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January 1, 1999
The AMA House of Delegates approved a resolution cosponsored by APA and the American Academy of Child and Adolescent Psychiatry (AACAP) urging that children who take guns to school be evaluated by a psychiatrist or mental health professional and, if necessary, receive treatment.
The AMA committee that reviewed the resolution had recommended that the house reject it, so the action on December 9 came as a pleasant surprise to APA, AACAP, and the other two cosponsors, the American Academy of Pediatrics and the AMA's Oklahoma delegation.
An alternate delegate to the AMA Section Council on Psychiatry, Jay Scully, M.D., commented on how the guns-in-schools issue evolved at the interim meeting of the House of Delegates, which was held last month in Honolulu.
"We were initially surprised that the reference committee had recommended" that the measure be rejected, said Scully, chair of APA's Council on Medical Education and Career Development. It was therefore "extremely heartening to see the widespread support for psychiatry. . .to override a reference committee position. We had thought perhaps to go for a referral as a compromise, but the overwhelming response of the house was to support our position, and it shows the good work everybody on the delegations has been doing."
The outcome reflected psychiatry's enhanced status in the AMA now as compared with a few years ago, he added.
APA past president Jerry Wiener, M.D., a delegate and section council member, commented, "I think really it was a victory for the [disturbed] children who take guns and other weapons to school. We feel that it was an enormously important decision by the house, and if it was a victory for psychiatry, it was that the resolution attracted enormous support from all segments of the House of Delegates - state delegations, specialty society delegations, and individual delegates all rose in almost unanimous, indeed, enthusiastic support of a resolution that, for reasons that seemed difficult to understand, the reference committee had recommended for non-adoption." This overwhelmingly broad support "occurred without our having to lobby for it."
APA past president John McIntyre, M.D., also a delegate and section council member, reflected on the action.
"I think it was somewhat unusual to get that amount of support in reversing an action of a reference committee," said McIntyre. "This clearly is an issue in which other mental health professionals have a significant role, but also psychiatrists have a significant role, and I think that the language that the house chose was appropriate," he commented.
The reference committee may have misconstrued "some of the testimony given in the committee talking about, at times, the sparsity of services available in schools," said McIntyre. "I think that was misinterpreted to mean that we shouldn't be providing this level of service, that schools should strive to obtain that level of service."
David Fassler, M.D., AACAP delegate and vice chair of the Section Council on Psychiatry, noted that the measure ultimately captured the concerns of physicians across various disciplines about guns in schools and the importance of providing access to appropriate services.
The resolution had originally stated that "the AMA recommend that all children who take guns or other weapons to school should receive an evaluation by an appropriately trained mental health professional" and that "children who are determined by such evaluation to have a mental illness should receive appropriate treatment." The final resolution was altered to state that the evaluation should be done by "a psychiatrist or other appropriately trained mental health professional," Fassler observed.
The resolution's passage means that it is now AMA policy that all children who bring a gun or other weapon to school should be evaluated by a psychiatrist or other appropriately trained mental health professional, and if determined to have a mental illness, they should receive appropriate treatment, Fassler said. It further states that the AMA will advocate for funding both for evaluation and treatment.
"The implementation phase will involve working collaboratively with the specialty societies including APA, AACAP, and the American Academy of Pediatrics, as well as numerous school organizations, including specifically the National Education Association, the National Parent-Teacher Association, the National Association of School Psychologists, and the National Association of School Guidance Counselors," he noted.
"We are optimistic that this resolution will initiate a broad-based effort to ensure that these children receive appropriate evaluation and treatment services."