The State of Connecticut’s Office of the Child Advocate recently published its full report on the December 14, 2012 school shooting event in Newtown. It refers to “missed opportunities” to have prevented the tragedy by recognizing signs and intervening to provide necessary mental health support to Adam Lanza, the shooter.
While it is counterproductive to look back and place blame on individuals in Adam Lanza’s life, it is the time to take a hard look at our health and education systems in the US and find ways to correct them to reduce the risk of untreated mental health issues leading to deadly mass violence. Comprehensive strategies are required to prevent school shootings.
School shootings typically involve a mix of suicidal thoughts, despair, and anger—in addition to access to guns. School personnel, primary care providers and parents are the right people to identify and to collaboratively develop and monitor plans for children and youth at risk and in despair.
Often there are signs of distress from the offender that, when ignored, may increase the odds of him/her committing an extreme act of violence. Building a cohesive and supportive school environment (with adequate staff training), as well as providing screening tools, streamlined referral pathways and training to primary healthcare providers are key to preventing horrific events like a school shooting.
To reduce the risk for individuals with emotional and behavioral challenges to become violent, programs and policies should have the following aims:
- To reduce the day-to-day aggression within schools and communities, including physical, social, and cyber forms. Experts feel that this chronic and overwhelming kind of stress wears on a school and community and can lead some youth with emotional and behavioral problems to be at greater risk for future violence, delinquency, as well as depression and suicidal acts. (Read about Partner for Prevention)
- To decrease the isolation these children and youth often feel by actively integrating them into peer activities. Schools that promote an inclusive school climate in which at-risk youth are also learning better problem-solving and conflict resolution skills are more likely to provide a safe and productive atmosphere. (Read about Project Access)
- To close gaps in mental health services for children with emotional and behavioral problems and to provide a broader continuum of mental health care.
Unintended Obstacles of Privacy Protection Laws
I would specifically draw policymakers’ attention to the unintended obstacles of privacy protection laws that govern healthcare such as HIPAA and education such as FERPA. Policies regarding the appropriate use and appropriate exceptions to these regulations need to be evaluated and amended to allow for better communication about the mental health needs of students.
While the protection of an individual’s health and educational information is essential to our patients, both psychological and physical safety must take precedent. Just as emergency situations allow for the sharing of information among healthcare providers without formal consent, we need to develop an effective modification to these regulations for “urgencies.” For example, most states require mandated reporting when a professional suspects a child is the victim of abuse and maltreatment. Could a similar process be implemented when we believe a youth to be under extreme emotional distress?
This will take courageous leadership from those in Washington and state capitols to champion new effective policies and programs that improve our mental health systems in our schools and communities.
Ultimately, we will never know how many mass casualty events were prevented when mentally ill at-risk individuals received the support they needed and went on to live non-violent lives. But perhaps history will reflect kindly when future citizens refer to mass shootings as something from our misguided past, in the time before we understood the real needs of youth with mental illness and the consequences of not intervening appropriately due to ineffective or inadequate policies.
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