The purpose of this post is to answer 4 questions on the topic of violence prediction. A brief general overview of school mass shooting in relation to nationwide gun policy in the United States will be provided.

Numerous studies have found that lax policies in some states and non-standard national gun laws are linked to the increased incidence of homicide and gun suicide in the United States. Additionally, gun ownership has been associated with higher levels of assaults and homicide using guns (Reeping et al., 2019). It is therefore not surprising that the third leading cause of death for people between the ages of 15 to 24 years in the United States is homicide (Goldstick et al., 2017).

Greatest Risk factors in My Community that Could be Associated with a Potential for Youth Violence.

According to Bushman et al. (2018), certain risk factors for adolescent and youth violence are gender, early childhood aggression, personality, and emotional dysregulation, obsession with weapons or death, substance use, and stress. Some of these factors are applicable to the youth in my community. For example, there are frequent concerning reports on the community school board website about disturbing incidents whereby kids were threatening to ‘kill’ each other at home on their video games. This is related to advances in video game technology has made it possible for these youth to play each other, and or form ‘killing groups’ from home. Some reports stated that some were staying up all night on a school night playing violent games, this interest and occupation with violent play are concerning. Second, like most American communities, there has been an increase in reports of substance use, especially in the local high school. Some children reported stealing opioid-type medication from their parents. Third, stress related to bullying, social teenage/youth difficulties, home stressors as well as educational stressors could all contribute to youth violence.

Thoughts About the Predictive Firearm Violence Risk Scale

The predictive firearm violence risk scale SaFETy (Serious fighting, Friend weapon carrying, community Environment, and firearm Threats) was developed specifically for the emergency department (ED) use. The ED has been identified as a significant location where youth violence can be recognized and appropriate actions initiated to prevent future violence (Goldstick et al., 2017). This tool is detailed and thorough but also seems easy to use and can be completed in 1-2 minutes. As such, I think it is an important screening tool that should be utilized in every ED in America given the prevalent youth violence in the country. This point is supported by the Centers for Disease Control and Prevention (n.d.) statement that youth violence is a critical public health concern and that it is preventable, and that risk assessment is crucial for future violence prevention.

Will I Use this Scale in My Practice? Why or why not?

The SaFETy risk scale is an important tool that I would use in my practice to help identify people at risk for future violence as well as implement appropriate actions to prevent future violence such as connection to behavioral health experts, targeted and individualized community support amongst others.

My Thoughts About the Columbine Shooter’s Mother’s TED Talk

I think Sue Klebold suffered a devastating trauma the day her son participated in the mass shooting in his high school. The shock of his actions coupled with his death must have been profound, one can only imagine! I think therefore that she is brave to keep putting herself out there in a community and or society that was and is still blaming her for not having been aware of her son’s mental state. She is selfless too demonstrated by her fundraising efforts for the victims and her dedication to speaking to youth and their family about her son’s actions.

However, I think the most important thing about the TED talk is the important points that she raises. One, about the prevalent misconception of mental illness, the stigma surrounding it, and the fact that the mental health system is not set up to fit those that do not fit into a diagnosis mold. This point was echoed by Rice et al. (2018) who found that the United States mental health system significantly underserved the youth compared to adults and that boys and young men were even more disadvantaged compared to girls and young women. Second, she discussed the ability of 17-year-olds to buy guns both legally and illegally at the time. As noted earlier, there is no national standard on gun ownership policy and access to them is easier in person or online in multiple states (Reeping et al., 2019).

Summary

Undoubtedly, faculty and students are vulnerable due to their increased risk for injury or even death in a mass shooting event evidence by multiple school shootings such as Columbine shooting, Marjory Stoneman Douglas High School shooting, and Sandy Hook Elementary, amongst others. Unfortunately, there is still no national protocol on how to prevent and or screen for violence and specifically gun violence. This continues to be a divisive issue with most opinions aligned along political lines.

However, the importance of screening youth for future violence cannot be overstated. Their needs to be more research dedicated to violence screening tools for different settings including tools that can even be utilized at home by parents and caregivers, such a tool might have been useful to Susan Klebold. Additionally, community education about prevention and risk factors needs to be taught because people closest to potentially violent youth are most likely to note them if they have the knowledge and tools at hand (CDC, n.d.; Rice et al., 2018).

References

Bushman, B. J., Coyne, S. M., Anderson, C. A., Bjorkqvist, K., Boxer, P., Dodge, K. A., Dubow, E. F., Farrington, D. P., Gentile, D. A., Huesmann, L. R., Lansford, J. E., Novaco, R. W., Ostrov, J. M., Underwood, M. K., Warburton, W. A., & Ybarra, M. L. (2018). Risk factors for youth violence: Youth violence commission, International Society for research on aggression (ISRA). Aggressive Behavior4, 331. https://doi.org/10.1002/ab.21766

Centers for Disease Control and Prevention (CDC). (n.d.). Youth violence. https://www.cdc.gov/violenceprevention/youthviolence/index.html

Goldstick, J. E., Carter, P. M., Walton, M. A., Dahlberg, L. L., Sumner, S. A., Zimmerman, M. A., & Cunningham, R. M. (2017). Development of the SaFETy score: a clinical screening tool for predicting future firearm violence risk. Annals of Internal Medicine10, 707. https://doi.org/10.7326/M16-1927

Reeping, P. M., Cerdá, M., Kalesan, B., Wiebe, D. J., Galea, S., & Branas, C. C. (2019). State gun laws, gun ownership, and mass shootings in the US: cross sectional time series. BMJ (Clinical Research Ed.)364, l542. https://doi.org/10.1136/bmj.l542

Rice, S. M., Purcell, R., & McGorry, P. D. (2018). Adolescent and young Adult male mental health: Transforming system failures into proactive models of engagement. Journal of Adolescent Health62(3), S9–S17. https://doi.org/10.1016/j.jadohealth.2017.07.024

 

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