Unfortunately, history repeated itself. According to an interim report on preventing school violence released by the U.S. Secret Service last October, most school shooters confided their violent intentions to one or more friends or fellow students prior to the incident. In only a few of the 37 incidents analyzed by the Secret Service, however, had the student or friend confided this information in an adult.
The Secret Service analyzed judicial, educational, and other files of 41 school shooters in 26 states between 1974 and 2000 (see box on page 54).
The APA Alliance is helping ninth and 10th grade students across the country understand that it is appropriate to confide in an adult when a friend is in danger or has a problem. Begun in 1998, the "When Not to Keep a Secret" contest is now held in 22 states, according to Alicia Muñoz, chair of the national essay contest and president-elect of the APA Alliance. Muñoz also heads the Friends of the San Diego Psychiatric Society.
The psychiatric society responded to the shooting by offering to provide crisis counseling and education about the psychological effects of violence to the community and identify individuals needing referrals, according to Gabrielle Shapiro, M.D., cochair of the society’s disaster response committee. She is also president of the San Diego chapter of the American Academy of Child and Adolescent Psychiatry.
Ten days after the shooting, Melissa White of La Habra High School in San Diego and three other high school students in California were honored for their winning essays at the state capitol.
White describes the dilemma in revealing secrets in her essay that placed second in the state contest.
"A lifetime bond can be created just from a small secret between two close friends. Telling a secret would be rude and hurtful to the other person because a bond would be broken. But there are times when someone else should know about a secret. Someone could be planning to hurt themselves or others by having an eating disorder, cutting, murder, or suicide."
Fear of retaliation is another barrier to providing information about another student to an adult, according to third-place winner Edward Smetak Jr., also from La Habra High. He told the Orange County Register, "You figure that if students threaten you when [you learn] they are cheating, the consequences will be a lot worse when they are planning some sort of violence."
Lois Flaherty, M.D., chair of APA’s Committee on Psychiatry and Mental Health in the Schools, told Psychiatric News, "Teens on the whole do not readily confide in adults, especially those at schools. Studies show that teens turn to their friends first for help with problems and then to their parents. Troubled adolescents are even less likely to confide in adults. This is a major challenge for professionals working with teenagers."
Williams had complained to friends in Maryland, where he had lived before moving to California in late 1999, that his peers at Santana High and in his neighborhood were picking on him constantly, according to the Post article.
The Secret Service report indicates that more than two-thirds of the school shooters—who were all boys—felt persecuted, harassed, and bullied. In some cases, the bullying and harassment were longstanding and severe, and revenge prompted the attack, according to the report.
Williams had also confided in an e-mail to a former girlfriend in Maryland that he felt suicidal, according to the article. Such comments are also common among school shooters, according to the Secret Service researchers. They reported that prior to the shooting incidents they reviewed, nearly three-quarters of the attackers threatened to kill or tried to kill themselves or made suicidal gestures." More than half the attackers had a history of feeling extremely depressed or desperate.
Flaherty supports a comprehensive approach to reducing school violence that involves safety measures such as metal detectors and expulsion of students with weapons, mental health services for troubled youngsters, and school programs that teach tolerance and respect.
She elaborates on how to improve the school environment in a new book, School Violence: Assessment, Management, and Prevention, edited by Mohammed Shafii, M.D., and Sharon Shafii and published last month by American Psychiatric Publishing Inc.
Teachers and counselors must make time to listen to students’ concerns, Flaherty emphasized. "The Centers for Disease Control and Prevention evaluated 17 school violence prevention programs recently and found that the students’ relationship with teachers was the most important prevention factor," she said.
Although teachers lack specialized training to respond effectively to troubled teenagers, they can be taught to recognize warning signs, said Flaherty. This can be done through case consultations with a mental health professional or formal classes.
Schools should have mental health professionals on site, but their level of training and the availability of such resources as psychiatric consultations and treatment programs is also important, said Flaherty.
Psychiatrists have a role to play as consultants to counselors and teachers. "We can use our expertise and training to assess the risks for violence and suicide and develop comprehensive treatment plans," said Flaherty.
The key is getting into the schools and establishing relationships with teachers and mental health professionals who work there. "We have to remember that [psychiatrists] are greatly outnumbered by mental health professionals in the schools. We need to convey to them that we are available and want to help," observed Flaherty.
"When I worked with community mental health centers in Baltimore several years ago, we sent an interdisciplinary team into the schools a half day a week to take referrals and consult with teachers. I and other psychiatrists at the mental health centers then discussed the cases with team members," she said.
A few years later, mental health centers were established in several Baltimore schools with a psychiatrist-consultant paid by the local departments of education and mental health, she said.
The "Interim Report on the Prevention of Targeted Violence in Schools" by the Secret Service is posted on the U.S. Department of Treasury Web site at www.treas.gov/usss/index.htm?ntac.htm&1. The "When to Tell a Secret" essays by Melissa White and Ed Smetak, Jr. are available at the Orange County Register Web site at www.ocregister.com/accent/teenessays00320cci.shtml Order information for the book School Violence: Assessment, Management, and Prevention is posted on the APPI Web site at www.appi.org under "School Violence." ▪
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