NRA chief executive Wayne LaPierre proposed creating a national mental health database after a gunman shot and killed twenty children and six adults at Sandy Hook Elementary School in Newtown, Connecticut last December. Mark Kelly, a gun-control advocate and the husband of former congresswoman Gabrielle Giffords, also called for greater restrictions to prevent mentally ill from obtaining firearms. Mental health professionals and advocates criticized the NRA's approach, claiming it disproportionately focused on a segment of the American public that is not responsible for the majority of firearm-related deaths.

Although the NRA has criticized almost all of the federal gun control legislation proposed since the Newtown massacre, the gun-rights organization endorsed a bill on mental health records proposed by Sen. Lindsey Graham (R-SC). The bill would reform the mental health restrictions of the National Instant Criminal Background Check System, although the Center for American Progress claimed Graham's proposed legislation would weaken, not strengthen, those restrictions. The NRA has also criticized proposed legislation addressing mental health and firearms in Colorado and Nevada as overly broad and unconstitutional.