our present climate of trying to effectively incorporate mental health issues into the NICS, but this makes me a little uneasy when I consider where it could lead.

http://www.uspreventiveservicestaskf...sion-in-adults
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Old January 26, 2016, 08:38 PM   #2
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Here's the test -- with the score sheet.

http://www.integration.samhsa.gov/im...0Questions.pdf

IMHO you'd have to be pretty far over the edge to check even a "1" for any of the questions. There's no choice for "once or twice" -- it's for a two week period, and the choices jump from "not at all" to "several days." To me, "several" means generally more than three and fewer than ten, so if my real answer to one of the questions is "once," I can't answer. So which one am I going to pick? Well, knowing they're gunning for my guns, I'm going straight down the zero column, and have a nice day, Doctor.

[Edit]Let me rephrase that:

"One" = one
"Two" = two ("a couple")
"A few" = three to five
"Several" = six to ten
"Many" = more than ten

Last edited by Aguila Blanca; January 26, 2016 at 08:46 PM.
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Old January 26, 2016, 08:52 PM   #3
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Cheer up ! Think of all the unsung social workers who will at last be recognized for their yeoman work in public safety. Did I mention they will probably get paid a lot of money for doing this?

They could have demeaning jobs working in asylums dealing with the criminally insane, but this kind of proactive approach to public mental health is going to keep them mainstream and appreciated.

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Old January 26, 2016, 10:31 PM   #4
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It seems pretty rigged to me. Not to mention that it appears to be developed by one of the largest anti-depression drug companies in the world. No conflict there I'm sure.
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Old January 26, 2016, 10:34 PM   #5
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The USPSTF recommends screening in all adults regardless of risk factors
Just what kind of recommendation did you expect from people who's job is to find ways to better prevent things??? OF COURSE They are going to recommend screening / testing of everyone, for everything. It is what they were created to do.

SO, ok, based on your answers to loaded questions. they decide you are depressed. NOW WHAT? (concerning gun rights, or even concerning your legal right to refuse treatment?????)
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Old January 27, 2016, 03:54 AM   #6
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Unfortunately, some of the questions fail to take into account other factors that might cause the symptoms. For example, I could probably score a 1 or 2 on questions 3, 4, 5, and 7 not because I'm depressed, but because I've been working night shift for the last four months (giving me insomnia) and I've been fighting a particularly nasty cold.
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Old January 27, 2016, 05:48 AM   #7
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Quote:
Originally Posted by 44 AMP
SO, ok, based on your answers to loaded questions. they decide you are depressed. NOW WHAT? (concerning gun rights, or even concerning your legal right to refuse treatment?????)
I do mental health assessments for a living. I can only speak from my own experience, but I have never called the FBI to make any sort of NICS report. The only time I have ever had to get the legal system involved in when securing an Emergency Detention, in cases where someone is an immediate threat to themselves or someone else, either due to suicidal thoughts, homicidal thoughts, or severe psychosis. This has to be ordered by an applicant, a licensed doctor, and a judge. This only happens maybe once every 25-40 times I do an assessment, probably less. The legal right to refuse treatment extends until a serious, imminent threat is realized, and I doubt this will change.

Quote:
Originally Posted by kilimanjaro
Cheer up ! Think of all the unsung social workers who will at last be recognized for their yeoman work in public safety. Did I mention they will probably get paid a lot of money for doing this?
You know what you call a social worker who gets paid a lot of money? One who changed careers. If you stay in social work, you don't expect high pay. Most of us do it because we truly enjoy working in the field. There's also a lot of us who are gun guys, so easy on the SW bashing.

Quote:
Originally Posted by TXAZ
It seems pretty rigged to me. Not to mention that it appears to be developed by one of the largest anti-depression drug companies in the world. No conflict there I'm sure.
[quote=Webleymkv Unfortunately, some of the questions fail to take into account other factors that might cause the symptoms. For example, I could probably score a 1 or 2 on questions 3, 4, 5, and 7 not because I'm depressed, but because I've been working night shift for the last four months (giving me insomnia) and I've been fighting a particularly nasty cold. [/quote]

It's actually a pretty standard assessment, and the scoring is pretty standard compared to others I have seen.

Mental health assessments are not discrete tools. It's a comprehensive look at the person, the stressors, the symptoms, and the environment. Yes, there are certain benchmarks that we look at, but even then the circumstances make a huge difference. It's not a black and white, score this much for this result, type of tool. It's a guide.
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Old January 28, 2016, 08:32 PM   #8
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JimmyR I have great respect for your profession and I am sure there are many here that feel the same. The problem is identifying folks who may have some mental health issues while not adequately treating those who are currently suffering from mental illness is a waste of resources. Yes, it may help a few and it certainly will be good for those involved in the manufacturing and distribution of psychotropic drugs, but it will do little to improve national mental health. The potential for abuse, especially by those looking to remove/control guns scares me.
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Old January 28, 2016, 08:48 PM   #9
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The potential for abuse, especially by those looking to remove/control guns scares me
That was my point exactly. What I see happening is a bill being introduced that requires all physicians to administer this questionnaire based on this recommendation, the results of which will then be a part of an individuals official records. Those records then being made a part of yet another 'list' to be correlated with the NCIS. There was no intent to bash anyone, or assign blame to any profession.
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Old January 29, 2016, 02:38 AM   #10
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1. A physician may be required to administer, but that doesn't mean you have to answer.
2. Everyone is depressed sometimes, and for a whole lot of different reasons.
3. Simply being depressed is not currently and should not be grounds for denying access to firearms. The standard in most places is "danger to one's self or others," which is sufficiently high to subject a person to detention for evaluation and treatment, and possible involuntary detention. That is good enough to seize firearms, especially if the threat is to others, but this does not mean that this should result in a lifetime ban, as current federal law provides. People do get better.
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Old January 29, 2016, 06:17 AM   #11
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I'll say again...
Quote:
but this makes me a little uneasy when I consider where it could lead.
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Old January 29, 2016, 06:33 AM   #12
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Anyone noticed on this "test" copyrighted by Pfizer that "fidgety" is misspelled as "figety?" Very professional...
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Old January 29, 2016, 06:50 PM   #13
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Anyone noticed on this "test" copyrighted by Pfizer that "fidgety" is misspelled as "figety?" Very professional...
True.

You'd think Pfizer would at least have spelled it "pfidgety" (or "pfigety").
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Old January 31, 2016, 11:22 AM   #14
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The risk of such screening is when state laws may use such to mandate sanctions against the gun owner.

The NY SAFE act is an example:

http://www.nyspsych.org/index.php?op...act&Itemid=140

NY has had about 38K reports and permits have been withdrawn:

http://www.syracuse.com/news/index.s...ave_weapo.html

It is an empirical question if 38K were truly risks. Or is it over-reporting to avoid liability and legal issues.
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Old January 31, 2016, 07:59 PM   #15
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Really? So if I get winter blues in late December and tend to sleepmore than usual, eat a lot of carbs, and feel tired or slow (assuming I mark off 2s on those), it's enough to qualify me with a major depressive disorder (5 checkmarks) if I answer honestly? How many people don't go through some period in their life where they don't feel some way that would qualify them on this test? I'm far from a mental health expert, but that seems a little odd to me.
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Old January 31, 2016, 09:06 PM   #16
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While I could link to the article, I could not get the test, so I don't know exactly what the questions are...(my computer said security settings prevent download- so either my computer is paranoid, or perhaps it is just too depressed to get the file...)

I don't need to see the actual questions, however, I know the kind they are, and here is the problem, anything based on a standardized test can be inaccurate, simply because we are NOT standardized individuals.

In some ways it is like the standard for alcohol impairment. They set a numerical limit, and once you hit it, you are legally impaired, no matter whether you are actually physically impaired or not. Likewise, some individuals will be significantly impaired well below the set legal limit.

I have issues with any "diagnosis" based only on arbitrary standards, and I REALLY have a issue with using that for any LEGAL decisions.

Seriously, what is the ultimate risk here, isn't it being deprived of your rights (and property) simply because your lifestyle doesn't meet their standards for what is right and proper??

Am I actually going to be punished for not being "happy enough"???
seems like this might be a possibility....

anybody else here remember when doctors main efforts were fixing broken bones and treating disease, not trying to get us to lead "better, healthier lives"? I do.
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Old January 31, 2016, 09:48 PM   #17
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44 AMP, there are 9 questions with 4 responses. 0 being "Never feel that way", 1 being "a couple days out of the last two weeks", 3 being "ever day/nearly every day".

The questions are things like "little interest or pleasure in doing things", "difficulty sleeping or sleeping too much", "feeling down", "having low energy" and go all the way up to "thoughts you would be better off dead"
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Old January 31, 2016, 11:59 PM   #18
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The questionnaire is to cover the past two weeks. The four possible answer categories are:
Not at all

Several days

More than half the days

Nearly every day
So ... what happens if you felt a little sad ONE day? Like maybe because you saw a little girl's puppy get run over on your way to work in the morning.

They hit me with this periodically at the VA hospital. I know what they're after -- I've been home from Vietnam for 47 years, but they'd love to diagnose me with PTSD, because that's the hot button these days, and if they can diagnose more cases they can get more money for treating it. And if I get diagnosed as having PTSD, I get reported to NICS.

I don't care how down I might feel on any given day, the answer to all questions is "Not at all."

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Old February 1, 2016, 01:16 AM   #19
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They hit me with this periodically at the VA hospital. I know what they're after -- I've been home from Vietnam for 47 years, but they'd love to diagnose me with PTSD, because that's the hot button these days, and if they can diagnose more cases they can get more money for treating it. And if I get diagnosed as having PTSD, I get reported to NICS.
This is ONE of the reasons I have avoided VA medicine in the 4 decades plus since my own active service.

I think the reporting to NICS is a fairly recent thing, but their history of mis and malfeasance of care is long and legendary.

As far as I'm concerned, VA medicine is proof that Muphy was an optimist.

And now, this excellent care model is being recommended to us (we will be forced, later, unless something changes) by our all knowing, caring, infallible government...
(yes Virginia, that is sarcasm...)
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Old February 1, 2016, 08:20 AM   #20
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I agree with Aquila Blanca. I get this "questionnaire" about twice a year at the VA. I ,too, do not trust their motives. So as "depressed" as I am I just answer with "zero's"! However; do NOT interpret this as mediocre care from the VA. For my true health care needs they perform quite adequately.
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Old February 1, 2016, 11:05 AM   #21
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For most people, most depression goes away after a while, as do the other 90% of mental health issues we all face as we go through life.

So answering 'None' on a questionnaire like this is perfectly alright, it's the first step to take in dealing with the issue anyway.
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Old February 1, 2016, 12:52 PM   #22
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From the form questionnaire & the score sheet it seems biased.
Examples:
All of the responses are multiple choice only.
The choices are (in the last 14 days)
Not at all =0
Several days = 1
More than 1/2 the days = 2
Nearly every day = 3

where is "Only one or two"?

The questions presuppose an issue & are ambiguous as well. For example if you ONLY answer the lowest possible response to question 5 (Poor appetite or over eating, no "light snacked because of an upset stomach on one day" response is possible) as the lowest response "Several days" you score a 1 (out of a possible 27), you're in a state of depression. The test now only qualifies HOW depressed you are, not if you are depressed.

In the final scores section there are 5 possible scores. The lowest possible (except for perfect "0") are all some severity of depression. There is no "Normal, not depressed" answer or score possible.
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Old February 1, 2016, 05:21 PM   #23
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Lets just hope that this never amounts to more than a recommendation.
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Old February 1, 2016, 09:40 PM   #24
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i have a question for those who use the VA. what forces you to answer those questions at all. why cant you just refuse or put not applicable if on paper. because someone asks me a question doesnt mean i have to answer it.
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Old February 2, 2016, 06:19 AM   #25
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Originally Posted by heyjoe
i have a question for those who use the VA. what forces you to answer those questions at all. why cant you just refuse or put not applicable if on paper. because someone asks me a question doesnt mean i have to answer it.
I don't know what would happen if I declined to answer. I don't poke tigers with sharp sticks, either.

You, as the patient, have no control over what the providers put in your record at the VA. If you decline to fill out a "simple lifestyle assessment," they could put down that you are uncooperative, or they could put down that you are concealing a mental issue, or they could put down that on the basis of observation they believe you have PTSD. The point is, who knows what they might write? Why take the chance, when it's easy to just circle all the zero answers and hand in the paper?
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