Diversity in healthcare, Psychopathology, Complementary, Crisis, Writing and rhetoric, Recreational Therapy, Inclusive Recreation Services, and Psychopharmacology

EDITORIAL

School Shootings and the Need for More School-Based Mental Health Services

Martell L. Teasley

The uptick in school shootings has gener- ated much debate in our society over methods to reduce this growing and tragic

problem. The increase in school shootings is real. “Specifically, school shootings increased from 23 to 179 between the 1980s and 1990s and also increased from 179 to 245 between the 1990’s and 2013” (Paolini, 2015, p. 4; data from Lee, 2013). High-profile school shootings have generated a national dialogue resulting in calls for remedy in the form of more mental health providers in schools, greater gun control measures, and more guns in schools to counter potential or active shooters. Whereas the “guns in schools” debate is highly controversial, the need for more mental health services is not.

Research demonstrates a complex web of factors associated with school shootings, of which mental health challenges is one variable. “Nationwide, 16.2% of all students; 16.0% of heterosexual students; 18.9% of gay, lesbian, and bisexual students; and 14.7% of not sure students had carried a weapon (e.g., gun, knife, or club)” to school (Kann et al., 2016, p. 9). In an overview of research literature on school shootings, Paolini (2015) determined that many school shooters were male (99 percent), with a high percentage having experienced school bullying, isolation because of not getting along with others, and noncompliance in the use of psychiatric medica- tion and problems with the side effects of such medi- cation. Most school shooters have no previous record of criminal justice activities, have access to guns at home, and may have dealt with a recent significant loss in their lives (Paolini, 2015). Exposure to gun violence in the media such as violent video games and films helps to increase youth aggression (Paolini, 2015). According to Paolini’s (2015) review, most at- tacks are premeditated, with 61 percent of school shooters carrying out attacks to “get revenge, and

81% of attackers held a grievance against another per- son at the time of the attack” (p. 3).

A study conducted by the Centers for Disease Control and Prevention found that nationwide about 20 percent of all students need mental health services for a variety of reason. Yet, many do not receive these services (Kann et al., 2016). “Approxi- mately half of all lifetime mental health disorders start by the mid-teens, and the onset of all major mental illnesses happen as early as 7 to 11 years of age” (Paolini, 2015, p. 5). The demand for greater mental health services comes while public school systems are facing many monetary challenges, as witnessed by mass school teacher strikes throughout the country. During the economic downturn of the Great Recession, cash-strapped school districts made cuts to what are considered “nonessential” personnel. For example, the Philadelphia school district attempted to cut in half its workforce of 110 school social workers. Although the national eco- nomic outlook has improved in recent years, school funding continues to face challenges. During early 2018, school teachers in Pueblo witnessed the first teacher strike in the state of Colorado in 25 years, and New Jersey teachers engaged in their first strike in 20 years. With the lowest pay for school teachers in the nation and state cuts to the school system by 9 percent since 2008, the Oklahoma school board backed the teacher strike in February 2018. More- over, demanding greater pay and benefits, the states of Arizona, Kentucky, and West Virginia all wit- nessed school teacher strikes in the first six months of 2018. State legislators avoided strikes in St. Paul, Minnesota, and in Pittsburgh through legislative action. When school revenues are cut, the hiring of related services personnel is considered nonessential.

A major challenge in gaining school-based men- tal health services is the high ratio of students to related services personnel. “The recommended

doi: 10.1093/cs/cdy015 © 2018 National Association of Social Workers 131

D ow

nloaded from https://academ

ic.oup.com /cs/article/40/3/131/5035074 by guest on 15 February 2023

ratio of school social worker to students by the National Association of Social Work[ers] is 1:250 general education students or 1:50 at-risk or inten- sive needs students” ( Johnston, n.d.). Yet, some states have ratios of one school social worker for every 1,000 students. The American School Coun- selor Association (ASCA, n.d.) also recommends a 250:1 ratio of students to school counselors. The ASCA October 2017 report identified wide dispa- rities in student-to-school-counselor ratios (Bray, 2017). Among states, rates were found as high as 924 to one and as low as 202 to one. Similarly, the National Association of School Psychologists (NASP, 2013) recommends a student-to-psychologists ratio of between 500 and 700 to one; however, the aver- age rate is approximately 1,000 to one. These less than optimal ratios for related services to students create barriers to mental health services and prevent students with problematic behaviors from getting access to services in schools. Overburdened service providers reduce the probability of service avail- ability and thus efforts aimed at violence preven- tion in schools. Collaboration to reduce school violence and identify students who need mental health services and measures to de-escalate anger are of extreme importance in a resource-deprived school system.

Another challenge to school-based mental health services is our national stigma toward seeking help frommental health providers. Gulliver, Griffiths, and Christensen’s (2010) review of quantitative and qualitative studies (N = 22) on adolescent percep- tion of barriers and facilitators to help seeking for mental health problems determined that “young people perceived stigma and embarrassment, prob- lems recognizing symptoms (poor mental health literacy), and a preference for self-reliance as the most important barriers to help-seeking” (p. 5). In addition, parents often find it difficult to recognize that their child is experiencing mental health problems and are reluctant to enforce medication compliance.

PREVENTION AND SCHOOL SAFETY On the prevention side, Paolini’s (2015) research identified several measures that should be con- sidered for schools working with youths who develop negative behaviors and have negative experiences that can lead to anger, academic prob- lems, and antisocial peer relationships. Among these measures are the use of psychosocial groups

to address grief and loss, the need for group bully- ing intervention, self-esteem and conflict resolu- tion, and prosocial group work to assist students with coping skills. NASP recommends a compre- hensive school safety policy that includes the following:

• Increased access to mental health services and supports in schools

• Development of safe and supportive schools • Implementation of school safety initiatives

that consider both psychological and physical safety

• Improved screening and threat assessment procedures to identify and meet the needs of individuals at risk for causing harm to them- selves and others

• Establishment of trained school safety and cri- sis teams

• A national campaign to reduce stigma around mental illness and to promote mental health on par with physical health

• Policies that limit exposure to media vio- lence among children, youths, and vulnera- ble populations

• Review and revision of current policies and legislation addressing access to firearms by those who have the potential to cause harm to themselves or others.

THE NEED FOR LEGISLATIVE ACTION Given the dynamics and research findings surround- ing the increase in school shootings, state legislators not only need to consider the best alternative to increasing school safety, but must likewise provide teachers with the time to focus on their jobs minus the headache of inadequate school resources and insufficient supportive services, particularly in the form of preventive measures. In March 2018 the state of Florida passed a bill that provides new men- tal health programs and more police for schools; the law has provisions to keep guns away from people with violent behavior and who show signs of mental illness. At the time of this writing the Charlotte– Mecklenburg, North Carolina, school board is con- sidering adding $4.4 million to 2018–2019 school year budget to hire more school social workers, counselors, and psychologists, as opposed to more school police (Glenn, 2018). Similarly, in Spring- field, Illinois, the state house legislators voted to hire more school mental health providers over the

132 Children & Schools Volume 40, Number 3 July 2018

D ow

nloaded from https://academ

ic.oup.com /cs/article/40/3/131/5035074 by guest on 15 February 2023

request to hire more police officers to maintain school safety; the bill has now moved on to the state senate (Associated Press, 2018).

The country appears to be at a crossroads on the need to repair and prepare public school systems for the rest of the 21st century and the ongoing decline in importance of the American public education enterprise. The increasing number of school shootings is a sign of adolescence affected by the social order and a need to build youth social com- petences and supportive services. Such a situation will require attention and resolve based on evi- dence and not politics. “Schools should be enabled to hire more school-based mental health profes- sionals (e.g. school counselors, school psychologists and school social workers) and funds should be allocated specifically for hiring these professionals” (NASP, 2013, p. 2). Although more correlation studies are needed on the effectiveness of related services personnel in prevention of school vio- lence, “model programs using school-based mental health and student service providers have reduced school suspensions, reduced referrals to the princi- pal’s office, reduced the use of weapons, force, and threats, and increased students’ feelings of safety” (American Counseling Association, 2013, p. 1). CS

REFERENCES American Counseling Association. (2013, February 11). Stu-

dent Support Act: Reducing the student to counselor ratio. Retrieved from https://www.counseling.org/gove rnment-affairs/public-policy/public-policy-news- view/position-papers/2013/02/11/student-support- act-reducing-the-student-to-counselor-ratio

American School Counselor Association. (n.d.). Student-to- school-counselor ratio 2014–2015. Retrieved from https://www.schoolcounselor.org/asca/media/asca/ home/Ratios14-15.pdf

Associated Press. (2018, April 27). Illinois House passes plan to put more social workers in schools.Retrieved from http:// www.wifr.com/content/news/Illinois-House-passes- plan-to-replace-security-guards-with-social-workers- 481098321.html

Bray, B. (2017, October 20). U.S. student-to-school coun- selor ratio shows slight improvement. Counseling Today. Retrieved from https://ct.counseling.org/ 2017/10/u-s-student-school-counselor-ratio-shows- slight-improvement/

Glenn, G. (2018).More mental health workers sought for increased demand in schools. Retrieved from http://wfae .org/post/more-mental-health-workers-sought- increased-demand-schools#stream/0

Gulliver, A., Griffiths, K. M., & Christensen, H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BMC Psychiatry, 10, 113. Retrieved from https:// bmcpsychiatry.biomedcentral.com/track/pdf/10 .1186/1471-244X-10-113

Johnston, R. (n.d.). School social work: A vital link in schools: A report on school social work services for the

Mankato area public school district [PowerPoint pre- sentation]. Retrieved from http://sbs.mnsu.edu/ socialwork/graduate/johnston.pdf

Kann, L., O’Malley Olsen, E., McManus, T., Harris, W. A., Shanklin, S. L., Flint, K. H., et al. (2016, August 12). Sexual identity, sex of sexual contacts, and health- related behaviors among students in grades 9–12— United States and selected sites, 2015.Morbidity and Mortality Weekly Report, 65(9), 1–202. Retrieved from https://www.cdc.gov/mmwr/volumes/65/ss/pdfs/ ss6509.pdf

Lee, J. H. (2013). School shootings in the U.S. public schools: Analysis through the eyes of an educator. Review of Higher Education and Self-Learning, 6, 88–120.

National Association of School Psychologists. (2013, Janu- ary).NASP recommendations for comprehensive school safety policies.Retrieved from https://www.nasp online.org/about-school-psychology/media-room/ press-releases/nasp-calls-for-comprehensive-school- safety-measures-and-common-sense-gun-violence- prevention-efforts

Paolini, A. (2015). School shootings and student mental health: Role of the school counselor in mitigating vio- lence (Article 90). VISTAS Online.Retrieved from https://www.counseling.org/docs/default-source/ vistas/school-shootings-and-student-mental-health.p

Martell L. Teasley, PhD, is dean, College of Social Work, University of Utah, 395 South 1500 East, Salt Lake City, UT 84112; e-mail: [email protected].

Advance Access Publication June 8, 2018

133Teasley / School Shootings and the Need for More School-Based Mental Health Services

D ow

nloaded from https://academ

ic.oup.com /cs/article/40/3/131/5035074 by guest on 15 February 2023

D ow

nloaded from https://academ

ic.oup.com /cs/article/40/3/131/5035074 by guest on 15 February 2023