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Frequently (by no means all the time but often enough) that's grossly insufficient.
-Some patients remain essentially untreated. You don't need to take medication (there is however a slow process for forcing patients who are sufficiently dangerous). Nybbler murder patient may in fact want to murder no-one other than Nybbler, and behave more or less while in the hospital while refusing treatment. After the initial period further involuntary commitment involves a judge - the judge may say "well he hasn't done anything bad since he got here, maybe he won't murder Nybbler?" and off he goes. Walks out of the hospital, buys the gun, murder goes. This is not theoretical, it happens (sometimes even with mass shooting events but does also show up in the local news when the death count is low). Solution: force people to get treatment without their consent. Or force them to stay in the hospital until they consent. Both are significantly more rights destroying.
-Some patients are only dangerous when they use drugs. While intoxicated and for a while after they are a psychiatric problem but outside that the health care system has no control over them. People who keep smoking PCP and want to murder people while on PCP should probably not be allowed to own guns. This should be fixed by arresting people who use and sell PCP but society isn't really electing to do this these days. Solution: reengage the war on drugs. Not a popular option.
-Much more common and much trickier is that it is common for people to be committed, accept treatment, temporarily get better, and then relapse. They then become a threat again. Sometimes quite quickly. Much more quickly than any court process would go. Charitably (and in truth pretty commonly) this happens because medication works well at reducing things like hallucination and aggression but not the negative symptoms lack apathy and avolition. When your symptom is that you can't be motivated to take medication and you don't care if the other symptoms come back, well then it is hard to stay on medication. And then the risk comes back.
Making a public and credible threat to murder someone for reasons that are universally not given as acceptable (ex: for no reason at all or for reasons of delusion) should be exclusionary to owning guns. We aren't talking for political reasons or because the neighbor slept with your wife, we are talking because you are convinced the neighbor is Proxima Centauri.
Nybbler's issue seems to be (although he won't clarify it) that it didn't go through a legal proceeding. But opening up legal proceedings is a huge can of worms.
Let's say someone (police, healthcare worker, concerned person, whatever) can open a complaint about someone's safety to own weapons. That's time consuming, expensive, might involve temporarily seizing guns or the person, will involve litigating if expression of political beliefs counts... way more abusable than present state.
The fact of the matter is that the vast vast majority of people who are involuntarily committed* really should not be allowed to own guns. Failures are rare. Should you find one (for instance someone who did a shit ton of PCP for ten years and then spent 50 years not using PCP and wants some guns) the expungement process works pretty well.
The modal involuntary patient isn't actually suicidal or homicidal, instead they are something like a schizophrenic who is so severe they just can't feed or care for themselves. Someone that disorganized isn't safe to own anything remotely dangerous, and if they had the financial ability to own a car (most don't) they probably shouldn't.
*assuming you agree with the suicide end of things, that's a bit trickier.
Why? You seem to be asserting that a risk of someone having a repeat episode while having a gun is unacceptable. I do not agree with this; disagreement with this is a primary reason behind why I'm against gun control. Freedom means authority figures should have neither the responsibility or authority to stop people from making shit decisions.
I agree this person is not safe to let out with guns, but the guns are irrelevant. The person you describe is not safe to let out, full stop. Not with guns or a car or even just their own fists.
I do have disagreements regarding the place of suicidal people here, but I'll put those aside.
I don't trust that all of this is the case currently or that it will remain the case. The particular case described in the OP already does not look like the expungement process working well and I do not expect this to improve. There is a large group standing right behind your reasonable safety concerns who wants any possible excuse to keep guns away from people, and given your previous top-level post I'm sure you're well aware that doctors' politics lean heavily towards that group.
You're thinking of this system in the hands of an impartial party. I am expecting this system to be in the hands of an anti-gun crusader sooner or later and want it hardened against misuse.
Would you feel more comfortable with this process if we were able to produce date that illustrates that patients admitted with homicidal ideation are equally or more likely to kill someone as felons?
Fundamentally we need to establish what level of problematic behavior disqualifies from gun use. Some amount is clearly appropriate there are people dumb or crazy enough to say "if you let me have a gun I'm going to kill X." Clearly they shouldn't be allowed to. Felons? Stickier not every felon is likely to kill someone but it's a good broad category. You could attack this laterally by making assault on healthcare workers a felony and charging it 100% of the time, but that would be even more overkill - it happens a lot and we try and let it go because a good number of people who do this aren't likely to cause trouble or are likely to cause a minimum of trouble.
While my co-workers (of most non-surgical specialties) are certainly politically motivated at times, and are unlikely to write a letter in support of someone owning guns because they don't believe in that for political reasons....and at the same time they aren't going to abuse the commitment process for political reasons. I could say its because of historical abuses leading to lots of ethic changes on this, I could say its because of the increased lawsuit risk, but realistically a large chunk of it is just because it's so infrequently anything other than intensely obvious (at least outside suicide, suicide risk gets a bit stickier).
Patients who are sick tend to be really fucking sick and unless you've seen it it's hard to understand. Your usual crazy schizophrenic homeless person wandering around on the street was deemed safe to go home. How bad do you think the ones who get dragged in are?
This seems to be a more specific group than previously discussed, so I'm not sure why data on them would matter to a discussion of involuntarily admitted patients as a whole. I also do not agree with rights being removed at a statistical level. Temporary violations of rights without due process are unfortunately necessary, but for a more permanent removal a just system requires an individual and adversarial process.
I'm more concerned about the (lack of) process here, but given it's a right I'd accept taking guns away at the same level which would justify locking them up for an extended time. If you wouldn't feel comfortable tossing them in a jail cell for their behavior I don't think it's bad enough to take their guns either.
Leading doctors in the US recently tried to distribute scarce health resources (covid-19 vaccines) by race. If that was non-political then non-political covers a lot I would consider political. I am concerned that some doctors will involuntarily admit a person for the purpose of getting them away from their guns long-term (i.e. past the immediate episode), and your word isn't sufficient to convince me that they aren't willing to do this.
I was under the impression these people do tend to get occasionally dragged in and involuntarily committed, then are eventually let go again.
The process is somewhat individual and adversarial. In NJ the way it works is more or less this - somebody has to be concerned about the patient (usually a family member, a concerned bystander, cops walking by) the patient is then taking an ED or Crisis Center on a temporary hold, at which point a social worker has to see them and think they need to be committed at which point they are seen by two physicians who have to feel it is appropriate. Individuals involved can be sued, fined, lose their license for abuse and so on. Then afterwards there is an expungement process. If the patient is held for an extended period of time without discharge then they have a formal court hearing that can and will result in release from the psychiatric hospital.
Obviously there is some abuse and laziness in the process, most typically the second physician would be like "eh I wasn't there, I'll assume the first doc was correct."
Ultimately this involves multiple trained professionals with skin in the game to make the determination that someone needs to be committed and they can always go through a court process afterwards.
I think some of the value here is that most people who end up committed don't have the functional status to do much of anything. If you make it opt-in most wouldn't, and wouldn't be able to get expunged. I'm fine with a more robust way of people getting their rights back but it has to be done in away that isn't too egregiously expensive and defaults to no because of how dangerous a small subsection of these people are, which is hard to convey if you've never seen them.
Crisis centers do occasionally catch people who will explicitly say that they are interested in killing people (in a sociopathic way) and loading them down with rights restrictions before they get started in an unalloyed good.
Hope all of that makes sense, typed fast.
Some other stuff: -While most doctors aren't anti-gun they aren't committing people purely to get them away from their guns unless the doc has concerns for threat and its therefore appropriate. This is because these settings are overworked, their aren't enough beds for those who really need them, and the hospital doesn't get paid if the insurance company doesn't think the patient actually needs to be committed and that rolls onto the doctor's head. In the worse case scenario no psychiatric hospital will take the committed patient because they clearly don't need psychiatric care and then the ED comes over and stabs the psychiatrists 80 million times for taking up a bed while someone is bleeding to death in chairs.
-Average disorganized street homeless person is harmless other than the inability to care for themselves even if they are vaguely threatening, so they tend not to get taken in unless they are actively harassing someone or committing some other crime like trespassing.
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