research paper about school shootings

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K-12 School Shootings: Implications for Policy, Prevention, and Child Well-Being

Paul m. reeping.

1. Department of Epidemiology, Columbia University, Mailman School of Public Health; New York, New York

Ariana Gobaud

Charles c. branas, sonali rajan.

2. Department of Health and Behavior Studies, Columbia University, Teachers College; New York, New York

Schools should be considered safe spaces for children in society, as children need to feel secure in order to grow and learn. This chapter argues that when a school shooting occurs, the harm can go beyond just those who are injured or killed, as the presumption of security is shattered, and the mental and emotional health of the students exposed to the violence is threatened. There are many possible interventions for preventing these attacks, including on the school, state, and federal level. This chapter explores the evidence behind some these interventions and describes the delicate balance in implementing these interventions without introducing undue stress and anxiety into a child’s everyday life.

Introduction

On December 14 th , 2012, a 20-year-old male, not yet legally old enough to carry a handgun, would go on to commit the deadliest K-12 school shooting in United States history. 1 Earlier in the morning, he would first murder his mother, a firearms enthusiast, and steal her Bushmaster XM15-E2S rifle, Izhmash Canta-12 12 gauge shotgun, SIG Sauer P226, and a Glock 20SF handgun, all of which were bought legally. 2 He then drove ten minutes away to Sandy Hook Elementary School in Newtown, Connecticut, a kindergarten through fourth grade primary school where over 400 were students enrolled. The school had security measures in place; for example: visitors needed to be identified and buzzed into the building, which was locked once the school day began. 1 Using the Bushmaster rifle, the perpetrator bypassed this system by shooting through plate glass in the front of the school. After killing the principal, school psychologist, and wounding a teacher who tried to stop the attack, he opened fire on two first-grade classrooms. 1 In one of the classrooms, he shot and killed a teacher and behavioral specialist who had attempted to shelter the students in the bathroom. He then murdered all the students except a six-year-old girl; she survived by hiding in the corner of the bathroom and playing dead, likely underneath her murdered classmates. Fifteen children perished in this classroom. 1 In the second classroom, the teacher and special needs teacher put themselves between the perpetrator and the children, and several students were able to escape the room when the shooter reloaded his firearm. Tragically, five students were still killed, including both teachers. Within approximately six minutes, twenty children (only 6–7 years old) and six adults were killed before the gunman committed suicide using the handgun. 1 This tragedy relaunched a national conversation about the occurrence of mass shootings, specifically the physical, psychological, and educational harm inflicted on children. Despite being touted as the “tipping point” in gun violence prevention, 3 only individual states have been successful in passing legislation in hopes of reducing mass shootings. To this day, there has not been significant legislation passed at the federal level to prevent these incidents from occurring in the future. 4

Using the most commonly used definition of a mass shooting—an incident where four or more individuals are killed by a single (or sometimes pair) of perpetrators 5 —studies have found that children and teens (individuals under the age of 18) make up a surprisingly high percentage of the victims killed in these tragedies. In 2019, children comprised 22% of the population in the United States, 6 and accounted for approximately 25% of victims in all mass shootings. 7 Children are even more likely to be victimized with a gun if the event occurs in the home. Between 2009 and 2016 there were 102 mass shootings, of which 71 occurred in the home, and 31 in public. Children under the age of 18 accounted for nearly half (44%) of the deaths in domestic mass shootings and 10% of the victims in public mass shootings. 8

Although children and teens are usually not targeted in public mass shootings, 8 school shootings in K-12 schools - which include mass shootings - remain one unfortunate exception. These tragedies primarily impact children and teens and are especially concerning given the age of the victims. The definition of a school shooting, like mass shootings, can vary widely, ranging from an accidental discharge of a gun at school, to the injury or death of a student by a firearm, to a school mass shooting. 9 Using the definition of any incident of interpersonal gunfire in a K-12 school, the Washington Post created a dataset that details any school shooting since the Columbine School Shooting, in 1999. 10 Using this data, the number of school shootings per year, with some of the most infamous school shootings labeled, is presented in Figure 1 . Regardless how a school shooting is defined, all of these events can have detrimental effects on a child’s well-being, development, and critical learning outcomes. This is particularly evident if we consider that school shootings impact not just those children who are physically injured and killed, but those who witness the shooting, hear gunshots, know a friend or family member who was killed, among other levels of exposure. 11 Indeed the short- and long-term implications of school shootings on communities across the U.S. can be devastating. 12 , 13

Number of school shootings in the United State since the Columbine School Shooting

K-12 school shootings are of particular interest given the expectation of safety within a school’s walls and the right of every child to learn and thrive in a safe school environment. An apt comparison can be made between school shootings and plane crashes. Deaths due to both are rare, 14 , 15 and planes and classrooms are also presumed to be safe places. However, due to the presumption of safety, if something goes wrong, the event is rightfully seen as not only tragic, but also preventable. As a result, both are more likely to make international news than more frequent tragedies such as car crashes or domestic shootings. 16 , 17 This heightened media response may be one reason why many are terrified of these events; in 2018, Americans rated mass shootings, including school shootings, as the second most important event of the year (with the first being the economy). 18 And the impact of a school shooting may feel particularly devastating, as schools are intended to be safe spaces within which children should be able to thrive and foster their physical, social, and emotional development. The notion that schools could be the site of such violence is counter to our understanding - and expectations of - what schools can and should be. At the same time, an argument can also be made that the fear associated with the anticipation of gun violence in schools is also due to a loss of control by the victims. 19 Just as a passenger on a plane has no way of preventing a mechanical dysfunction or error by the pilot, a parent has little ability to stop a school shooting in the moment. Importantly, however, the two scenarios differ in the way society responds to them. Despite how rare plane crashes prove to be, if one occurs, there is an immediate investigation and steps are made to prevent a future occurrence with significant investments of money and research. The airline industry continues to produce safer airplanes, stricter safety regulations, and a commitment to bringing the number of the accidents to zero. This same mentality should exist with shootings in schools—they are tragedies that should not exist in modern society. Yet, the number of school mass shootings, which had been relatively consistent year-to-year since the 1999 Columbine High School mass shooting, has started to increase in incidence since 2015. 9 In fact, data indicate that more mass school shootings occurred in K-12 schools in 2017 than any other year. 9 Furthermore, the solutions to preventing a school shooting are not as straightforward as preventing a mechanical failure in a machine, as they need to consider the mental and educational well-being of children.

Harm Beyond Injury and Death

Research has confirmed that the implications of youth being exposed to gun violence - particularly a school shooting - can occur, even if no one is killed or injured. 11 For example, a significant body of work has demonstrated that the anticipation of violence more generally can lead to heightened anxiety, fear, and depression across a range of populations. 20 – 22 According to the Washington Post , well over 200 instances of gunfire in K-12 schools have occurred in the U.S. in the twenty years since the Columbine shooting in Colorado, 10 the most publicly notable being mass shooting tragedies at schools like Sandy Hook Elementary School in Connecticut and at Marjory Stoneman Douglas High School in Florida. While approximately 150 students and educators have been killed and 300 injured by mass shootings in schools, more than 236,000 students have been exposed to gun violence at their K-12 school since Columbine. 10 The number of students exposed to interpersonal gunfire in their schools per year is presented in Figure 2 . 10 This number, however, is still an underestimate of the total harm created by these events as the reactions and responses to the school mass shootings could also have negative mental health outcomes for children across the United States through anxiety of the anticipation that a shooting might take place at their school in the future.

Number of students exposed to interpersonal gunfire in the United States since the Columbine school shooting.

For example, the hundreds of thousands of students who may have avoided being physically injured by a firearm during these attacks may still experience long term mental health consequences. Any sense of security or safety in their schools—an essential component of learning 23 —can be disrupted with insecurity after these tragedies. A review by Lowe and Galea 24 published in 2017 examined forty-nine articles covering fifteen mass shootings, four of which were in K-12 settings. Among these articles, the most common psychological outcomes that were assessed and found to be elevated among this population were post-traumatic stress disorder (PTSD) and major depression, although evidence of generalized anxiety disorder, acute stress disorder, alcohol related conditions, drug use disorder, panic disorder, adjustment disorder, and anti-social personality disorder were also found to be significant in individuals’ lives who had been affected by a mass shooting. 24 Although psychological conditions were found to be more severe for those who had greater exposure (i.e. witnessing the attack or knowing a victim), those with little direct exposure to the shooting still had at least short-term mental distress of some kind following the incident. 24 And further, although this review included both adults and minors, children and teens who were exposed to these events often experienced higher rates of psychological disorders, including PTSD, in comparison to their adult counterparts. In another study, depending on the way in which they are exposed, approximately 30 to 40% of children who are exposed to a life threatening event develop symptoms of post-traumatic stress disorder. 25 In some cases, mental anguish, often fueled by survivor’s guilt and trauma, 26 can result in deaths years after the incident. For example, two Marjory Stoneman Douglas students committed suicide a little over a year after the school mass shooting, and a father of a Sandy Hook Elementary School victim committed suicide in 2019. 27 , 28

Indeed, gun violence in K-12 schools persists, with potentially devastating and traumatic implications for communities around the U.S. In the following sections we present evidence in support of several solutions at multiple levels for this endemic, while also evaluating the lack of evidence that exists for other solutions that are currently in place.

Solutions and Gaps in Evidence

Like all public health crises, the solution to the persistence of gun violence in K-12 schools will require a multifaceted and coordinated effort that draws on a wide range of evidence-informed strategies and involves multiple stakeholders. Importantly, these solutions must also consider the well-being of children in their approach. In this section we identify examples of current approaches to gun violence prevention in schools and speak to their strengths and limitations.

School-Level:

Physical security measures.

The image of a school has changed since the 1999 Columbine shooting in Littleton, CO with the implementation of security measures, such as metal detectors, armed guards, and zero-tolerance policies. 29 In 1999, less than 20% of schools had security cameras; now more than 80% do. 29 These policies also disproportionately affect schools in communities with a lower social-economic status and where the primary population are students of color—regardless of crime rates—and are one facet of the school-to-prison pipeline. 30 , 31 Unfortunately, evidence surrounding these policies is limited, and when available, conflicting. Some researchers have found that more security measures in school, such as metal detectors and armed guards, resulted in students feeling less safe compared to schools without these measures. 32 – 34 Other researchers have reported the opposite: students felt more safe with these policies, 35 or that these security measures have little effect on academic performance. 36 Furthermore, while there is evidence in support of some behavior interventions in preventing school violence, such as counseling, mentoring, and peer mediation, 38 – 40 most studies evaluating physical security policies have been inconclusive. 41 This dilemma proposes a problem: school districts are not only implementing policies that have not been proven to be effective in reducing violence, but also are doing so without knowing the mental health consequences of these measures. The lives significantly influenced by school shootings are vast and uncountable; therefore, research on the best ways to reduce harm related to these tragedies, both mental and physical, is critical.

Lockdowns and Active Shooter Drills

In the weeks before the school shooting at Sandy Hook Elementary, the school had practiced lockdown and safety procedures; in fact, it is thought that the shooter bypassed one of the first grade classrooms because the teacher had forgotten to remove black construction paper from the window of their classroom door. 1 In the years following, lockdown and active shooting drills have increased in American schools: according to the National Center for Education Statistics, nearly 95% of schools now conduct these drills. 37 These drills are meant to help students and teachers practice quickly locking the door and windows/blinds, finding cover in a classroom, and remaining quiet, and in some instances include multi-optional responses such as teaching students and educators how to create barricades, evacuate the school, and actively resist a shooter. 42 Simulation studies have shown that lockdowns, particularly multi-optional ones, may save lives. 42 But the implementation of these drills is not without controversy, as there is fear that they might by harmful for a child’s emotional and mental wellbeing, 43 can be used to the shooter’s advantage, 44 or may numb students’ reactions to if a real shooting were to occur. 45 Indeed, one survey among students between the ages of 14 and 24 found that while 56% reported that they do help to teach students what to do in case of an attack, 60% of the 815 respondents reported that while the drill made them feel “scared and hopeless.” 46 It is therefore important that these drills are implemented appropriately. For example, if the drills are well planned and the students are warned about the drill before it happens (as opposed to being surprised), some of the harm from these practices could be avoided. 47 Even so, school psychologists should be included in both the planning and aftermath of active shooter drills to prevent trauma from occurring, especially with students of younger ages. 48

Arming our teachers

The shooting at Marjory Stoneman Douglas High School in Parkland, Florida, reignited a national conversation around arming teachers with firearms. Though not a new idea, it brought this concept to the forefront of our national discourse. Unfortunately, and as recent work has illustrated, little is known about the effectiveness of arming teachers in deterring gun violence in schools, 49 including how its implementation would work. For example, many law enforcement officers receive over 800 hours of basic training, which includes 168 hours of training specifically on weapon use, self-defense tactics, and the use of force. 50 However, states that have laws aimed at arming school personnel offer significantly less training - if any - to their school staff. 49 Research also suggests that arming teachers could heighten levels of anxiety and negatively affect a school’s climate, as opposed to serving as an effective deterrence of gun violence. 51 The large majority of teachers and parents are opposed to the idea as well. A recent survey of 500 U.S. teachers found that 73 percent opposed proposals to arm school staff, 52 and a survey of parents of elementary, middle, and high school students, found that 63 percent oppose arming teachers. 53 Arming teachers would also require a contingency plan in place for all possible firearm-related scenarios (whether intentional or accidental), an understanding about the implications of this proposed effort on teacher burden and burnout, a clear sense of how this would resonate or possibly conflict with existing school policies, and an exorbitant cost investment. 49 , 54

Efforts to address early antecedents of violent behavior

The prevention of engagement in violence behavior among children - particular adolescents - has a long and complicated history. As a health crisis, gun violence in schools and its related behavioral antecedents should be addressed, not solely or primarily with punitive measures. In today’s school environment, children are often viewed as either perpetrators to be punished or as victims to be protected without building on their agency. 55 However, investing in evidence-based preventive efforts that are intended to promote critical skill development - and doing so in ways that recognize the resources and agency that children and adolescents bring to the issue - is likely a far more effective way to address both the perceived threat of gun violence and prevent the onset of violent tendencies among youth, while also promoting well-being more broadly. For example, skill-oriented initiatives with a social emotional learning (SEL) focus have been shown to help youth develop healthier coping mechanisms and improve capabilities to address and manage social anxieties, interpersonal conflict with peers and sexual partners, feelings of anger or frustration, challenges with emotion regulation, and engagement in aggressive behaviors. 56 Investing in such efforts early on in one’s developmental trajectory has the potential to be effective, as research demonstrates that experiences with violence beget more violence. 57 In line with work in developmental epidemiology 58 , 59 we anticipate that prevention strategies that reduce the onset of more minor incidents of violence among youth (hypothesized to be “early antecedents” of gun violence), in turn may prevent incidents of gun violence. Other school- and classroom-based initiatives focused on the school climate 60 – 62 and engaging parents in the school community 63 have also been shown to have an impact on reducing aggressive and violent behaviors more broadly. At the same time, work on positive youth development programs have identified short-term impacts on reducing violent outcomes, but the long-term efficacy of such efforts is not clear. 64 Indeed, much of this work has also elucidated that more research is needed to better understand the efficacy of such preventive efforts on reducing gun violence in schools. 63 But these efforts can and should be considered part of a broader menu of strategies that schools pursue as they consider how best to keep their communities safe.

Bullying and warning signs

The majority of K-12 school mass shootings are perpetrated by minors, 9 and in many incidences, research has found that bullying - both being the target or committing the bullying - is a major risk factor for committing school based violence. 65 An evaluation of fifteen mass shootings found that thirteen of the perpetrators had experienced acute or chronic rejection. 66 For example, in the case of the Sandy Hook mass shooting, the gunman had been described as “very withdrawn emotionally” and “quiet and socially awkward.” 67 In response to these commonalities between the perpetrators, Sandy Hook Promise, an organization with a mission to “create a culture engaged in preventing shootings, violence, and other harmful acts in schools,” developed the Start With Hello program and curriculum. 68 The goal of this program is to teach students to be more socially inclusive of one another, with hope that this will reduce bullying and rejection that some students might experience.

In many cases of school violence, there often are also warning signs preceding the event. A study conducted by the Secret Service and the U.S. Department of Education reviewed all targeted school violence incidents from 1974 to June 2000 and identified behavioral warning signs in 93% of the cases. 69 In 81% of the incidents, other people, often the shooter’s peers, had some knowledge of the plans. 69 In a follow-up study conducted from 2008 to 2017, researchers found that 100% of the perpetrators showed concerning behaviors, and in 77% of school shooting incidents at least one person knew about the attackers plan. 70 These numbers represent an important place for an intervention, and the Start With Hello campaign could be a first step in getting individuals the support that they need. The age-level appropriate curriculum may be effective in helping students identify possible warning signs of potential future attacks, and encourage students to feel comfortable telling an adult or mentor about these warning signs without fear of retribution for themselves or the person they are concerned for. 68

State and Federal Level:

Red flag and extreme risk protection orders.

In circumstances where the perpetrator is old enough to own a firearm, data on behavioral warning signs also suggest risk-based firearm removal laws could be an effective tool for prevention. Based on the presumption that a person’s risk for violence can fluctuate over time, these laws may prevent a firearm associated tragedy by temporarily removing the firearm from the individual. These laws, often referred to as “red flag laws” or “extreme risk protection orders”, are in effect in 19 states and the District of Columbia as of July 2020. 71 The law is specific to each state, but in most cases, law enforcement or family members may petition a court to temporarily suspend an individual’s right to possess or purchase a firearm. Current research is limited but shows promising evidence of the effectiveness of these state level risk-based firearm removal policies. Two studies evaluated these laws in Connecticut and Indiana. 72 , 73 The results were inconclusive for violence prevention but promising for suicide prevention. However, it is important to recognize that this law would not have prevented the mass shooting at Sandy Hook, and other school shootings like Sandy Hook. Most school shootings are perpetrated by minors who are often already unable to legally possess a firearm. As long as firearms are as widely accessible as they are in the United States, the effectiveness of this strategy against preventing school shootings is still unknown. Further research is needed in order to adequately assess the realities of both implementing these orders and their resulting effectiveness in addressing violence prevention.

Gun-Free Zones

In 1990, one of the most well-known instances of a federal law intended to prevent shootings in schools, the Gun-Free Zones Act of 1990, 74 was passed. The bill outlawed any individual from knowingly possessing a firearm within 1000 feet from school (public or private) grounds, with some exceptions 74 According to the National Criminal Justice Reference Service (NCJRS), the penalty for breaking this law is a fine up to $5,000 or imprisonment of up to five years. 75 This policy has become highly politicized in recent years. Just three days after the 2012 school shooting at Sandy Hook Elementary School in Newtown, Connecticut, editorials began to appear online blaming the shooting on the fact Sandy Hook Elementary was a gun-free zone. 76 While proponents of the law believe this helps to keep guns away from schools, opponents of gun-free zones believe that perpetrators may target these areas due to the belief that the victims would not be able to defend themselves as they are unarmed. Despite the controversy, there is currently no peer-reviewed evidence to the effectiveness of gun-free zones. 77

Given that the majority of school shootings are perpetrated by a minor, 9 Child Access Prevention (CAP) Laws could be an effective policy to prevent school shootings. CAP laws require that a firearm is properly stored and locked so that a child would not be able to access it. In most cases, some tragedy with a child must occur for these policies to be invoked.

The RAND Corporation has determined that there is substantial evidence that CAP laws prevent accidental shootings and suicides (the only policy to achieve a “supportive” rating), and there is some evidence that CAP laws also prevent violent crime. 78 In 2020, 29 states and the District of Columbia have implemented some form of CAP law, although the details can vary greatly by jurisdiction. With variation, fourteen states and the District of Columbia only require that the individual was negligent in storing and locking the firearm. 79 However, in the other fourteen states, there is an additional requirement that the individual recklessly endangered their child by not properly locking and storing their firearm in order to be charged. In these states, it must be proven that the individual was aware of the risks but disregarded these dangers in their failure to secure their firearm. 79 The punishments for improper storage (either negligent or reckless) can also vary in these states from a misdemeanor to a felony. 79 Therefore, the effectiveness of these laws depends on the specific state. 80

Conclusions

K-12 school shootings are exceedingly rare events in the United States, but even a single occurrence that places a child and their well-being at-risk is one too many. Schools should be spaces where students are safe, supported, and able to engage, thrive, and learn. When a school shooting occurs, the harm extends far beyond those who have been physically injured or killed and can have significant effects that impact the mental health, learning, and emotional well-being of children within the school community. There are a number of current practices and policy in place with the goal of preventing K-12 school shootings, however, these solutions must account for the well-being and developmental needs of children and ensure they are not harmful in their own ways. For example, research has illustrated that metal detectors in schools have the potential to make students feel less safe, 32 – 34 and arming teachers could increase anxiety of students and teachers alike. 49 At the same time, there are other school safety efforts (for example, behavioral threat assessments, notification technologies, and emergency preparedness drills and programs – among others), which may be effective in deterring school gun violence. Rigorous research, however, is needed to evaluate the effectiveness of these kinds of tactics independently and, perhaps more importantly, in tandem and as part of a school’s larger safety plan.

Additionally, some evidence suggests that investing in the implementation of positive youth development programs, increased access to comprehensive mental health care for children, and/or implementing anti-bullying and inclusion programs ought to be part of a broader and long-term vision for gun violence prevention. Given the critical role schools play in shaping a child’s development, schools have the potential to address early antecedents of violence behavior and investing in this kind of evidence-based programming for students could be an important component without waiting for new laws to be passed. 81 Lastly, and from a policy perspective, the evidence is clear that the passing of specific laws intended to prevent school shootings and other types of gun violence should be a goal—CAP laws, for example, have been shown to be effective at preventing children from accessing firearms. 78 When taken together, this multi-level approach has enormous potential to effectively prevent school shootings and foster the long-term well-being of children.

References:

New study of gun violence in schools identifies long-term harms

The most comprehensive analysis to date of American children who experience gun violence at school finds that they have higher rates of school absenteeism, lower high school and college graduation rates, and earn lower incomes by their mid-twenties.

The study, posted as an  NBER working paper  on Monday and co-authored by  Maya Rossin-Slater , a SIEPR faculty fellow and assistant professor of medicine, shows that students at schools where a shooting occurs — including incidents in which a gun is fired, but no one is physically injured or killed — face lasting negative consequences. On average, shooting-exposed students are:

• More likely to be chronically absent from school and repeat a grade.
• Less likely to graduate high school, enroll in college, or earn a bachelor’s degree.
• Less likely to hold a job as young adults.

Moreover, by the ages of 24 to 26, those who attended a school where a shooting occurred earn 13.5 percent less compared to same-age individuals who attended similar schools and to cohorts who attended the same schools in years before the shooting took place. The researchers estimate that this reduction in earnings amounts to a loss in lifetime income of $115,550 per shooting-exposed student.

Rossin-Slater says the study, which analyzes all Texas public schools that experienced a shooting over the past two decades, shines a light on how pervasive and harmful the effects of gun violence are.  The results show that the adversity is universal, cutting across race, ethnicity, gender, and socioeconomic status.

“Attention in the media on gun violence in schools tends to focus on the mass, indiscriminate, horrific events like Sandy Hook and Parkland and the victims, their families and friends,” Rossin-Slater says. “But there are many more shootings that take place at American schools in which nobody dies. Our research shows that children exposed to these shootings nevertheless experience massive disruptions in their learning and later economic well-being.”

According to Rossin-Slater, who is also a core faculty member at  Stanford Health Policy , research on school shootings to date has largely focused on short-run impacts using average outcomes at the state or school level. Hers is one of the first studies to use large-scale individual-level data and follow students into early adulthood.

It also offers new evidence for policy debates on gun violence in the United States. Viewed through fatality rates alone, school shootings represent only a small fraction of the country’s gun violence fallout even as they have become more frequent. But this research and other recent studies show that the damage is much bigger than the death toll — and that school shootings represent a particularly harmful type of gun violence because of their long-run impacts on surviving students.

“When there’s a school shooting, you don’t just have one child in a classroom who has experienced violence, maybe at home or in their neighborhood,” Rossin-Slater says. “The negative impacts of gun violence get amplified because now you can have an entire classroom or grade cohort of trauma-affected children.”

First analysis of long-term impacts

More than 20 years after the Columbine High School massacre, the number of school shootings in the United States has more than doubled. In their paper, Rossin-Slater and her co-authors estimate that, in 2018 and 2019 alone, more than 100,000 American children attended a school where a shooting took place.

Prior studies on the effects of school shootings have shown that they have negative impacts on children’s mental well-being. Last year, for example, Rossin-Slater, whose broader research agenda examines how public policies and other factors impact child health and well-being, co-authored a study that found a 21 percent increase in antidepressant use among youth under age 20 in local communities where fatal school shootings occurred in the prior two years.

Much of the existing research on educational outcomes has relied on data at the state, district and school levels, and finds that shootings tend to lower test scores and enrollment. While useful, the results can be difficult to interpret, Rossin-Slater says. 

“We can’t always know, for example, whether the effects are universal or perhaps driven by a small subgroup of students,” she says. “We also don’t know much about the longer-term implications of shootings on children’s well-being.”

Her latest study breaks new ground on a few fronts. Along with Marika Cabral and Bokyung Kim from the University of Texas at Austin, and Molly Schnell and Hannes Schwandt from Northwestern University, Rossin-Slater collected and analyzed data on individual students’ educational and economic trajectories through age 26. 

They did this by linking several datasets, including detailed student-level records on all public K-12 students in Texas with information about school staff, records on all individuals enrolled in Texas public colleges and universities, as well as employment and earnings records for all Texas residents. They study the 33 public schools in Texas where shootings occurred between 1995 and 2016.

The team’s findings are troubling. In the first two years after a school shooting, students are more likely to be chronically absent from school and to repeat a grade. To study longer-term outcomes, the team analyzed shootings that took place in high schools. 

They found that students who were sophomores and juniors at the time of the incident were 3.7 percent less likely to graduate high school; 9.5 percent less likely to enroll in any college; 17.2 percent less likely to enroll in a 4-year college; and 15.3 percent less likely to obtain a bachelor’s degree by age 26.

Meanwhile, students who were in grades 9 to 11 when the shooting occurred were 6.3 percent less likely to be employed between the ages of 24 and 26. They also earned about $2,780 — or 13.5 percent — less than students who attended similar schools and students who attended the same schools in the years before the shooting occurred. This effect translates into a $115,550 loss in lifetime earnings per shooting-exposed student.

The researchers report additional findings. For example, while the adverse impacts are universal, the researchers find some evidence that non-Hispanic Black students and those who receive free or reduced price lunches experience larger increases in chronic absenteeism and grade repetition. They also analyzed whether students change schools in the years after a shooting, but do not find any evidence suggesting that they do. 

Using data on school staffing, the researchers also find that the presence of mental health professionals on campus — including school counselors and psychologists — does not mediate the adverse impacts of a shooting. Rossin-Slater says that further research is needed to understand how school resources may be used to help undo some of the harm of exposure to shootings.

Potential pandemic fallout

Rossin-Slater says that the research shows that policy discussions about the costs of gun violence should not only focus on the fatalities, but also account for the large costs of exposure to violence on children’s long-term educational and economic trajectories. Though the number of deaths on school campuses is low when compared to deaths from gun violence in other places, the damage for those exposed is far-reaching. “Schools,” she says, “turn out to be particularly bad settings for this type of violence.”

The COVID-19 pandemic makes this awareness even more urgent, says Rossin-Slater. While widespread school closures have diminished the frequency of gun violence on school campuses, the mental health effects of the crisis could ultimately lead to more violence when students return to in-person learning, she says.

“In a country in which guns are generally available, gun violence can be easily triggered by mental health issues and economic disadvantages,” Rossin-Slater says. “The pandemic has generated adversity on both fronts, and while we should be happy when kids are back to learning in school, it’s also critical to pay a lot of attention to their mental well-being and their economic circumstances. We urgently need policies that can prevent gun violence from occurring at schools in the first place, and if and when it does occur, we need to make sure to provide resources to students who are at school when it happens.”

Marika Cabral, Molly Schnell and Hannes Schwandt were academic visitors in residence at SIEPR during the 2018-19 academic year, where they began working with Rossin-Slater.  The collaboration among Rossin-Slater, Schnell and Schwandt on the impact school shootings have on antidepressant use is showcased in  this video series . 

Krysten Crawford is a freelance writer

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Study Quantifies Dramatic Rise in School Shootings and Related Fatalities Since 1970

Researchers find likelihood of children being a school shooting victim quadrupled since 1970, and offer preventative steps.

March 6, 2024

Key Takeaways

• Incidence of school shootings increasing dramatically: In the 53 years leading up to May 2022, the number of school shootings annually increased more than 12 times.
• Children more likely to be victims. The likelihood of children being school shooting victims has increased more than fourfold, and the rate of death from school shootings has risen more than sixfold.
• A total of 2,056 school shooting incidents were analyzed: The incidents involved 3,083 victims, including 2,033 children ages 5-17 years, and 1,050 adults ages 18-74 years.

CHICAGO: The incidence of school shootings more than quadrupled over the past 53 years, according to a new study analyzing data from the Center for Homeland Defense and Security (CHDS). To curtail the trend and help prevent future school shootings, researchers offered five key steps to address the problem through a public health approach.

The study, published in the Journal of the American College of Surgeons (JACS) , analyzed 2,056 school shooting incidents involving 3,083 victims in a period ending in May 2022, including 2,033 children ages 5-17 and 1,050 adults ages 18-74.

Key Study Findings Include:

• The number of school shootings annually has increased from 20 incidents in 1970 to 251 in 2021.Victims and shooters were predominantly male—77% and 96%, respectively.
• Nearly two-thirds of the shooters were under the age of 17 years.
• Handguns were by far the most common weapon used in school shootings, accounting for 84%, followed by rifles (7%) and shotguns (4%).
• Rifles were the deadliest weapon, with a fatality-to-wounded ratio of 0.45 vs. 0.41 for shooters using multiple weapons, 0.35 for handguns, and 0.30 for shotguns.
• From 1970 to 2021, the rate of children being school shooting victims more than quadrupled, from 0.49 to 2.21 per 1 million population. Deaths increased more than sixfold, from 0.16 to 0.97 per 1 million population.
• California had the most school shootings (214), followed by Texas (176), and Florida (120). However, the District of Columbia had the highest rate of school shootings per 100 schools (5.5), followed by Delaware (5.4), and Louisiana (4.6).

“As trauma surgeons, we're tasked with caring for these shooting victims, and as such, we hoped, through our study we would be able to reveal and acknowledge an ongoing public health epidemic, not just with firearm violence in general, but school shootings specifically,” said lead study author Louis J. Magnotti, MD, MS, FACS, professor of surgery and a trauma surgeon at the University of Arizona College of Medicine in Tucson. The study raises the issue of how children gain access to firearms. “This underscores the necessity of responsible ownership and proper education and training for all firearm owners,” Dr. Magnotti said. “Policymakers need to address these issues by focusing on improving knowledge of secure firearm storage amongst parents, educating the school community about potential risks, and engaging in programs and policy discussions concerning strategies to limit youth access to guns.”

The study notes five key steps to a public health approach to prevent school shootings:

• Defining and monitoring school shootings
• Implementing preventative interventions
• Identifying factors that pose risks or offer protection
• Testing the effectiveness of interventions
• Ensuring widespread adoption of the most successful approaches

“Firearm violence is a public health crisis and it needs to be addressed,” Dr. Magnotti said. “By applying this approach, we can focus our efforts on minimizing the impact of firearm violence.”

The study also suggests that preventative initiatives should incorporate recommendations for safe firearm storage from the American College of Surgeons Committee on Trauma (ACS COT) Firearm Strategy Team (FAST).

“This is an important paper because it documents the significant increase in school shootings over the past five decades. Not only have school shootings increased, but fatalities have increased even more than the number of shootings,” said Ronald M. Stewart, MD, FACS, chair of the department of surgery at University Hospital, San Antonio, Texas, who wasn’t involved with the study. “Although there are limits to the data set used in this study – it doesn't subclassify the events or the type of firearm used – this is important research that reports on data collected in a standardized process over a long period of time.”

Study co-authors are Bellal Joseph, MD, FACS; Hamidreza Hosseinpour, MD; Tanya Anand, MD, MPH, FACS; Christina M. Colosimo, DO, MS; Adam C. Nelson, MD, FACS; Collin Stewart, MD, FACS; Audrey L. Spencer, MD; and Bo Zhang, MD, of the Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona; and Joseph Sakran, MD, MPH, FACS, of the Division of Acute Care Surgery, Johns Hopkins Hospital, Baltimore.

The findings were first presented December 2023 at the Southern Surgical Association 135th Annual Meeting in Hot Springs, Virginia.

Disclosure Information: Dr. Sakran is chair of the board and chief medical officer of Brady United.

The study is published as an  article in press  on the  JACS  website.

Citation: Joseph B, Hosseinpour H, Sakran, J. Defining the Problem: 53 Years of Firearm Violence Afflicting America’s Schools. Journal of American College of Surgeons , 2024 . DOI: 10.1097/XCS.0000000000000955

About the American College of Surgeons

The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has approximately 90,000 members and is the largest organization of surgeons in the world. "FACS" designates that a surgeon is a Fellow of the American College of Surgeons.

• Dan Hamilton | 312-202-5328
• Sheila Lai | 312-202-5403
• Email: [email protected]

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Youth Responses to School Shootings: a Review

• Child and Family Disaster Psychiatry (B Pfefferbaum, Section Editor)
• Published: 19 May 2018
• Volume 20 , article number  47 , ( 2018 )

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• Áine Travers 1 ,
• Tracey McDonagh 1 &
• Ask Elklit 1  

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Purpose of Review

This paper aims to synthesize research relating to youth responses to school shootings between 2014 and 2017. The main questions it addresses are how such events impact young people psychologically, and what risk or protective factors may contribute to different trajectories of recovery?

Recent Findings

Recent research suggests that most young people exposed to school shootings demonstrate resilience, exhibiting no long-term dysfunction. However, a minority will experience severe and chronic symptoms. The likelihood of experiencing clinically significant reactions is influenced by pre-trauma functioning as well as peri-traumatic and post-traumatic factors. These include proximity to the trauma, peri-traumatic dissociation, post-traumatic emotional regulation difficulties, social support, and flexibility of coping styles.

Research that separates the distinguishing features of young people with differing recovery styles is vital to tailor intervention. But methodological and design issues associated with such research necessitates caution in drawing conclusions. Variation in definitions and measures and the self-report nature of many of the studies are potential sources of bias. Greater uniformity across designs would enhance confidence and allow for improved evidence-based intervention.

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Effects of Mass Shootings on the Mental Health of Children and Adolescents

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How school shootings hurt student achievement and enrollment

This updated collection of research suggests student achievement falls after school shootings and enrollment drops as some families move away.

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This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License .

by Denise-Marie Ordway, The Journalist's Resource March 28, 2023

This <a target="_blank" href="https://journalistsresource.org/education/school-shootings-student-achievement/">article</a> first appeared on <a target="_blank" href="https://journalistsresource.org">The Journalist's Resource</a> and is republished here under a Creative Commons license.<img src="https://journalistsresource.org/wp-content/uploads/2020/11/cropped-jr-favicon-150x150.png" style="width:1em;height:1em;margin-left:10px;">

This collection of research on U.S. school shootings, originally published in February 2018 and updated in December 2021, has been updated again with new data and research on how these violent events affect student achievement and campus enrollment.  

Ten people died and another 13 have been injured in U.S. school shootings so far this year , Education Week’s 2023 School Shooting Tracker shows.

On March 27, three 9-year-olds and three adult staff members were  killed at The Covenant School in Nashville, Tennessee. It’s the deadliest school shooting since May 2022, when an 18-year-old former student gunned down 19 children and two teachers at Robb Elementary School in Uvalde, Texas .

As journalists rush to collect facts, they try to put these events into context, focusing, for example, on questions about gun policies and how the communities involved are grappling with their loss.

Long after news crews leave, though, those who witnessed these tragedies will bear their consequences. Extensive research suggests that exposure to violence can hurt children’s health and well-being for years into the future. It also can desensitize them — violence, in their eyes, becomes an acceptable way to handle problems, researchers explain.

Below, we’ve pulled together research that looks at other consequences that might seem less obvious to reporters covering school shootings. These studies offer insights into how student academic performance and enrollment can fall following a mass shooting on campus.

Toward the bottom of this piece, you’ll find other resources we think you’ll find helpful, including a guide on interviewing children from the national Education Writers Association and an explainer on firearm technology and vocabulary from Columbia University’s Dart Center for Journalism & Trauma. __________

The Effects of Campus Shootings on School Finance and Student Composition Lang “Kate” Yang and Maithreyi Gopalan. Education Finance and Policy, March 2023.

This paper, based on an analysis of shootings at U.S. public schools between 1999 and 2018, provides “the first causal estimates of campus shootings on [school] district finance, staffing, and student composition on a national scale,” the researchers write.

The main takeaways:

• School shootings were associated with increased spending — an additional $248 per student, on average. Schools spent this money primarily on capital projects such as building repairs and security upgrades and on student support services such as mental health and psychological services.
• The federal government paid for most of these new costs. “While campus shootings are localized events, the costs are shared by all taxpayers as federal transfers provide the main source of funding increases.”
• Enrollment dropped after a school shooting as higher-income families left the area. “The exiting effect is not confined to the public school system either,” Yang and Gopalan write. “After shootings occur on public school campuses, enrollments drop among private schools located within the public school district boundary.”
• The average number of teachers per 100 students did not change after shootings, confirming prior research indicating “shootings do not lead to a crowd-out of instructional resources.” The number of guidance counselors rose temporarily, during the first year or two after a shooting.

Trauma at School: The Impacts of Shootings on Students’ Human Capital and Economic Outcomes Marika Cabral, Bokyung Kim, Maya Rossin-Slater, Molly Schnell and Hannes Schwandt. National Bureau of Economic Research working paper, revised May 2022.

Researchers studied public school shootings in Texas to gauge their impact on students’ education and future job earnings. They focus on the 33 shootings that took place on school grounds during school hours between 1995 and 2016.

The analysis reveals:

• Children who attended public schools where a shooting occurred were, on average, 1.8 percentage points more likely to be chronically absent than kids at similar schools that had no shootings. Students exposed to school shootings were 1.3 percentage points more likely to repeat a grade, on average.
• Students who were sophomores or juniors when a shooting occurred at their high school were 2.9 percentage points less likely to graduate high school when compared with students in the same grades who attended similar schools without shootings. They were 5.5 percentage points less likely to enroll in a four-year college, on average.
• Students exposed to a school shooting in grades 9, 10 or 11 were 4.4 percentage points less likely to have jobs when they reached the age of 24 to 26, and their lifetime earnings were projected to be lower. “ Our estimates imply a $115,550 reduction (in 2018 dollars) in the present discounted value of lifetime earnings per shooting-exposed student,” the researchers write.

Exposure to a School Shooting and Subsequent Well-Being Phillip B. Levine and Robin McKnight. National Bureau of Economic Research working paper, December 2020.

Student test scores fell and chronic absenteeism rose, especially among boys, at public elementary schools across Newtown, Connecticut, after a massacre at Sandy Hook Elementary School in 2012, according to this analysis.

The researchers examined student test scores at 14 elementary and middle schools in the U.S. that experienced fatal shootings between 2009 and 2016. One person died in each of those shootings, except for at Sandy Hook Elementary, where 20 first-graders and 6 educators were killed. The researchers also looked at changes in chronic absenteeism, or the proportion of children who missed more than 10% of school days in a given academic year.

What Levine and McKnight learned: As a whole, the 14 public schools did not see changes in test scores or absentee rates for boys or girls. But when they looked specifically at the scores of third- and fourth-graders in Newtown, Connecticut, between 2008 and 2018, they found that student performance dropped across elementary schools after the shooting at Sandy Hook Elementary.

“At Sandy Hook, test results fell dramatically after the shooting,” they write. “Results rebounded somewhat over time as the affected cohorts aged out of the school. At other Newtown elementary schools, these data suggest that test scores fell as well, suggesting a broad impact within the district.”

Chronic absenteeism spiked.

“Chronic absenteeism at Sandy Hook Elementary more than doubled in the year after the shooting,” the researchers write. “It also increased at other elementary schools in the district, although to a lesser extent.”

The Relationships Between Violence in Childhood and Educational Outcomes: A Global Systematic Review and Meta-analysis Deborah Fry, Xiangming Fang, Stuart Elliott, Tabitha Casey, Xiaodong Zheng, Jiaoyuan Li, Lani Florian and Gillean McCluskey. Child Abuse & Neglect, January 2018.

This research article examines dozens of studies from 21 countries to understand the relationship between different types of violence in childhood and a range of education-related outcomes such as academic performance, absenteeism and graduation and dropout rates. The study finds that all types of childhood violence have an impact. For example, children who experience physical violence are 20% less likely to graduate. Children who experience any type of violence are less likely to earn high grades and test scores.

The Effect of Community Traumatic Events on Student Achievement: Evidence from the Beltway Sniper Attacks Seth Gershenson and Erdal Tekin. Education Finance and Policy, May 2017.

This study looks at how traumatic events such as mass shootings affect the performance of students living in the community where the events occurred. Gershenson and Tekin focused specifically on how elementary school students in Virginia performed on standardized tests after the “Beltway Sniper” attacks of 2002. “The main results indicate that the attacks significantly reduced school-level proficiency rates in schools within five miles of an attack. Evidence of a causal effect is most robust for math proficiency rates in the third and fifth grades, and third grade reading proficiency, suggesting that the shootings caused a decline in school proficiency rates of about 2% to 5%. Particularly concerning from an equity standpoint, these effects appear to be entirely driven by achievement declines in schools that serve higher proportions of racial minority and socioeconomically disadvantaged students.”

The Effect of High School Shootings on Schools and Student Performance Louis-Philippe Beland and Dongwoo Kim. Educational Evaluation and Policy Analysis, March 2016.

This study suggests that high schools where fatal shootings have occurred experience a 5.8% drop in freshmen enrollment, on average, following the event. The researchers also examined standardized test scores in California and found that scores in math and English declined for students who remain enrolled after the shooting. Beland and Kim did not find statistically significant impacts on graduation or suspension rates or student attendance.

School Shootings and Private School Enrollment Rahi Abouk and Scott Adams. Economics Letters, February 2013.

This study finds that school shootings increase enrollment at private high schools, particularly in suburban and rural areas. Abouk and Adams looked at enrollment at public and private high schools nationwide between 1998 and 2009 and matched that data with school shooting reports. Private school enrollments increased an estimated 9.7% to 11.6% in the academic year immediately following a shooting. Meanwhile, public school enrollment fell an estimated 0.4% to 1.3%. “Parents overestimate the potential for such events to be repeated, particularly those that occur in suburban and rural areas, because of intense media coverage,” the authors write.

Other resources:

• The U.S. Centers for Disease Control and Prevention’s WONDER database provides data on causes of death by age, year and census region. In 2020, firearm-related injuries became the leading cause of death among youth aged 1 to 19 years.
• Our tip sheet, “ Trauma-Informed Journalism: What It Is, Why It’s Important and Tips for Practicing It ,” offers guidance on interviewing  individuals who have experienced trauma and helping them tell their stories.
• The Education Writers Association created a tip sheet on covering school shootings and a guide on interviewing children .
• Another one of our tip sheets, “ 7 Things Journalists Should Know About Guns, ” briefs journalists on basic terminology and warns them about some of the pitfalls of covering gun issues.
• Columbia University’s Dart Center for Journalism & Trauma offers a range of resources for covering mass shootings, including an explainer on firearm technology and vocabulary .

Photo by Fabrice Florin obtained from Flickr and used under a Creative Commons license.

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Five Facts About Mass Shootings in K-12 Schools

Preventing mass shootings in the United States, particularly those occurring in school settings, is an important priority for families, government leaders and officials, public safety agencies, mental health professionals, educators, and local communities. What does the evidence say about how to detect, prevent, and respond to these tragic events? Here’s what we’ve learned through NIJ-sponsored research: [1]

1. Most people who commit a mass shooting are in crisis leading up to it and are likely to leak their plans to others, presenting opportunities for intervention.

Before their acts of violence, most individuals who carry out a K-12 mass shooting show outward signs of crisis. Through social media and other means, they often publicly broadcast a high degree of personal instability and an inability to cope in their current mental state. Almost all are actively suicidal.

Case studies show that most of these individuals engage in warning behaviors, usually leaking their plans directly to peers or through social media. [2] Yet most leaks of K-12 mass shooting plans are not reported to authorities before the shooting.

Research shows that leaking mass shooting plans is associated with a cry for help. [3] Analyses of case reports from successfully averted K-12 mass shootings point to crisis intervention as a promising strategy for K-12 mass shooting prevention. [4] Programs and strategies found to prevent school shootings and school violence generally could hold promise for preventing school mass shootings as well.

2. Everyone can help prevent school mass shootings.

Most individuals who carry out a K-12 mass shooting are insiders, with some connection to the school they target. Often, they are current or former students.

Research suggests that communities can help prevent school mass shootings by working together to address student crises and trauma, recognizing and reporting threats of violence, and following up consistently.

Two-thirds of foiled plots in all mass shootings (including school mass shootings) are detected through public reporting. Having a mechanism in place to collect information on threats of possible school violence and thwarted attempts is a good first step.

The School Safety Tip Line Toolkit is one resource to consider for developing and implementing a school tip line. [5] The Mass Attacks Defense Toolkit details evidence-based suggestions for recognizing warning signs and creating collaborative systems to follow up consistently in each case. [6] The Averted School Violence Database enables schools to share details about averted school violence incidents and lessons learned that can prevent future acts of violence. [7]

3. Threat assessment is a promising prevention strategy to assess and respond to mass shooting threats, as well as other threats of violence by students.

For schools that adopt threat assessment protocols, school communities are educated to assess threats of violence reported to them. [8] Threat assessment teams, including school officials, mental health personnel, and law enforcement, respond to each threat as warranted by the circumstances. An appropriate response might include referral of a student to mental health professionals, involvement of law enforcement, or both.

Emphasizing the mental health needs of students who pose threats can encourage their student peers to report on those threats without fear of being stigmatized as a “snitch.” In an evaluation study, educating students on this distinction increased their willingness to report threats. [9]

Many educational and public safety experts agree that threat assessment can be a valuable tool. But an ongoing challenge for schools is to implement threat assessment in a manner that minimizes unintended negative consequences. [10]

4. Individuals who commit a school shooting are most likely to obtain a weapon by theft from a family member, indicating a need for more secure firearm storage practices.

In an open-source database study, 80% of individuals who carried out a K-12 mass shooting stole the firearm used in the shooting from a family member. [11] In contrast, those who committed mass shootings outside of schools often purchased guns lawfully (77%).

K-12 mass shootings were more likely to involve the use of a semi-automatic assault weapon than mass shootings in other settings, but handguns were still the most common weapon used in K-12 mass shootings.

Explore more information about the backgrounds, guns, and motivations of individuals who commit mass shootings using The Violence Project interactive database. [12]

5. The overwhelming majority of individuals who commit K-12 mass shootings struggle with various aspects of mental well-being.

Nearly all individuals who carried out a K-12 mass shooting (92%-100%) were found to be suicidal before or during the shooting. [13] Most experienced significant childhood hardship or trauma. Those who commit K-12 mass shootings commonly have histories of antisocial behavior and, in a minority of cases, various forms of psychoses.

Despite the prevalence of mental well-being struggles in these individuals’ life histories, studies suggest that profiling based on mental health does not aid prevention. [14] However, research on common psychological factors associated with K-12 mass shootings, along with other factors that precipitate school violence, can help inform targeted intervention in coordination with crisis intervention, threat assessment, and improved firearm safety practices.

Learn more from these NIJ reports:

• Understanding the Causes of School Violence Using Open Source Data
• A Multi-Level, Multi-Method Investigation of the Psycho-Social Life Histories of Mass Shooters
• The Causes and Consequences of School Violence: A Review
• A Comprehensive School Safety Framework: Report to the Committees on Appropriations

[note 1] National Institute of Justice funding award description, “Student Threat Assessment as a Safe and Supportive Prevention Strategy,” at the Rector & Visitors of the University of Virginia, award number 2014-CK-BX-0004 ; National Institute of Justice funding award description, “Understanding the Causes of School Violence Using Open Source Data,” at the Research Foundation of the City University of New York, award number 2016-CK-BX-0013 ; National Institute of Justice funding award description, “Mass Shooter Database,” at Hamline University, award number 2018-75-CX-0023 , and National Institute of Justice funding award description, “Improving the Understanding of Mass Shooting Plots,” at the RAND Corporation, award number 2019-R2-CX-0003 .

[note 2] Meagan N. Abel, Steven Chermak, and Joshua D. Freilich, “ Pre-Attack Warning Behaviors of 20 Adolescent School Shooters: A Case Study Analysis ,” Crime & Delinquency 68 no. 5 (2022): 786-813.

[note 3] Jillian Peterson et al., “ Communication of Intent To Do Harm Preceding Mass Public Shootings in the United States, 1966 to 2019 ,” JAMA Network Open 4 no. 11 (2021): e2133073.

[note 4] Abel, Chermak, and Freilich, “Pre-Attack Warning Behaviors”; and Jillian Peterson and James Densley, The Violence Project: How To Stop a Mass Shooting Epidemic (New York: Abrams Press, 2021).

[note 5] Michael Planty et al., School Safety Tip Line Toolkit , Research Triangle Park, NC: RTI International.

[note 6] RAND Corporation, “ Mass Attacks Defense Toolkit: Preventing Mass Attacks, Saving Lives ."

[note 7] National Police Foundation, Averted School Violence (ASV) Database: 2021 Analysis Update , Washington, DC: U.S. Department of Justice, Office of Community Oriented Policing Services.

[note 8] Dewey Cornell and Jennifer Maeng, “ Student Threat Assessment as a Safe and Supportive Prevention Strategy, Final Technical Report ,” Final report to the National Institute of Justice, award number 2014-CK-BX-0004, August 2020, NCJ 255102.

[note 9] Shelby L. Stohlman and Dewey G. Cornell, “ An Online Educational Program To Increase Student Understanding of Threat Assessment ,” Journal of School Heath 89 no. 11 (2019): 899-906.

[note 10] Cornell and Maeng, “Student Threat Assessment.”

[note 11] Jillian Peterson, “ A Multi-Level, Multi-Method Investigation of the Psycho-Social Life Histories of Mass Shooters ,” Final report to the National Institute of Justice, award number 2018-75-CX-0023, September 2021, NCJ 302101.

[note 12] The Violence Project, “ Mass Shooter Database .”

[note 13] Peterson, “A Multi-Level, Multi-Method Investigation.” 14Dewey G. Cornell, “ Threat Assessment as a School Violence Prevention Strategy ,” Criminology & Public Policy 19 no. 1 (2020): 235-252.

[note 14] Dewey G. Cornell, “Threat Assessment as a School Violence Prevention Strategy,” Criminology & Public Policy 19 no. 1 (2020): 235-252, https://doi.org/10.1111/1745-9133.12471.

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The mental health effects of school shootings.

After a school shooting, students’ prescriptions for mental health conditions spike and remain high for years

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Until we can prevent school shootings from happening, we need to recognize—and work to mitigate—the impacts that these events are having on the mental health of American youth.”

Molly Schnell IPR economist

School shootings not only cost communities the lives of students and educators, but these devastating events can leave surviving students traumatized. 

A new study finds that the use of prescription drugs to treat mental health conditions, including depression and anxiety, increased by over 25% among youth living near fatal school shootings. Five and a half years later, the use of these medications remained high.

Conducted by IPR economists Molly Schnell and Hannes Schwandt  co-authored with Northwestern graduate student Max Pienkny and Stanford professor Maya Rossin-Slater, the study points to the ways school shootings continue to affect students’ mental health years later. Prescriptions peaked three and a half years after the shootings and then stayed elevated for another year and a half.

The study builds on previous research by Schnell, Schwandt, and Rossin-Slater showing that youth antidepressant use increased by over 20% in the two years following fatal school shootings. Other research by Schnell and Schwandt and additional collaborators reveals that students who experienced a school shooting were less likely to graduate college and be employed by their early 20s—quantifying the long-term damage of gun violence.

The researchers looked at 15 fatal school shootings that occurred between February 2008 and January 2013 tracked by the Washington Post’s school shootings database . Using data from the IQVIA Longitudinal Prescription Data (LRx) database from 2006 to 2018, they compared prescriptions written in a 5-mile radius of a school where a shooting occurred to those written in an area 10 to 15 miles away.

They focused on antidepressant, antipsychotic, and antianxiety medications—often used in the treatment of trauma—for patients between 5 and 19 years old at the time of a shooting. Antidepressants accounted for 57% of the increase in prescriptions, 36% came from antipsychotics, and 6% were from antianxiety medications.

“What surprised us the most was how persistent the effects are,” Schwandt said. “We can follow children for over five years and essentially find no evidence of a fading of the initial mental health effects.”

The researchers saw a particularly sharp jump in medication use among children and teenagers who weren’t previously taking any psychotropic prescriptions. 

While the researchers note that it’s unlikely that the average American student will attend a school where a shooting occurs, the fear of experiencing this kind of event could contribute to teenagers’ rising mental health issues. Shooter drills at school and media coverage of shootings at other schools might heighten students’ stress and anxiety. 

“Until we can prevent school shootings from happening, we need to recognize—and work to mitigate—the impacts that these events are having on the mental health of American youth,” Schnell said. 

The evidence also highlights how essential policies are that support survivors of school shootings.

“Policies in the aftermath of shootings need to focus on the survivors who face long-term mental health consequences in response to these tragic events,” Schwandt said. “The long-term costs of shootings that we uncover also provide additional reasons to invest in measures that reduce the risk of school shootings.”

He says an important area of research is how to get mental health services to students, such as through school-based health centers. Disadvantaged students can especially benefit from these types of services. Schnell, Schwandt, Pienkny, and their co-authors are currently studying how school-based health centers can help students recover from traumatic events and improve their wellbeing and academic performance.

Molly Schell is assistant professor of economics and Hannes Schwandt is associate professor of human development. Both are IPR fellows.

Photo credit: iStock

Published: August 14, 2024.

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Why do school shootings keep happening in the United States?

Vcu homeland security expert william v. pelfrey jr. answers this question and more., share this story.

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By Joan Tupponce

The first thought that raced through William Pelfrey Jr.’s mind when he heard the breaking news about the school shooting at Robb Elementary School in Uvalde, Texas, was typical of any parent with young kids.

“It made me want to get into my vehicle and drive to their schools,” said Pelfrey, Ph.D., an expert in the field of homeland security, terrorism and radicalization and a professor of homeland security/emergency preparedness and criminal justice in the L. Douglas Wilder School of Government and Public Affairs at Virginia Commonwealth University. “From a professional perspective, it reminded me there are too many people with guns, the wrong people with guns and that nothing is going to change.”

Guns are now the leading cause of death among children and adolescents in the U.S., according to the Centers for Disease Control and Prevention. No other developed economy has as many violent firearm deaths as the U.S., according to the Institute for Health Metrics and Evaluation.

“School shootings happen in the U.S. at an alarming rate, but they rarely happen elsewhere in the world. Eighty or 90 percent of all the school shootings in the world happen in the U.S. They are concentrated here,” Pelfrey said.

How did the U.S. get to this point and what can be done? Pelfrey fields those questions and more with VCU News.

Why does this keep happening?

It’s a simple question, but the answers are extremely complicated. There are some political overtones to it. Guns are ubiquitous in the U.S. There are more guns than people. The U.S. population is about 334 million and the number of guns in the U.S. is more than 390 million (according to a report by the Small Arms Survey, a Geneva-based organization). We have the highest civilian gun ownership in the world by a huge margin. That’s an extraordinary number relative to the rest of the world. The next countries that have as many guns are war-torn countries like Serbia or Yemen.

Another element is school safety is not as high as it should be. It’s easy to maintain basic school safety but not everybody does a good job of that.

A third element is social media, a component that revolves around how people make it OK on social media to act on violence. There is a faction of government, particularly a right-wing government element, that condones or encourages violence. They do so in an oblique way saying something like, “Our country is under threat. We have to stand up and protect our country. We need to take up arms to defend our country, our way of life.” When you do that, you are condoning acts that are dangerous. The U.S. border is populated by a lot of citizens who have dubbed themselves border protection and they stand at the border with guns waiting for someone to illegally cross the border and they take them into custody even though they are not law enforcement.

How do you categorize mass shootings?

Some are artifacts of bullying. A victim of bullying decides they are going to respond with extreme violence, and it’s usually not against their perpetrators. It’s a show of force to demonstrate they won’t be bullied again. They can stand up for themselves. That describes Sandy Hook and Columbine and some other shootings.

The second category of mass shootings is domestic terrorism. Those people had been self-radicalized on social media and believe their actions represent a higher good. What they are doing is for a bigger purpose than themselves. They are willing to die, almost like a suicide terrorist, to further the goals of the theology they support.

A lot of people don’t fit into either category. The mass shooting era began with Charles Whitman in 1966 when he climbed a bell tower at the University of Texas and started shooting people. He did that because he had a tumor in his brain. There was no kind of pattern, but it created a behavioral matrix that has been followed by any number of people in the U.S.

How easy is it to buy a gun?

In the U.S., you can walk into a gun store and buy as many assault rifles as you want if you have cash and are over 18 and you meet just a couple of other loose criteria. Guns are so easily obtained that it’s easy to commit violent crime. We don’t do a good job in our criminal justice system of prohibiting people that probably shouldn’t have them from securing guns.

In most countries there are tests you have to take. You have to demonstrate you need a gun for a specific reason. You have to pass a gun ownership exam to show you can use it safely. You have to maintain license requirements. We don’t do any of that in the U.S. We are going the other way. Texas last year made it easier for people to get a gun in what was already an incredibly permissive state.

What types of guns are especially dangerous to own?

Assault weapons — assault rifles and assault pistols. We don’t track who buys them. You go into a gun store and buy a gun. A criminal background check is run, but no one keeps track of what you bought or how much you paid for it or what you do with it when you walk out the door. You could buy 20 assault rifles, drive to Washington, D.C., and sell them and nobody knows it because there is no reporting mechanism to identify that you sold the guns.

It is a crime to sell a gun to a convicted felon or to take them out of state to sell. But our penalties are so lax that it’s not a deterrent. A straw buyer is a person who buys guns legally and then illegally sells them for profit. There are a small number of gun stores that welcome straw buyers and subsequently represent easy funnels for guns in illegal locations. Straw buyers go to stores where they know they can walk in with $30,000 or $40,000 in cash and walk out with a bunch of pistols and assault rifles and go back to the streets and sell those guns, especially in cities with restrictive gun laws. That’s one of the cheap mechanisms for guns getting into the hands of criminals.

Why is screening a person who wants to buy a gun so important?

There are people who should have red flags that would preclude gun ownership, but we don’t have that in place. We could look over the past 20 or so years at some of the major school shootings like Parkwood (Florida); Newtown (Connecticut); Columbine (Colorado); Uvalde (Texas); even the shooting in Buffalo (New York). These were people that had a history of mental illness or a history of being bullied and were threatening to lash out. People don’t seem to connect the risk factors to gun ownership and the propensity for subsequent violence. And that is just a tragedy.

What is the role of social media in all of this?

It has a powerful role because of far-right extremism. The Buffalo shooter was a self-radicalized domestic terrorist. He had a strongly held belief about the infringement of races on the Caucasian race. He was an avid follower of far-right extremists’ diatribe and used some of what he found as rationalization to act and commit violence.

Not true for every shooter. In Columbine, Newtown, Uvaldi, these were bullied misfits. They didn’t fit in groups and had a history of being marginalized by their peers. They found a different path for getting even and that was through violence. But there is a different population and I believe it’s one of the most dangerous threats to the U.S. and that is far-right extremists, which inspired far-right violent extremists. Social media has a tremendous role in that. There is no single bad guy we can legitimize or take out. There are hundreds of podcasts and thousands of self-proclaimed thought leaders and they write really nasty, vicious stuff and have followers. Some of those people act on what they read. No government entity does a good job counter-messaging extremists.

How does bullying play into this?

Schools don’t do a great job with bullying prevention. One of my areas of research is bullying and cyberbullying. I’ve worked with schools, and we talk about bullying identification. Schools don’t do that until it’s too late. Schools need to adopt bullying and cyberbullying identification measures and then practice them. The best tactic I’ve seen is analogous to the “see something, say something” messaging that was rampant in New York after 9/11. That same logic can be applied in schools to enable citizens to get involved in terrorism prevention. Students can be empowered to identify bullies and then the school can come in to support fellow students.

Some people talk about arming teachers or school administrators. What do you think of that as a way of prevention?

Several years ago, Virginia considered doing that. I did a report for the Department of Criminal Justice Services in Virginia on the merits and risks of arming school personnel. Most high schools have an armed resource officer on scene, but most middle and elementary schools don’t. Arming teachers or school personnel is an incredibly dangerous enterprise that could lead to the death of that person because if police respond to a shooting and see someone with a gun, they are going to shoot them. Or, the teacher could accidentally shoot another staff member or police officer or, in the worst case, a student.

At Uvalde, there was a police resource officer on scene, at Columbine a school resource officer was on scene, at Parkland a school resource officer was on scene. If a trained police officer can’t prevent a school shooting, what are the chances that a teacher who is not well trained can prevent a school shooting? I think the odds are pretty low. I think the risk dramatically outweighs any potential benefits.

Can you talk about the opposite views we have in the U.S. about guns?

We live in a country with two competing paradigms. One thought paradigm is that everybody needs guns and then we will all be safe. The other is the exact opposite. Nobody should have guns and we will all be safe. Those two paradigms cannot coexist. They are diametrically opposed. But our political structure is such that they can’t be reconciled.

After the Sandy Hook shooting there was a huge motivation for gun control, limiting who could buy guns and the kind of guns people could buy. That faded away rapidly. I expect the same thing will happen here, and it’s depressing to say that, but I see very little political will to enact any meaningful changes.

Mass shootings are going to happen again. It’s a pattern. School shootings and mass shootings happen about every year or two in the U.S. and I guarantee that there is going to be another one in a year and another one after that and nothing is going to change until enough people develop a political will to support meaningful gun changes.

What predictions do you have for the future when it comes to gun laws?

I expect there will be some change in gun laws, but they won’t be substantial. It will provide political cover for some people to say we are doing things, we are making things safer, but they won’t make things safer. I expect gun sales will go up even more because people now feel like they have to protect themselves and their family members because the government isn’t doing that.

I also expect that there is going to be some investigation into police practices at Uvalde because police didn’t go into that school immediately. In fact, several police officers stood outside waiting for reinforcements to arrive. That is going to lead to internal investigation and also police policy changes, which I expect will become popular across the U.S. Many police departments implemented a policy suggesting officers need to go into a school and engage an active shooter no matter what. That didn’t happen in Uvalde. As a policing expert, I don’t know how that is possible.

Do people use mental health as a scapegoat for these shootings?

Yes, it’s an easy target. A lot of people point to mental health and say the U.S. needs more mental health funding. They disregard there was a gun that shot these people. Only a small percentage of these shootings were people that had been diagnosed with a mental illness. We want to rationalize this type of behavior. We want to understand it. We presume that the people who commit these vile acts are disturbed, that they are mentally ill, otherwise they are like us and that’s untenable.

It creates an easy political target that allows politicians to rationalize their failure to enact reasonable gun laws. We have laws about who can buy guns — you have to be 18, you can’t be a convicted felon. There are guns that are restrictive. It’s not legal to sell fully automatic weapons. You can’t buy a tank. But whenever reasonable gun restrictions are opposed or discussed, there is a small faction of citizens and politicians that go crazy, and that’s a tragedy.

Over the past 50 years there has only been one meaningful law passed limiting guns — the 1994 Federal Assault Weapons Ban, passed under President Bill Clinton. That expired 10 years later under a Republican president. When that expired, people began buying guns at a substantially higher rate than ever before. They presumed that under another Democratic president or Congress gun sales would be limited again. So assault rifles, which had been a small portion of gun purchases prior to the ban, became a big part of gun sales.

Estimates are that a quarter to a third of all guns sold now in the U.S. are assault rifle platforms. That is a big number. Seven years after the ban expired, guns sales had doubled. A few years later they doubled again. It’s amazing that the ban had a counter-productive effect, which is it dramatically increased gun sales and people’s motivations to buy guns, particularly assault rifles.

As a policing expert, there is no reason anyone who is not military or law enforcement should ever have an assault rifle. I come from a family of hunters. Every year we would go hunting. I know rifles and shotguns. An assault rifle is a vastly inferior tool for anything other than shooting people. It’s not good for hunting or self-defense. A shotgun or a pistol is more effective. There is no reason for a civilian to have an assault rifle, but they do.

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Stress of mass shootings causing cascade of collective traumas

The regularity of mass shootings is razing Americans’ mental health—heightening stress and dulling compassion in ways that demand broader concern, engagement, and change

Vol. 53 No. 6 Print version: page 20

• Gun Violence and Crime
• Physical Abuse and Violence

As mass shootings continue to erupt in schools, grocery stores, restaurants, and other public places and establishments we visit every week, Americans are living in fear. For children and teens, whose mental health is already in crisis , the ongoing backdrop of violence is steadily eroding the sense of well-being, safety, and efficacy known to be essential for healthy development. As of Oct. 26, there have been 566 mass shootings reported and verified in the United States in 2023, according to the Gun Violence Archive . The incidence of mass shootings in the United States is growing and is correlated with increases in gun sales ( Newsome, K., et al., Journal of Surgical Research , Vol. 280, 2022 ).

On top of recent surges in depression, anxiety, and suicides, a majority of teens now say they worry about a shooting happening at their school ( Pew Research Center , 2018). Those concerns have been linked with elevated anxiety levels and fear among students (O’Brien, C., & Taku, K., Personality and Individual Differences , Vol. 186, 2022 ). Meanwhile, clinical psychologists, including Erika Felix, PhD, of the University of California, Santa Barbara, say the young people they treat are on high alert, constantly planning their escape route if violence breaks out in public.

“These tragedies are happening far too often, and the result is that many young people are feeling this constant back-of-the-mind stress,” Felix said.

That stress is, of course, embedded within the context of the pandemic, the conflicts in the Middle East and Ukraine, economic challenges, political polarization, climate-related disasters, and other factors, which combine to create what psychologist Roxane Cohen Silver, PhD, of the University of California, Irvine, calls a “cascade of collective traumas” that the nation is facing together.

“We’re not starting at a place where everybody is healthy and thriving,” said Rinad Beidas, PhD, a professor of psychiatry, medical ethics and health policy, and medicine at the University of Pennsylvania’s Perelman School of Medicine. “Our reserves are depleted as a nation and our young people are suffering.”

Fear of mass shootings has left a large majority of Americans feeling stressed, including a third of adults who say they now avoid certain places and events as a result ( Stress in America: Fear of mass shootings , APA, 2019). Experts say the frequency of mass shootings, amplified by our near-constant access to media coverage of such events, amounts to an accumulation of exposure that is harming everyone’s mental health.

[ Related: APA resources for coping with mass shootings ]

“The more catastrophic events we’re exposed to as a nation, the more impacted we’re going to be on a psychological level,” said Jonathan S. Comer, PhD, a professor of psychology and psychiatry at Florida International University.

While some people report panic and distress, others feel numb. Psychological reactions to a crisis vary from one person to the next, based on factors such as age, trauma history, and proximity to an incident. But research has started to reveal who is most likely to be affected, what the long-term mental health problems will be, and what role media exposure plays. Psychology offers guidance about how to channel concern into action amid these atrocities.

“We’re at a really important inflection point as a country where we all understand that what’s currently happening with regard to mass shootings cannot continue,” said Beidas, who also directs the Penn Medicine Nudge Unit and Penn Implementation Science Center. “I come to this with a lot of hope that we’re all recognizing that it’s time to do things differently.”

A cycle of distress

Mass shootings account for about 1% of annual firearm deaths in the United States, but they occupy an outsize space in the public consciousness.

“These events are still relatively rare, but it doesn’t feel that way,” said school psychologist Franci Crepeau-Hobson, PhD, an associate professor and director of clinical training at the University of Colorado Denver’s School of Education and Human Development. “I think that everybody’s sense of security has been threatened.”

For survivors and witnesses of mass shootings, suffering tends to be particularly severe. Studies have documented increases in posttraumatic stress disorder (PTSD), major depression, anxiety disorders, substance use disorder, and other conditions among people who have survived a mass shooting.

“A common theme is that more exposure tends to be associated with more severe symptoms,” said clinical psychologist Sarah Lowe, PhD, an assistant professor of social and behavioral sciences at Yale School of Public Health, who led a 2015 literature review on the mental health consequences of mass shootings ( Trauma, Violence, and Abuse , Vol. 18, No. 1, 2015 ).

But the research is still very limited. In Lowe’s review, PTSD prevalence ranged from 3% to 91%, depending on the study, and methodological questions remain, such as what even constitutes a mass shooting.

Though relatively few people will witness or survive mass shootings, many more will experience them through news reports and social media.

“There’s a great deal of evidence that individuals who are far away from mass shootings can face anxiety and impairments, and this is often correlated with the amount of media exposure they have,” Comer said.

Such findings are highly concerning given how intertwined people’s lives are with media, researchers say. Silver and her colleagues have studied that link for more than 20 years, showing how high levels of exposure to media coverage of 9/11 and the Boston Marathon bombings predicted symptoms of acute stress and posttraumatic stress ( Psychological Science , Vol. 24, No. 9, 2013 ; PNAS , Vol. 111, No. 1, 2014 ).

Over time, media exposure to mass violence can even fuel a cycle of distress, where persistent worry about future violence predicts more media consumption and more stress, the researchers found (Thompson, R. R., et al., Science Advances , Vol. 5, No. 4, 2019 ). That constant worry, known as “perseverative cognition,” has been linked to declines in physical health, including cardiovascular problems (Ottaviani, C., et al., Psychological Bulletin , Vol. 142, No. 3, 2016 ; JAMA Psychiatry , Vol. 65, No. 1, 2008 ).

In addition to the risks of media exposure, people with a history of trauma are more likely to experience posttraumatic stress (PTS) symptoms following a new exposure, such as a terrorist attack or mass shooting (Garfin, D. R., et al., Psychological Science , Vol. 26, No. 6, 2015 ). Physical proximity to an incident also carries a higher risk of mental health problems. One study of 44 school shootings found that antidepressant use increased more than 20% among young people who lived within 5 miles of a shooting, versus those who lived 10 to 15 miles away (Rossin-Slater, M., et al., PNAS , Vol. 117, No. 38, 2020 ).

Psychological proximity—the degree to which we relate to another person or an event—also increases the risk for PTS symptoms (Thoresen, S., et al., European Journal of Psychotraumatology , Vol. 3, No. 1, 2012 ).

“Oftentimes, the more one identifies with the victims, the more difficulty they have in the aftermath of an event like this,” Comer said.

While some people worry regularly about mass shootings, many are fatigued by the seemingly endless cycle of violence that moves rapidly through the media and public discourse.

“There’s not one single way people are experiencing these tragedies, and there’s no one-size-fits-all response,” Silver said. “One person might be very impacted by an event, and another may not be concerned about it at all.”

Research by cognitive psychologists helps explains how we perceive mass violence and why it can leave some people feeling numb. Paul Slovic, PhD, a professor of psychology at the University of Oregon, and his colleagues have shown that in many cases, the more people who die in an incident of mass violence, the less we care. They call this phenomenon the “ deadly arithmetic of compassion .”

Their research shows that people’s intuitive feelings of concern for victims of violence don’t respond well to statistics and don’t scale up. In other words, the horror people felt when 19 children and two adults were shot and killed at Robb Elementary School in Uvalde, Texas, isn’t 21 times greater than what people feel when one child is murdered. Slovic and other psychologists call this dampening of the emotional response “psychic numbing.”

At the same time, people often have a false sense of inefficacy in the face of very large problems, which can lead to inaction and disengagement. In one study, participants who saw statistics about the magnitude of the hunger crisis in Africa donated about half as much money as those who saw a photo of a single child in need ( PLoS ONE , Vol. 9, No. 6, 2014 ).

“If we believe there’s a problem that we can’t do anything about, it makes sense that we don’t attend to it, because it’s very distressing to dwell on things you can’t fix,” Slovic said.

Finally, research on what’s known as the “prominence effect” shows how people often struggle to make decisions when they require weighing complex tradeoffs ( University of Illinois Law Review Slip Opinions , 2015). In the case of gun legislation, this helps explain why the complex calculus of lives saved versus freedoms sacrificed has largely resulted in inaction at the policy level.

And on top of this deadly arithmetic, our attention is a scarce resource. Time passes, memories fade, and we’re inclined to shift our attention elsewhere if we don’t see progress. National surveys have shown that support for gun legislation spikes in the immediate aftermath of a mass shooting but fades within a few weeks (Jose, R., et al., Psychology of Violence , Vol. 11, No. 4, 2021 ; Filindra, A., et al., Social Science Quarterly , Vol. 101, No. 5, 2020 ).

“Our mind deceives us into underreacting to the most important problems in the world, including mass violence,” Slovic said. “But when one of these events occurs, we do have a window of opportunity when people are awake, emotionally engaged, and motivated for action.”

Youth on high alert

The stress of mass shootings may weigh particularly heavily on children and teens, whose mental health is already in turmoil. In 2021, three leading pediatric organizations declared a national emergency , while the U.S. Surgeon General issued a special advisory on youth mental health , citing a 57% increase in suicides between 2007 and 2018 (Curtin, S. C., National Vital Statistics Reports , Vol. 69, No. 11, 2020 ).

Research shows that at least some of that distress can be attributed to mass violence. One study of more than 2,000 teens found that greater concern about school shootings and violence predicted increases in anxiety and panic six months later (Riehm, K. E., et al., JAMA Network Open , Vol. 4, No. 11, 2021 ).

“When I talk to kids about this, I am shocked by how inured and accepting they are,” said Don Grant, PhD, the executive director of outpatient services for Newport Academy in Santa Monica, California, and is president of APA’s Division 46 (Society for Media Psychology and Technology). “They don’t know a world where there’s not an active shooter drill at school.”

In the educational context, that constant vigilance can be particularly problematic, and research on threat perception suggests that prolonged heightened anxiety may interfere with learning, said Crepeau-Hobson. Students who are constantly worried about a toxic stressor, such as gun violence, devote more mental resources to emotions and fewer to executive functions, including learning, memory, and sustaining attention (Dettmer, A. M., & Hughes, T. L., Education Week , 2022).

“When threat perceptions are escalated and stress responses are activated, we can’t access the higher parts of our brain,” Crepeau-Hobson said.

Data suggest those effects could be far-reaching. A 2020 report from the National Bureau of Economic Research found that school shootings increased absenteeism, reduced high school and college graduation rates, and decreased retention of teachers. Those effects persisted into the mid-20s of young adults who attended schools where a shooting occurred; they had lower employment rates and earnings than their peers (Cabral, M., et al., NBER Working Paper 28311 , 2022).

“It’s not just that individual young people experience these really deleterious effects, but there is also a societal effect,” Beidas said.

Because mass shootings impact children and teens at the individual, institutional, and societal levels, experts say a tiered approach is needed to minimize harm.

In the family context, it’s important to initiate conversations with children and teens after an incident, even if they aren’t part of the affected community, said Comer.

“When kids hear about these events from their parents, they tend to do better than when they hear about it from their friends or the media first,” he said.

If a child or teen becomes hypervigilant or starts to avoid certain places or activities, that may indicate a need for professional support, said Grant.

Educators and policymakers also need empirical data on what makes schools safe—both physically and psychologically, said Crepeau-Hobson, a member of the APA’s Division 16 (School Psychology) executive committee.

“A number of schools are wasting their resources on strategies that aren’t particularly helpful, without thinking about their psychological impact on children who are coming to school to learn,” she said.

School districts across the nation are spending billions of dollars to enhance security, installing emergency alert systems and hiring additional personnel. But many of the new approaches lack evidence and could even cause harm. For example, a law enforcement presence may make some students feel safer but may undermine a sense of safety in others, such as students of color. Early studies of active shooter drills—which are now nearly ubiquitous—suggest they may increase anxiety, stress, and depression symptoms in children and adolescents (“ The Impact of Active Shooter Drills in Schools ,” Everytown Research and Policy , 2020).

Communities also need to be prepared to support children in the immediate aftermath of a mass shooting. Last year, Comer launched the Network for Enhancing Wellness and Disaster-Affected Youth ( new day ), which delivers large-scale professional training on disaster mental health across the country. new day teaches Psychological First Aid and other skills to teachers, coaches, nurses, and others who work with children and teens.

Sustaining engagement

More research is also needed on how mental health services can best support survivors, families, and affected communities in the aftermath of a mass shooting, experts say. Richer firearm-injury and mortality datasets can also help researchers better understand the conditions surrounding these crises.

But many feel change is urgently needed, and that partnering with the firearm community—to promote more secure storage of firearms, for example—is one way to start reducing firearm injuries and deaths right away, Beidas said.

More than 7 million Americans bought firearms for the first time between January 2019 and April 2021, mostly for self-protection (Miller, M., et al., Annals of Internal Medicine , Vol. 175, No. 2, 2022 ). That suggests many people need education on secure storage (see “ Talking to patients about firearm safety,” April 2022 Monitor ), and that the recommended method of storing a gun unloaded and locked, with ammunition locked separately, might not be acceptable to all firearm owners.

“We need to establish a shared mission with the firearm community,” Beidas said, “and keep in mind that a harm reduction approach is the most effective way to change behavior.”

At the policy level, a majority of Americans support stricter gun laws, but progress in that domain may be incremental (Jose, R., et al., Psychology of Violence , Vol. 11, No. 4, 2021 ). Slovic said it’s important to stay engaged and not to let a false sense of inefficacy prevent us from taking steps in the right direction.

“Just because we can’t fix a problem in its entirety doesn’t mean that we shouldn’t do what we can do to make a difference,” he said. “We cannot afford to let our minds deceive us into underreacting.”

Further reading

Empowering communities to prevent mass shootings Stringer, H., Monitor on Psychology , January 2022

When the shooting stops: The impact of gun violence on survivors in America Everytown Research and Policy , 2022

Coping with cascading collective traumas in the United States Silver, R. C., et al., Nature Human Behavior , 2020

Prevention of firearm injuries among children and adolescents Cunningham, R. M., et al., JAMA Pediatrics , 2019

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