Psychiatrists Need Bigger Role in Civic Engagement

With gun violence on the rise and many mentally ill in the criminal justice system, psychiatrists should help to improve the situation.

TORONTO — As gun violence continues to make news on an almost daily basis, the problem has become a public health issue with serious consequences because of it. And although mental health clinicians may not want to get involved in the issue, it is imperative for them to become more civically engaged in order to stem the tide of violence, according to one psychiatrist.

“I think the dialogue has been sorely lacking, perhaps in part, because physicians can shy away from matters of politics and public policy,” said John Halpern, MD, associate director of substance abuse research, Biological Psychiatry Laboratory, at Harvard Medical School-McLean Hospital, in Belmont, Mass. “We have an obligation as physicians to weigh in on matters of social importance that intersects with our field and our field is smack dab in the center of it.”

Halpern spoke with Psychiatry Advisor prior to co-chairing a forum at the American Psychiatric Association Annual Meeting on gun violence, human rights and the need for more physician participation in civic engagement.

More than 30,000 Americans each year die by gun. Part of the problem, according to Halpern, is a lack of tighter regulations on the sale of firearms, especially by those who are mentally ill. “You need a license and [background check] to purchase a gun. You want to capture people who might have mental issues [from purchasing guns] but the system for this is not well established.”

Halpern also lamented the fact that because state mental health budgets were leading to fiscal problems beginning in the 1940s, states began to cut back on those services, leading to “reinstitutionalizing [mentally ill] in the criminal justice system.” He added that the nation’s three largest mental hospitals are actually prisons: the Los Angeles County jail, Rikers Island in New York and the Cook County jail in Chicago.

Some psychiatrists are taking a public stand on such matters, Halpern said, noting the work of the American Association of Social Psychiatry (AASP), whose goal is to “promote consciousness of social factors in the psychiatric disorders of our patients,” according to the association’s website.

Incidentally, AASP is presenting its Abraham L. Halpern Humanitarian Award — named after John’s father — at the forum to recently sworn in U.S. Surgeon General Vivek Murthy, MD, who co-founded Doctors for America, a national organization of doctors and medical students promoting civic engagement to improve the health care system.

“As physicians, there’s more for us to do…and then go back to our communities,” Halpern said, adding that clinicians can and should become bigger advocates by doing things as simple as writing letters to the editor and contacting government officials.

“Organized medicine needs to get along,” he added. “To do nothing breaks [a key] law of medicine. First, do no harm. But sometimes the absence of action is negligence.”


Halpern J, et al. Gun Violence, Human Rights and the Need for More Physician Participation in Civic Engagement. Forum at: APA 2015. May 16-20, 2015; Toronto, Canada.