Let It End With Us

Introduction

School shootings are all too common in the United States of America. Solutions to this problem have been successfully accomplished in many other countries. Unfortunately, the United States stands alone with the frequency of school and mass shootings.

I choose to address this problem because children should not have to constantly be aware of where to hide just in case a shooter comes into their school. The United States is the land of the free, yet nearly every day school or mass shootings chip away at this freedom, leaving students to live in fear and uncertainty. Gun violence and school gun violence affect everyone whether directly or indirectly, and are things that almost everyone agrees need to be stopped. Mental health plays a role in some of this violence, but so does easy access to a large variety of guns. My program focuses on providing increased access to mental health resources and stricter gun regulation to help prevent school shootings in Delaware and potentially across the nation.

Many programs currently exist to minimize the possibility of school shootings, but the number of school shootings is still very high because little has been done at the governmental level. I chose this topic to suggest a logical process in order to help prevent these tragic events from ever occurring again.

This aligns with the Delaware Academy of Medicine/Delaware Public Health Association because it works to educate the population about school shootings, a public health concern. This is an issue that has been a problem for decades and is likely to be a serious issue for decades to come, unless strong action is actually and finally taken by state and federal legislatures.

Background

Mass shootings can occur anywhere but the ones occurring in schools are often the most emotionally charged. School shootings have been occurring in the United States for decades. Due to the media coverage, the first school shooting people tend to remember is the Columbine High School Shooting in 1999. Since then, hundreds of school shootings have occurred, including ones with a high number of casualties such as Virginia Tech (32), Sandy Hook Elementary School (26), Marjorie Stoneman Douglas High School (17) and most recently Robb Elementary School (21). Internationally, the United States stands alone in the number, magnitude and frequency of these unimaginable events. School shootings typically occur because a person is dealing with a mix of suicidal thoughts, despair and anger and has access to guns.¹ Each of the decades since the 1990’s have had a major school shooting resulting in the death of at least ten people.² The Columbine High School Shooting was the first school shooting that gained wide media attention which resulted in the death of thirteen people: twelve students and one teacher.² Research has been done in order to study the perpetrators of these horrific crimes. Bonanno and Levinson researched shootings up to the Sandy Hook Tragedy in 2012. In this study they determined that 95% of school shooters were current students and 5% former students and that the perpetrators came from a variety of different backgrounds. Some had high grades, some were failing, some were popular, others social outcasts: some had a good family situation where others came from broken families or were in the foster system. Although shooters came from a variety of backgrounds it was reported that 93% had engaged in concerning behaviors that could have been predictive of them planning a violent event.² Sixty-eight percent of gun incidents at schools involve a weapon a student got from home, family member or friend, and almost half of parents who own a gun incorrectly assume their children don't know where the guns are stored.³

Everytown has been collecting school gun violence statistics since the Sandy Hook Elementary school shooting in 2012. Sixty-three percent of guns fired were in K-12 schools.⁴ Large scale shootings such as Sandy Hook and Marjorie Stoneman Douglas make up roughly 1% of school shootings that occur.⁴ Gun violence can lead to more than death or physical injuries; it can lead to psychological trauma, difficulty concentrating and decreased standardized test scores. Although large scale mass shootings are rare, over 500 school shootings have occurred between 2013-2019.⁴ These shootings are psychologically damaging, and have long term effects on the students and teachers.⁴

From 1994-2004 the United States instituted a ban on assault weapons. This law banned the possession, manufacturing and transferring of semi-automatic firearms designated as assault weapons that hold more than ten rounds of ammunition at a time.⁵ This expired after ten years, with many arguing it took away second amendment rights and did not accomplish much.⁵ Both the Sandy Hook and Marjorie Stoneman Douglas shooters used assault style weapons in the years after the ban was lifted.⁶ This ban was not perfect and did not decrease overall gun violence, but did drastically reduce the death toll in mass shootings.⁶ Common sense laws like the assault weapon ban are important to implement and surveys show that the majority of the U.S. population is in favor of such laws. Numerous common sense laws were implemented after mass shootings in countries such as the United Kingdom, Canada and Australia and these countries have since seen a large reduction in the number of mass shootings.⁷

After mass shootings in Canada, Australia and the United Kingdom, gun laws were quickly put in place that included laws that increased background checks, had a waiting period to purchase a gun, required mandatory safety courses and instituted a gun buyback program.⁷ In the UK, these new stricter regulations were passed less than two weeks after a deadly school shooting in Scotland in 1996. Since that time, zero school shootings have occurred in the UK.⁷ These countries show that common sense laws can greatly reduce the number of all kinds of mass shootings.

Studies have found that a number of school shooters have had an untreated mental illness.⁸ Dr. Ira Glick from Stanford University studied thirty-five mass shootings that occurred where the shooter survived. Her team was able to use medical evidence to determine twenty-eight had mental illnesses including schizophrenia and personality disorders, for which none of those studied were being medicated.⁸ Increasing mental health resources in schools might be very beneficial, especially since the COVID-19 pandemic added the stress of social isolation and loss of loved ones to many individuals; certain companies such as Mental Elephant exist in order to provide these resources. New legislation called the Mental Health Reform Reauthorization Act of 2022 is being considered in the federal government. This act would further add to similar mental health legislation from 2016, but include the effects of COVID-19.

Although mental health has a role in mass shootings and every country has mental health issues within its population, the United States is the only country that has hundreds of school shootings each year. Many states in the United States allow easy access to guns for everybody, even those with a history of violence.

History of violence is another cause of mass shootings. Serious mental disorders are believed by many to be the main contributor to mass shootings, but only 5% of all mass shootings are performed by people with a mental disorder.⁹ A majority of mass shootings are perpetrated by those who have a history of legal violence, desire to be remembered, and feelings of emptiness.

The idea that the mentally ill are violent is stigmatizing and creates a dangerous and harmful bias that can lead people to not seek mental health resources.¹⁰ It is not easy to determine if people with mental illness have any of the red flags indicating they may have the potential to commit a school or mass shooting so although improved mental health resources and education are important, a multipronged approach to prevention is necessary.

Most recently, the mass shooting at Robb Elementary School on May 24, 2022, left nineteen students and two teachers dead. Since the Columbine shooting in 1999, one hundred sixty-nine students in America have been killed in mass school shootings (defined as four or more deaths).¹¹

Unlike many other countries, the United States has not put any stricter gun control laws or regulations into place, and the country continues to see gun tragedy after gun tragedy. No assault weapon bans currently exist in the U.S., despite the overwhelming approval of a majority of Americans.⁷ Legislature at the federal level cannot agree on the appropriate steps to take on this issue.⁷ The Trump administration even rolled back gun regulations by removing an Obama administration act that prevented those with mental illness from buying a gun.⁷

In 2020, there was a decrease in school shootings (likely due to the COVID- 19 pandemic), but that year also had the highest rate of overall gun violence in U.S. history.⁷ The U.S. has less than 5% of the world’s population, but over 40% of the world’s total guns.⁷ The solution is not a one step process; an effective intervention needs both gun control laws and more readily available mental health resources.

Social-Ecological Model

The Social Ecological Model (SEM) was created by a team of researchers including K.R. McLeroy and was based on Uri Broffenbrenner’s Ecological Model, but the SEM was adjusted to be used for health promotion instead of child development. The SEM is made up of five constructs: intrapersonal factors, interpersonal processes and primary groups, institutional factors, community factors and public policy.¹²

Intrapersonal factors are characteristics that an individual holds; one's knowledge, beliefs and attitudes. Interpersonal processes and primary groups are social interactions and social support systems such as relationships and communication with family, friends and coworkers. Institutional factors are social institutions with rules and regulations such as schools. Community factors are the relationships among different organizations and institutions. The final construct is public policy which are laws and policies at the local, state and federal level.

The constructs of intrapersonal factors, interpersonal processes and primary groups, institutional factors and public policy all have a role in the occurrence of school shootings and must be analyzed in order to create an effective intervention. In order to increase awareness of mental health issues and their role in school shootings Let It End With Us will include solutions for each of these constructs.

Intrapersonal Factors

Mental health illnesses in the context of school shootings can be due to interpersonal factors like genetics, lacking access to treatment, and lack of education. There are also environmental factors (history of child abuse or adverse childhood advents (ACEs) that can lead to mental health issues or amplify existing ones. Let It End With Us will create and implement a mass media campaign to provide education about mental health and decrease its stigma. It will also provide resources and qualified guidance counselors to students to increase access to treatment.

Interpersonal Factors

Children who are exposed to violence and bullying may be at an increased risk for violent behavior. Let It End With Us will provide schools with the tools necessary to create an anti-bullying environment where students feel safe and accepted.

Institutional Factors

School administrations and teachers need to be diligent in noticing students engaging in suspicious activities and unusual behavior. Students who see these behaviors should feel confident in their school administration in taking the necessary action to stop and seek help for the student(s) showing these behaviors. Let It End With Us will educate both students and teachers on warning signs that can often lead to school shootings.

Public Policy

The final construct that has a role in school shootings is public policy. Mental health is a large factor that contributes to school shootings, but the majority of those with mental health issues, both treated and untreated, do not participate in violent acts. Thus, better mental health resources are necessary but not enough. Let It End With Us will work with the Delaware Legislature to put in place policies that address mental health and provide better resources, both in and out of school. It will also work to make guns harder to obtain for this population, ban the sale and possession of assault weapons, create common sense gun laws that prevent those with obvious mental health issues from purchasing a gun, and advocate for detailed background checks, mandatory registration of guns, and safety courses required before a gun can be purchased.

Implementing programs, laws and policies to educate and treat mental health and to make guns harder to buy has been shown to have a large impact on reducing school shootings, and mass shootings in general.

Let It End With Us

Let It End With Us uses the social-ecological model of change to address school shootings in Delaware and the United States and how to prevent them. The intrapersonal, interpersonal, institutional and public policy constructs of the SEM will inform the Let It End With Us program on the three main goals that allow schools, school staff, government and students to work together to end this epidemic (See Appendix A).

The first goal of the program is education. This entails increasing awareness of gun violence and signs of potential school shooters by putting posters up in Delaware schools, educating about the correlation between mental health and school shooters, educating students so that they can get involved and work to end school gun violence, and work to create better safety programs and drills to practice for students, teachers, and staff (See Appendix B). These actions will allow people who might be directly involved in school shootings to be more prepared to potentially stop a shooting before it happens.

The next goal is a communication plan which involves creating social media platforms such as Instagram and Tik Tok. The social media accounts will have posts that educate on school gun violence, show school gun violence statistics, talk about mental health and talk about signs of a school shooter and what people can do to prevent them. Social media allows for the fast distribution of messages and a larger reach.

The last goal is arguably the most important: affecting change in public policy. These policies include gun regulations that would put common sense gun laws and an assault weapon ban into place. Other laws will deal with access to mental health care and work on increasing the availability and affordability of mental health resources both in and out of schools.

These three goals all work together to prevent school shootings by focusing on education, mental health resources and public policy. Delaware is a small state and itself has not had a lot of school shootings, but states could learn from Delaware and implement similar programs in order to decrease the number of school shootings, and other shootings, they have to help stop the gun violence epidemic throughout the United States of America.

Discussion

School gun violence and gun violence in general is a public health issue. Gun violence relates to the social determinants of health, health in all policies and health promotion. School gun violence does not just affect those who are injured, but all the students in the school as well as the community as a whole.

Social determinants of health (where a person is born, lives, grows and works) include aspects such as health care access and quality, education access and quality, economic stability, social and community context and neighborhood and built environment.¹³ Certain areas, communities and schools have increased use of firearms and shootings. This can not only lead to an increased risk of premature death, but also to psychological trauma to both children, adolescents and adults. Where a person lives and their socioeconomic status can determine the amount of violence they will see or be a victim of in their lifetime.

Health in all policies integrates health considerations into policy making in order to improve the health of a population.¹⁴ Part of decreasing school gun violence, and gun violence in general, is accomplished by creating laws. These laws would involve limiting those who can own a gun and restricting the type of guns people can own. Decreasing gun deaths, especially of young people, will improve both the physical and mental health of the population.

Educating about gun violence and gun safety is promoting the health of the population. Education is necessary for people to understand the impact guns continue to have on individuals, families and communities. Health promotion programs aimed to reduce school gun violence could focus on gun safety, mental health and ways to protect yourself in the case of an active shooter.

There are many other aspects of public health that contribute to school shootings, but social determinants of health, health and policy and health promotion are the three major parts of what makes school gun violence a public health issue. Policies, education and increased access to certain resources could decrease the number of shootings, thereby allowing more children to have long lives without the long-lasting trauma that shootings can cause.

Conclusion

I learned a lot from completing this internship. Gun violence has become increasingly prevalent in our society and is a major issue in the United States. What makes the U.S. an outlier to the rest of the world is critical to understand in order to take the steps needed to reduce the number of deaths and improve our public health. It is beneficial to look at the statistics to determine what other countries are doing to successfully reduce or eliminate these events from occurring. Although this is a heartbreaking topic, it is something everyone should educate themselves about no matter where they stand on gun rights and regulations. School shootings in the US affect everyone and are a critical public health issue. Gun regulations and mental health problems need to be seriously addressed to really make a substantial difference.

Implementing school education programs to promote awareness and provide resources are crucial for success. However, education programs and increased mental health resources will only go so far. A major national gun law, the bipartisan 2022 gun law, was developed in response to the Buffalo and Uvalde shootings. This bill expands background checks for those under twenty-one, gives authorities ten days to look at mental health records, and sets aside money for states to provide better mental health programs and put in place red flag laws which allows a gun to be taken away from someone deemed dangerous.⁹ Continued pressure on Congress and a focus on education and mental health will hopefully move the US towards a more peaceful and healthier society.

No matter how much research or statistics show the damage guns have in schools, nothing has changed, even after major school shootings such as Sandy Hook Elementary School, Marjorie Stoneman Douglas High School, and most recently Robb Elementary School. Although I learned what could be done to stop these tragedies, they will still occur, and anyone’s school could be next initiating fear in students, parents and the community.

Appendix A. Logic Model

Goal		Implementation Activities/ Objectives	Short Term Deliverables	Midterm Outputs	Long Term Outcomes
Education	1.	Create posters for schools in Delaware showing school shootings statistics	8/31/22 Posters created	10/15/22 Posters available in ½ of Delaware K-12 schools	1/15/23 Posters available in all Delaware K-12 schools
	2.	Increase student participation in ending gun violence in schools	9/30/22 Initiate school ambassador program	10/15/22 Half of all K-12 DE schools will have student ambassador programs	1/15/23 75% of all DE K-12 schools will have student ambassador program
	3.	Educate students, teachers and staff on signs of a potential school shooter	10/31/22 Create posters on the topic and create a curriculum to be taught in schools	12/31/22 Posters and curriculum available to ½ DE K-12 schools	2/28/23 Posters and curriculum available to all Delaware K-12 schools
	4.	Educate on the correlation of mental health and school shootings	8/31/22 Create videos, social media posts and posters	9/30/22 Information posted and available for everyone	10/31/22 75% of Delawareans are aware of the correlation between mental health and school shootings
	5.	Update school safety plans and security regarding school shootings	10/31/22- 25% of K-12 schools in DE have updated safety plans and protocols in place	2/28/23 50% of DE K-12 schools have updated safety plans and protocols	5/31/23 All K-12 DE schools have updated safety plans and protocols in place
Communication Plan	1.	Create an Instagram, Tik Tok and Twitter	9/1/22 Accounts created	10/23 Accounts are updated by student social media ambassadors
Public Policy	1.	Reach out to legislators in DE Regarding gun laws		12/31/22 Have a plan set by the Legislatures to get gun laws passed in Delaware	Ongoing advocacy for federal and local gun regulations
	2.	Increase mental health resources available to all Delawareans	10/22 Speak to Delaware legislators about increasing the access to mental health resources especially in schools		1/31/23 Pass policy that makes mental health resources more affordable in DE
	3.	Increase training for guidance counselors in schools regarding mental health	9/30/22 Determine appropriate training resources	12/15/22 Have better training for school guidance counselors