In Reply Mr Kels highlights a confusing aspect of federal and state laws that disqualify certain people from accessing firearms. What types of involuntary mental health interventions result in a gun-prohibiting record that is reportable to the NICS? The question is difficult to answer because commitment practices vary substantially by state and locality.
Under federal law, individuals lose their firearm rights if they have been “committed to a mental institution.” In many states, commitment proceedings have 2 stages. The initial stage is a short period (eg, 3-5 days) of hospitalization for the purposes of providing emergency treatment and evaluation of whether patients meet commitment criteria; the second stage is a formal commitment hearing. These admissions are often authorized by an emergency medicine physician or mental health professional and in some states are ratified ex parte by a magistrate. These patients are discharged quite often before a formal hearing is required, so hospitalization never results in a commitment order.
Swanson JW, Bonnie RJ, Appelbaum PS. Firearm Access and Risk of Suicide—Reply. JAMA. 2016;315(19):2124-2125. doi:10.1001/jama.2016.1071