Did Nevada’s Broken Mental Health System Help Arm Manhattan Killer?

In the wake of the shooting in Manhattan this week that left four people dead, one common question I’ve seen posed in the media is how the killer was able to legally purchase firearms and even obtain a concealed carry license despite a history of mental illness. 

According to officials, the suspect was placed on mental health holds on two separate occasions, once in 2022 and again in 2024. Las Vegas television station KTNV has reported that in neither case, though, does it appear that he was involuntarily committed after the initial 72-hour hold expired, which would have been necessary for him to lose his Second Amendment rights under federal law. 

Randy Sutton, a retired Metro Police lieutenant who now leads the charity TheWoundedBlue.org — which aids police officers who have been injured in the line of duty — says the priority for cops is getting help for people in crisis.

“Many times when law enforcement officers respond to someone who is in crisis, the procedure is to take them to the nearest emergency room in order for an [medical doctor] to perform an examination,” Sutton said. “Very often, it’s at that point, at that juncture, where the physician doesn’t send the individual to a mental health facility.”

One of the reasons: There aren’t a lot of those facilities in Las Vegas, so doctors may send only the worst cases. In the rest, the doctor may decide the person has been stabilized enough to return home.

Was the suspect not considered enough of a danger to himself or others to take up one of the few beds available in an in-patient facility? Possibly. It’s also possible that there weren’t any beds available at all. As of 2020, Nevada ranked dead last in the nation in overall mental health, according to Mental Health America’s 2020 State of Mental Health report. One of the big reasons for that ranking is a lack of resources. 

The Nevada Department of Health and Human Services has reported that every day an average 102 individuals are “waiting in emergency rooms across Nevada for behavioral health services”, while noting that the state lacks accurate data on he number of people turned away from services “due to a lack of beds or appropriate care.” 

That same report indicates that Nevada has 11 inpatient psychiatric facilities and seven residential treatment organizations, with approximately 739 mental health beds throughout the state serving a population of more than 3,000,000 residents. That’s not a lot to begin with, and staffing shortages in those facilities may reduce the number of beds that are actually available.  

While some gun control advocates want to lower the bar to strip someone of their Second Amendment rights by making an initial mental health hold or voluntary commitments disqualifying factors for legal gun possession, that’s the wrong move from both a constitutional and common sense perspective. The purpose of a mental health hold is to establish whether someone is a danger to themselves or others and should be placed in an in-patient facility. It’s not proof of dangerousness by itself. Prohibiting those who voluntarily place themselves in a psychiatric hospital from owning or possessing firearms in the future is a really good way to persuade people not to treat their mental illness in the first place. 

We have a mental health crisis in this country. While it may be most acute in Nevada, virtually every state in the union has a lack of mental healthcare workers and access to care is a problem for tens of millions of Americans. This is one of the many reasons I’m opposed to “red flag” laws; they’re a cheap way for the government to say it’s “doing something” to address those who pose a danger to themselves or others without actually addressing their dangerousness. 

Taking on this crisis isn’t easy, and it will require a significant amount of spending, but unlike putting more gun control laws in place it will actually make a difference in terms of both public safety and individual wellbeing. Instead of asking why this killer could get a gun, we should be asking why he couldn’t get the help it’s clear he so desperately needed. 

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