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A Word From the President: A National Tragedy Sparks Reflection

AAMC Reporter: February 2013

We at the AAMC individually, and as an association, engaged in some deep reflection in the wake of this national tragedy. My Leadership Team colleagues and I began to wonder what role the AAMC should play, not only in the gun control debate, but also in national conversations about social issues that we know are intimately tied to health.

While our mission statement is “to serve and lead the academic medicine community to improve the health of all,” we humbly acknowledge that we simply cannot have the expertise to take the lead on specific policy recommendations on every issue. In the gun control debate, for example, we do not feel qualified to take a position on the number of rounds of ammunition that should be legal. Or, for example, when it comes to the caloric content of fast food or beverages, or debates about air quality in certain communities, it is not the voice of the AAMC that is best suited to speak out on these issues.

We knew, however, that we could not be silent at the solemn moment of national reflection brought about by the events in Newtown. We recognized an opportunity to frame the gun control debate as first and foremost a public health issue, while leaving the finer points of the debate to other policy experts. The AAMC, along with 51 other medical associations, added our support to a letter sent to the president and House and Senate leadership stressing the importance of providing sufficient access to mental health services in preventing gun violence.

We also were privileged to attend a White House meeting with Department of Health and Human Services Secretary Kathleen Sebelius as part of the president’s task force on decreasing gun violence. AAMC Chief Academic Officer John Prescott, M.D., joined representatives from eight other health care organizations, as well as representatives from the offices of the president and vice president. There was agreement among attendees that physicians need to be free to discuss firearm safety issues with their patients and parents of patients, and that we need greater access to mental health services and research on violence prevention. We expect this to be a continuing conversation with President Obama’s administration officials, especially Vice President Biden.

Medical schools and teaching hospitals are all too familiar with the devastating consequences of gun violence, having played vital roles in some of our most recent national atrocities. Whether caring for those wounded by the 2011 Tucson shooting, treating the Aurora victims last summer, or standing at the very epicenter of a gun violence tragedy as Johns Hopkins Hospital did in 2010, your institutions see firsthand the real costs of such senseless violence. See the front-page story for more on how academic medicine is harnessing the power of research to help confront the nation’s gun violence epidemic.

Our institutions also are on the frontlines working to educate the communities at their doorstep. Temple University Hospital’s “Cradle to Grave” program was featured in The New York Times earlier this month. This highly interactive, two-hour experience confronts youth who stand the greatest chance of becoming either the perpetrators or the victims of violence with the realities of youth violence on a personal level. Cradle to Grave has reached thousands of participants since it began in 2006.

Other innovative work is going on through the University of Chicago Medicine’s (UCM) Urban Health Initiative, which leveraged its Community Grand Rounds to educate Chicagoans about the mental health impact of gun and youth violence—something common on the city’s South Side. UCM physician Doriane Miller, M.D., wrote a play, It Shoudda Been Me, to explore the experiences of youth who have witnessed violence. It Shoudda Been Me was so well received that it was produced twice by a local professional theatre company.

Speaking as a psychiatrist, the mental health implications of the current gun violence issue hit especially close to home for me. I have worked extensively with psychiatric patients across the spectrum of mental health and know all too well the stigma associated with seeking help. The National Institute of Mental Health estimates that, in a given year, approximately one-quarter of adults are diagnosable for one or more mental health disorders—far more than the approximately 13 percent of adults seeking treatment every year.

Clearly, we must do a better job in this nation of recognizing, accurately diagnosing, and treating mental health issues. As the Fort Hood shooting and the recent slaying of veterans Chris Kyle, former Navy SEAL and author of American Sniper, and Chad Littlefield demonstrate, sometimes untreated mental health conditions can have catastrophic consequences. We cannot, however, let these tragedies further add to the stigma of mental illness and prevent people from getting the help they need. In reality, “the mentally ill are more often victims than perpetrators of violence,” finds a 2003 paper by Heather Stuart, Ph.D., of Queens University that reviewed the link between violence and mental illness.

Today, the national consciousness rightly is focused on gun violence, and we must make a real and lasting commitment to work together on meaningful solutions to prevent future tragedies. Whatever the issue at hand, we at the AAMC stand ready to be a voice that speaks not from a partisan political perspective, but rather from a public health standpoint. As the leaders of the nation’s medical schools and teaching hospitals, we must play a major role in addressing this national challenge through our research and expertise. Those lost in Newtown, and indeed all Americans, deserve no less.

Darrell G. Kirch, M.D.
AAMC President and CEO