March 3, 2013
Dr. Ahmed Faheem: Guns not the only issue
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CHARLESTON, W.Va. -- The spike in gun violence across the United States in the last few months has led to many discussions about limiting the size of ammunition clips, expanding the requirements for background checks, and banning certain classes of weapons. Unfortunately, the myriad legitimate concerns about how to best mediate access to firearms and ammunition of all sorts have some merit, but will not fully solve the problem.

With more than 300 million guns currently in circulation in the United States, I am convinced that it will be behavioral health experts and changes in code, law, and public perception that will be most effective in keeping guns out of the wrong hands. Right now a background check of someone who wants to purchase a gun might find out the potential purchaser has been in a psychiatric hospital, but will not discover why because of HIPAA regulations. A background check won't learn whether the person was having panic attacks in public settings or threatening to kill people.

I want to be clear here: I am not calling for an end to HIPAA regulations. Since they were implemented in the mid-1990s, they have helped protect the privacy of American citizens in many ways. What I am saying is that there exists a complex web of federal and state regulations, many of which have unintended consequences. We need to address those regulations to ensure we have a comprehensive and effective behavioral health system that is accessible and beneficial to everyone, as individuals as well as to society as a whole. This is a more important focus for violence prevention efforts than gun regulation is ever likely to be.

The Comprehensive Behavioral Health Commission, of which I am honored to be the chairman, is currently trying to do precisely that, as are several other state and federal agencies, working groups, as well as the West Virginia Court system. We are looking at behavioral health programs and services, the existing stigma surrounding mental health treatment, and other issues involving mental health care.

For instance, one of the biggest issues West Virginia faces is simply a lack of sufficient individual and institutional providers; in short, there are not enough therapists, psychologists, and psychiatrists, especially in the more rural regions of West Virginia. Overall, the commission aims to increase accessibility to treatment, support voluntary treatment choice and liberties, and increase public safety through our efforts.

Specifically, the Commission and the Court are right now looking at ways to improve West Virginia's network of involuntary commitment process and supporting studies about the assessment of the children and youth of our state to streamline our systems and ensure care is accessible.

I want to stress that the vast majority of people facing behavioral health issues are not threats to society. In my experience, such individuals are extremely rare. However, only by addressing our behavioral health services system, in all its entirety and complexity, will we determine how best to both join people with the help they need and protect society -- and especially the most vulnerable among us -- from dangerous violence.

Faheem is a Beckley psychiatrist and chairman of the Comprehensive Behavioral Health Commission, which represents a cross-section of state agencies from the Department of Health and Human Resources to the court system.

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