In the time since recent school shootings have taken place, there have been positive proposals made with the goal of decreasing the risk of violence in schools. A number of well-intended recommendations for how schools should operate attempt to afford those in schools greater protection and safety. However, some proposals and recommendations have not included enough careful thought about likely unintended negative consequences.
For example, a recent generally productive proposal by a multidisciplinary group, endorsed by multiple professional organizations and individuals, included a recommendation that there should be a “screen out” of persons who have been hospitalized for violence toward oneself; of course, that would include individuals who have been hospitalized because of suicide attempts or self-injury.
If that proposal was put into effect, it would produce significant negative consequences because there is a substantial proportion of individuals in schools who make suicide attempts or engage in self-injury. To screen these students out of schools would not allow them to return after their hospital treatment (and would be contrary to another part of the same proposal that states “reform of school discipline to reduce exclusionary practices”).
It is crucial to put these considerations into a balanced context. It clearly is extremely important to reduce school and other shootings as much as possible, and yet deciding that children and adolescents who have been suicidal or self-injurious should be screened out of school is counterproductive.
The frequency of youth suicide has been increasing. The most recent data are from 2015. A recent article reported that the teen suicide rate doubled for girls between 2007 and 2015. In that same time frame, for boys, the suicide rate increased 30 percent. For adolescent girls, the 2015 suicide rate was at a 40-year high.
Suicide was the second leading cause of death in the 10- to 14-year-old age group. It was also the second leading cause of death in the 15-to 24-year-old age group.
For every youngster who commits suicide, there are many more who make attempts and an even greater number of very seriously consider it. A 2015 survey of high school students found that, in the prior 12 months, just under 9 percent had made a suicide attempt and just under 3 percent had made an attempt that resulted in treatment by a healthcare professional. That survey also reported that over 14 percent of high school students had made a plan to commit suicide in the prior 12 months.
Nonsuicidal self-injury can also be a significant factor in youth hospitalization. A recent study reported that 13 percent of teenagers reported having engaged in such behavior in the prior year.
There are no easy answers here. Society should not turn a blind eye to school shooting deaths. At the same time, based on the data above, a reasonably conservative estimate would be that 2 or 3 percent of the students at a typical high school might make a suicide attempt or engage in self-injury that results in hospitalization. Therefore, if a high school has 2000 students, about 40 to 60 per year potentially would be screened out and not allowed to return. It would be highly detrimental to those vulnerable students and very negative educational policy.
We need to ask if individuals who have been suicidal are at greater risk of violence toward others. In the United States, there is a negative correlation between suicide and homicide – those who have been suicidal are likely at a lower risk for homicide than the general population. Therefore, eliminating students who have been suicidal from schools would do nothing to decrease the risk of school shootings and deaths.
Of course, it is easier to identify what should not be done than what might improve matters (I am not dealing at all here with concerns like school building security or debates about gun control). For years, many professionals have worked on attempting to predict violence, and it remains extremely challenging. One relatively comprehensive approach focuses on collecting information on each relevant individual that pertains to numerous types of personal historical, clinical, and relatively dynamic factors. Historical information includes, in part, past violence or other antisocial behavior. Clinical information focuses on the presence of disorders or conditions that may have an association with aggressive behavior (is important to note that most mental health conditions are not associated with an increased risk of violence). Dynamic factors are those that can change and contribute to frustrations that might heighten the short-term risk of aggression, such as relationship, financial, or residential stresses.
Such an approach has been found to improve the predictions of violence among individuals who have been incarcerated or on probation – arrests, reincarceration, or violence during incarceration provide data about whether an individual has acted in a violent manner. However, because it is much more difficult to collect information about violent behavior in the community, it is basically unknown how well such an assessment approach would work to decrease school shootings. At the same time, this relatively comprehensive approach to collect and cognitively process relevant risk information is probably the best type of methodology that we have, and therefore it makes sense to put it to use to try to increase school safety.
American Academy of Suicidology (2017). Youth suicide fact sheet. VIEW HERE
Bills & Li (2005). Correlating homicide and suicide. International Journal of Epidemiology, 34, 837-845.
Yang et al. (2010). The efficacy in violence prediction: a meta-analytic comparison of nine risk assessment tools. Psychological Bulletin, 136, 740 – 767.