The Arms Act: Health professionals have role in reducing firearms risk

A Royal Commission of Inquiry into the tragic 2019 terrorist attack on the Christchurch masjidain made a series of recommendations to ensure a more robust firearms licensing system in New Zealand. On 30 November 2022, a significant step towards this was achieved with the launch of Te Tari Pūreke | Firearms Safety Authority. This dedicated regulatory agency inside New Zealand Police now oversees the legitimate possession and use of firearms.

Changes to the Arms Act 1983 also followed the Christchurch attack, some of which require health practitioners to play an important role.

People are often surprised to learn there are currently approximately 240,000 firearms licence holders in New Zealand – so roughly one in every 20 New Zealanders has a firearms licence. There are various estimates of how many individual firearms are legitimately held by these licence holders; however, most commentators agree it is likely in the vicinity of 1,000,000 to 1,500,000 firearms.

About 90 per cent of all licence holders are men, with three-quarters of all licence holders being over age 40. Geographically, the majority can be found in our provincial regions, with Canterbury and the southern South Island being the two biggest districts for licence holders, and central North Island being the third.

These New Zealanders own and use firearms for a range of very valid reasons: some use them for recreational purposes, such as hunting or sport; some use them for gathering kai; some for pest control; and some are collectors.

You must now consider notifying Te Tari Pūreke of relevant health concerns relating to your patients who have firearms access

On 24 December 2020, the Arms Legislation Act 2020 introduced changes to the Arms Act. These amendments impact on health practitioners in two ways:

• You must now consider notifying Te Tari Pūreke of relevant health concerns relating to your patients who have firearms access.
• You will receive a notification from Te Tari Pūreke if a patient of yours has been issued with a firearms licence.

The Arms Act interpretation of health practitioner is:

• A medical practitioner registered with the Medical Council of New Zealand.
• A nurse practitioner registered with the Nursing Council of New Zealand.
• A psychologist registered with the New Zealand Psychologists Board.
• A duly authorised officer under the Mental Health (Compulsory Assessment and Treatment) Act 1992.

You must consider notifying Te Tari Pūreke as soon as practicable if:

• you have attended or been consulted in respect of a person who you know or have reason to believe is a firearms owner; and
• you consider that the health condition or disability of the licence holder is such that, at the current time, the firearms owner is a risk to themselves, or to others, so should not have access to firearms

This is covered by Section 92 of the Arms Act. “Reason to believe” is not defined in the act; however, it can be interpreted to mean that you must form your belief based on your interpretation of the facts (ie, your medical assessment at the time you saw them and any other relevant information). The belief need not be proven correct later.

There is no exhaustive list of health conditions that may be relevant to safe possession and use of firearms. Essentially, any health condition, either mental or physical, that may detrimentally affect the person’s ability to safely possess firearms, may be considered a risk.

This can cover a huge number of conditions, but examples include dementia or other cognitive impairment or brain injury; severe depression, anxiety or suicidal ideations; a disclosure of family or intimate partner violence; significant visual or hearing impairment; and coordination or mobility issues, such as end-stage Parkinson disease.

What is important, is whether the health condition is developing or manifesting itself (or is likely to) in such a way that, in the interests of individual or public safety, you believe the person should not continue to possess firearms.

No. Te Tari Pūreke make the decision around this and will determine whether someone is “fit and proper” to hold a licence. However, the information provided by you, around whether someone could be a risk to themselves or others, is essential in enabling Te Tari Pūreke to determine this.

It is the responsibility of Te Tari Pūreke to notify the applicant’s health practitioner when a firearms licence has been issued or when a licence holder notifies Te Tari Pūreke that they have changed their health practitioner.

However, you shouldn’t assume your patient is not a firearms licence holder just because you have not received a notification from Te Tari Pūreke. This is because the licence holder may have chosen to nominate someone other than their registered GP as their health practitioner when applying for a firearms licence. A patient might also have changed health practitioner without notifying Te Tari Pūreke.

We suggest you record firearms licence holder information in a readily visible way on your practice management system so other practitioners can be alerted if needed.

If you think the licence holder poses an immediate or imminent danger of self-harm or harm to others, please call 111 and ask for police.

If you have concerns that do not pose an immediate or imminent danger due to a patient’s access to firearms:

• use the online Health Practitioner Reporting form (visit firearmssafetyauthority.govt.nz, scroll down and click on the “Information for health practitioners” link near the bottom of the homepage); or
• phone the non-emergency police number 105.

Only provide information that is relevant to your opinion. The information you provide is not the only piece of information Te Tari Pūreke can consider when deciding on someone’s fit and proper status to hold a firearms licence. In many cases, they will also consider information from other sources before reaching a decision.

A member of Te Tari Pūreke will contact you when your report has been received. This is an opportunity for you to raise any other concerns and discuss the next steps.

After being notified, there are a number of actions that Te Tari Pūreke can take depending on the degree of concern you have raised and any other information they hold about the licence holder. A graduated response model is used, meaning Te Tari Pūreke has more options than issuing a licence holder with a warning or undertaking licence revocation. Possible actions could include a requirement for the licence holder to undergo further medical assessment by another health practitioner, or the commencement of a suspension or revocation of the licence under the Arms Act. By no means do all notifications end in revocation of a licence.

Yes. As long as you act in good faith, you are not liable to criminal, civil or disciplinary proceedings by disclosing personal information while performing any of the notifications under the act. This protection is provided under Section 92(5) of the Arms Act.

You should be aware that if the licence holder requests this information, it will be provided unless there is risk to a person’s safety.

If it feels safe and appropriate to do so, you can discuss the notification with your patient. They may well be keen to engage in the process and ensure that their health condition isn’t impacting on their ability to use their firearms safely.

However, in many situations, this may not be possible or may not feel safe for you or your practice team. Do not put yourself at risk. If in doubt, do not disclose this to your patient. If you choose to make a notification, you can use the free text fields in the online reporting form to raise these concerns, requesting non-disclosure.

Also remember that notifying Te Tari Pūreke is not mandated, and the Arms Act asks you to consider doing this. You can of course consult with others (eg, colleagues or your medical protection organisation) if needed.

You may decide that, while you have concerns about a person having access to firearms, these concerns are not sufficient to warrant raising them with Te Tari Pūreke at that time. In this case, you may still want to offer advice to your patient about their access to firearms. You may remind them that if their health circumstances deteriorate further and they have concerns about their safety or the safety of others, they may want to consider surrendering their firearms to a friend who is a licensed firearms holder, or voluntarily to Te Tari Pūreke while they are unwell. More about surrendering a firearms licence is available on the Te Tari Pūreke website.

We appreciate that health practitioners’ roles are demanding and difficult at times, and that these changes may add to your workload. We also acknowledge that considering whether to make a notification about a patient, with whom you may have a long and trusted therapeutic relationship, isn’t easy and may have long-lasting repercussions. However, we hope you are as keen as we are to ensure New Zealand is a place where our communities and whānau are safe. We thank you for the integral role you play in that.

Kendra Hill is senior partnerships advisor – health sector at Te Tari Pūreke | Firearms Safety Authority. Cathy Stephenson is a specialist GP at 502 Rangatahi Ora, Porirua, a senior clinical lecturer in sexual assault and intimate partner violence at the University of Otago, and a member of the Minister’s Arms Advisory Group