Tennessee has enacted a first-of-its-kind law requiring medical examiners to investigate whether mass shooters were under the influence of psychiatric medications—an issue long shielded by privacy laws but now moving into public view.
The legislation, SB1146, was co-authored by the nonprofit AbleChild, a parental rights and medical transparency group that has long raised concerns about the risks of psychotropic drugs, particularly in children. The bill also had support from Amy Miller, former director of the Reform Pharma initiative under now-HHS Secretary Robert F. Kennedy Jr.
Effective July 1, 2025, the law mandates that county medical examiners perform toxicology tests, gather medical records, and consult with healthcare providers in mass shooting cases involving four or more deaths. The data—excluding personal identifiers—will be submitted to the Tennessee Department of Health and the University of Tennessee Health Science Center, which will issue quarterly reports analyzing the findings.
Psychotropic drugs named in the bill include antidepressants, antipsychotics, stimulants, anxiolytics, and hormone-altering medications. These medications are widely prescribed across the U.S., including in California, where mental health services and pharmaceutical interventions are deeply integrated into public health systems.
The law comes at a time when public confidence in psychiatric medications is facing renewed scrutiny. A 2022 umbrella review in Molecular Psychiatry found no consistent evidence supporting the widely promoted “chemical imbalance” theory of depression. Meanwhile, ADHD diagnoses and stimulant prescriptions continue to rise nationwide.
A major 2025 New York Times Magazine article detailed new research showing that ADHD symptoms may be better understood as situational and environmental—rather than permanent brain disorders. The article highlighted a decades-long failure to identify reliable biological markers for ADHD, and cited long-term studies showing that medications like Ritalin and Adderall provide short-term behavioral effects but little long-term academic benefit. Side effects such as emotional flattening, dependency, and suppressed growth remain a concern.
Professor Edmund Sonuga-Barke of King’s College London, quoted in the piece, noted that “rather than trying to treat and resolve the biology, we should be focusing on building environments that improve outcomes and mental health.”
Backers of the Tennessee law argue that increased transparency is long overdue. Miller has stated that tracking the role of prescription drugs in acts of mass violence is necessary for informed policymaking and should not be blocked by institutional or legal inertia.
The legislation passed with bipartisan support: 76-20 in the Tennessee House and 27-5 in the Senate. Lawmakers in Wyoming are reportedly drafting a similar bill, and some advocates say California could eventually follow—particularly given its active debates on mental health, school safety, and prescription drug oversight.
With California home to both expansive behavioral health programs and a growing number of mass shooting incidents, questions are emerging about how much data is currently being collected—and whether a law like SB1146 could help fill critical gaps in public understanding.
As Tennessee prepares to begin quarterly reporting this summer, other states and public health agencies will be watching the results closely.
