Abstract

Introduction

Assessment

Media Coverage

Accessibility

Method

Results

Focus of Studies

Federal and National Reports

State Reports

Local Reports

Diagram (PRISMA fow diagram)

Access to Community Counseling and School

Training

Multidisciplinary Threat Assessment

Monitoring and Following up

Involuntary Treatment

Prevention of Bullying

Interdisciplinary Communication

Discussion

Limitations

Future Research

References

Abstract

     Mental health services are frequently scrutinized following mass school shootings. Subsequently, national, federal, state, and local commissions convene to identify preventative measures including implications for mental health. In order to address the question of what recommendations were offered to mental health professionals, a systematic review of commission reports covering multiple school shootings was conducted. After a comprehensive database search, 16 qualifying reports covering incidents from 1974 through 2018 were identified and reviewed. Several themes emerged, which are pertinent to mental health providers. Suggestions included expanding access to counseling, increasing training of school personnel on threat assessment and mental illness, using interdisciplinary threat assessment teams, monitoring and following up on treatment plans, expanding involuntary treatment, implementing bullying prevention, and increasing interdisciplinary communication.

Introduction

     Over the past decade, the number of multiple-victim homicides in school settings has increased in the United States of America (USA; Center for Disease Control [CDC], 2019). After such occurrences of mass school shootings, the media frequently discusses mental health issues as a contributing factor (Silva & Capellan, 2019). Second to the perpetrator’s level of aggressiveness, mental health concerns were the most frequently mentioned issues in news articles (Barbieri & Connell, 2015). Initially, the goal of the current study was to conduct a systematic review of peer-reviewed studies to determine which mental health recommendations reduce incidents of school shootings. However, there was a paucity of peer-reviewed research addressing these concerns. Rather, the research focused primarily on the efcacy of threat assessments, the content of media coverage after an incident, and the overall accessibility of mental healthcare in schools. Thus, a brief literature review of these studies in the introduction will establish the necessity to analyze non-peer-reviewed sources for mental health recommendations and to reveal areas deserving further attention. The current study conducted a systematic review of local, state, federal, and national commissions that convened after school shooting incidents to answer the question of what mental health recommendations were provided to reduce incidents of school shootings.

Results

     The results of the search are illustrated in a PRISMA fow diagram (Fig. 1). A total of 36 records were screened. Those excluded were news articles, not commission reports. Using an internet search engine, eighteen commission reports were identifed that included school shootings, however two reports did not include mental health recommendations and were set aside. Of the remaining reports, 16 were identifed using the eligibility criteria: one was national, seven were federal, four were state, and four were local. Eight reports covered one shooting incident, and eight reports covered more than one incident (Table 1). Of those eight reports that covered multiple incidents, three identifed the locations of each incident and fve withheld the locations of the incidents (Table 1). These incidents covered a span from 1974 to 2018. The most comprehensive report reviewed 260 shooting incidents that took place on school grounds (Table 1). Incidents included in each report difered due to the individual committee’s inclusion criteria.