The Washington PostDemocracy Dies in Darkness

Talking about mental health and guns is easy. Doing something is not.

People look at handguns during a gun show at the Dulles Expo Center in Chantilly, Va., on Oct. 3, 2015. (Jabin Botsford/The Washington Post)

There's a kind of usual order of national business -- a grim ritual that's been established for the hours and days after a mass shooting.

After the final death and injury toll are established, an elected official or candidate — usually a Democrat — will call for stricter gun control. Then, another elected official or contender for public office — usually a Republican — will object to efforts to politicize the tragedy. Victims and their family members step forward to tell their harrowing stories and weigh in on one of the two sides mentioned above.

Then, it all just goes away until the next mass shooting.

For all the seemingly intractable points of disagreement, though, there has been one thing both sides generally agree upon: keeping guns out of the hands of those with mental health problems. Poll numbers gathered by the Public Religion Research Institute in 2013 drive that home:

Such agreement is a key first step. The big problem, though, is that mental illness alone is not a solid indicator that crime will follow a gun purchase. What we know for sure is that mass shootings typically happen after a person with or without a known mental illness has made threats, in some way declared public admiration for violent behavior or behaved violently legally obtains a gun.

That last group — domestic abusers who have behaved violently but not necessarily been convicted of a crime that might prevent them from purchasing a gun — has been the subject of a lot of attention in state legislatures. In fact, since 2013, at least 18 states have passed laws that prohibit these individuals from obtaining guns. Those laws apply to people never arrested or convicted of a crime and those who have never been involuntarily committed to a mental health institution but are perhaps disturbed.

Similarly, a law passed in California in 2014 will allow the family members and law enforcement aware of a person who has made violent threats or seems imbalanced enough to represent a threat to others to go to court and obtain an order that prevents that person from buying a gun. The law will go into effect January 2016.

Right now, only those who have been involuntarily committed — meaning committed to a mental health institution by court order — are likely to trigger a no-purchase response from the the federal background check system governing retail gun sales across the country. Limiting gun bans to those who have been involuntarily committed leaves a lot of people with serious problems and histories of violence legally able to obtain a gun. It's also worth noting here that in the age of managed care and limited government supports for mental health hospitalizations, many people cannot receive in-patient treatment if they want it.  So it stands to reason that both approaches listed above will identify some additional people who may pose a serious threat if armed.

It's also true that both approaches have been the subject of some debate with the traditional Democrat-Republican break but have managed to become law — albeit more so in blue states — despite about half of Americans opposing stricter gun laws.

But it's a third approach — the permit to purchase — that has run into lots of political trouble.

Right now, four states — Iowa, Michigan, North Carolina and New York — require people who want to purchase a handgun to first obtain a permit from local law enforcement. Another four — Connecticut, Illinois, Massachusetts and New Jersey — require permits to purchase all firearms. And in Maryland, permits to purchase control the sale of handguns and assault weapons. So that's nine states total — almost all of them blue states.

In some of these states, this check happens instead of a federal background check at a gun store. In others, it happens in addition to that federal check; it happens first. And two of these states, California and New Jersey, also require those seeking gun permits to waive privacy restrictions that would otherwise make it difficult to check to see if a potential buyer has ever been committed to a mental hospital.

Gun control advocates — including law enforcement associations, at least one state attorney general and just about all the nation's gun control-backing lobbyists — say that right-to-purchase permits are essential. Right-to-purchase permits involve  a process controlled by local law enforcement agencies that generally require background checks and sheriff approval before a handgun purchase can be made (private resale or in-store retail).

In short, gun control advocates say, right-to-purchase permits add another layer of protection, another chance to stop people who are dangerous or unstable but not federally barred from obtaining a gun. Those local sheriffs, gun control advocates say, are more likely to know if an applicant has been the subject of a domestic violence protection order or mental health emergency call. And, they say, the states with permit-to-purchase laws boast lower firearm-involved death rates than those that do not. The reason: Even criminals will obtain guns legally when they can then use them for illegal purposes, or buy them off someone who can.

But gun rights advocates, including but certainly not limited to the National Riffle Association (NRA), argue that gun-control advocates are delusional. Only mythical local sheriffs are familiar with every oddball who has also made threats or behaved violently in their community — a near impossibility in even mid-sized cities. Instead, they say, most sheriffs in states with permit-to-purchase laws simply have to rely on the very same federal databases accessible to gun stores to make a decision on a purchase permit.

That's precisely what gun rights advocates told Guns magazine in June. Gun-rights supporters insist that no law is going to stop those determined to purchase guns illegally or use them in a way that clearly violates the law.

The proper questions are really whether such a proposal passes legal muster, what difference a legal proposal can make and how effective those already in place have been?

When North Carolina's Republican-controlled legislature considered and then debated long and hard the idea of ending its permit-to-purchase law this year, two statistics came up over and over again.

One was how in Missouri, where lawmakers repealed that state's permit-to-purchase law in 2007, that state's murder rate involving handguns grew 25 percent between 2008 and 2010 and 14 percent when researchers looked at homicide data through 2012, according to a 2014 Johns Hopkins Bloomberg School of Public Health Center for Gun Policy and Research study. There were no changes in homicides by other means.

The other was a second study, released by the same research team in 2015, in which a 1995 permit-to-purchase law was credited with at least helping to reduce Connecticut's murder-by-gun rate 40 percent.

Gun rights advocates and lawmakers rolled out a now familiar argument. People in North Carolina would ultimately be safer if more of them are armed. They pushed for a total repeal of the program but then compromised.

The North Carolina permit-to-purchase program survived. A major feature of the deal: Local sheriffs will only be allowed to look at applicants criminal and mental health records going back five years.

CORRECTION: The story above has been altered to reflect the correct time during which the Public Religion Research Institute data was gathered.