Emergency Preparedness Drills for Active and Mass Shootings in Schools

PURPOSE OF REVIEW

There is widespread use of emergency preparedness drills in public K-12 schools across the US, but considerable variability exists in the types of protocols used and how these practices are conducted. This review examines research into both "lockdown drills" and "active shooter drills" as it relates to their impact on participants across different outcomes and evaluations of their procedural integrity.

RECENT FINDINGS

A number of studies on lockdown drills yielded largely consistent findings about their impacts, whereas findings related to the effects of active shooter drills are less uniform. The research also demonstrated that lockdown drills, though not active shooter drills, can help participants build skill mastery to be able to successfully deploy the procedure. Differences in how drills impact participants and whether they cultivate skill mastery are largely attributable to the type of drill being conducted. This review suggests that employing clearly defined drill procedures incorporating best practices, coupled with instructional training, can help schools prepare for emergencies without creating trauma for participants.

Experiences of stress and social safety among sexual and gender minority youth by disability status

BACKGROUND

Though separate bodies of research have shown sexual and gender minority (SGM) youth, and youth with disabilities, separately, face distinct social and health disparities, little is known about youth who both identify as SGM and have disabilities.

OBJECTIVE

The current study examined differences in wellbeing among SGM youth by disability category (i.e., physical, developmental, psychiatric) across victimization, bullying, dating violence, school safety, and experienced stress.

METHODS

Using self-reported data from 9418 SGM youth aged 13-17 in the United States, multivariate linear regressions were conducted to examine how stress and social safety experiences varied across disability status.

RESULTS

Compared to SGM youth without a disability, SGM youth across all disability categories (physical, developmental, psychiatric) had greater odds of LGBT- and disability-based victimization, greater average stress, as well as lower levels of school safety. SGM youth with any disability, physical disability, or psychiatric disability also had greater odds of dating violence compared to SGM youth without a disability.

CONCLUSION

SGM youth with disabilities may be in particular need of targeted programs that address both disability and sexual/gender identities, and may benefit from increased supports across developmental contexts (e.g., against bullying in school). Stakeholders should consider how such support can be improved, tailored, and implemented, for SGM youth and the diversity of disabilities they have.

Gender Sexuality Alliances and School Safety: Who Benefits Most, and Do Additive School-Led Practices Strengthen the Link?

While Gender and Sexuality Alliances (GSAs) are associated with higher acceptance of sexual diversity and lower bullying-victimization, it is unclear which individual and school-level attributes strengthen these associations. Nationally representative data (N = 1,567 students; Mage = 15.4, SD = 0.16; 34% boys, 66% girls, 51% heterosexual, 49% sexually-diverse after propensity score matching) in 139 Dutch secondary schools were used. Multilevel regression analyses revealed that GSA presence was linked to more inclusive attitudes about sexual diversity and a safer disclosure climate among sexually-diverse students, and lower general bullying-victimization when the school had a GSA combined with school practices to tackle bullying. School professionals and researchers are recommended to recognize the significance of individual and school-level factors that affect GSA correlates.

Adolescent mental health in Japan and Russia: The role of body image, bullying victimisation and school environment

This study examined associations between self-reported mental health problems, body image, bullying victimisation and school safety in large adolescent samples in Japan and Russia, considering the effects of gender, culture and their interactions. In both Japan and Russia, girls reported a greater number of mental health problems, less bullying victimisation and much higher body dissatisfaction than boys did. Japanese adolescents rated themselves higher on total difficulties, reported less body dissatisfaction and bullying victimisation, and rated their school safety lower than that of Russian youths. Cross-cultural differences in total difficulties and body image were qualified by gender. Body dissatisfaction, bullying victimisation and school safety all independently contributed to adolescent mental health problems. The protective effect of school safety on total difficulties was larger for girls than for boys; the strength of the association between bullying victimisation and adolescent mental health problems differed across genders and cultures. The findings indicate a need for a cross-cultural approach and provide a strong basis for targeted interventions that seek to improve adolescent mental health.

Mass shootings, firearm injuries, and mental health

INTRODUCTION

The correlation between mass shootings, firearm injuries, and mental health is an ongoing polarized debate within the U.S., making it essential to develop public policy on mental illness and firearm injuries exacerbated by a significant increase in firearm sales in March 2020. Although many mass shooters are labeled "mentally ill," mental illness is only present in a small minority of cases. Most mentally ill people are never violent but are more likely to be the victims of violence. Easy access to firearms and a triggering event deriving from social and economic inequalities are primary causes of mass shootings and growing online radicalization. Radicalization can easily lead to fatal firearm injuries, particularly for individuals with diagnosed or undiagnosed mental illness.

RECOMMENDATIONS

Proposed solutions include permits for firearms purchase, including a 25-year-old age limit, universal background checks, and banning large-capacity magazines. Additionally, a speedy and effective law enforcement response is the sole factor and the most reliable way to stop a mass shooting once it has started. The research identified several other recommendations, including expanding Medicare and mental health care access, expanding school safety and law enforcement training, and promoting public education about mental health and firearm safety.

Gun violence in K-12 schools in the United States: Moving towards a preventive (versus reactive) framework

Intentional shootings in K-12 schools in the U.S. persist as a public health problem. The number of shootings in K-12 schools has increased precipitously since 2017. And with approximately 100,000 K-12 public schools nationally serving 51 million children, investing in a comprehensive gun violence prevention strategy is critical. Unfortunately, our current school gun violence prevention approach almost exclusively centers reactive strategies that are in place to respond to acts of gun violence in the moment, rather than preventive strategies that would prevent them from occurring at all. Reliance on these strategies alone, however, is not sufficient. In line with the core tenets of public health prevention and the Whole School, Whole Child, Whole Community model, we present a more expansive school gun violence prevention framework that broadens the spectrum of what constitutes "school gun violence prevention." Our work highlights how enhancing basic neighborhood and school structures-including investments in public libraries, affordable housing, and universal school-based violence prevention programs-are key to both preventing gun violence and promoting well-being. We also highlight the role of stricter gun laws, reasonable school security efforts, bystander interventions, building awareness within school communities, and meaningful investments in early interventions and mental health services. Children, who have been tragically exposed to any number of adverse experiences in the wake of the COVID-19 pandemic, deserve more reasoned choices and large-scale investments in understanding and cutting off the root causes of school gun violence; not just a reliance on strategies that focus on what to do in the moment of a violent act. As gun violence in K-12 schools persists, we must reframe the discourse about school gun violence around prevention, not reaction.

Peer victimization, environmental and psychological distress, and academic performance among children in China: A serial mediation model moderated by migrant status

BACKGROUND

Despite robust evidence indicating the adverse academic, psychological, and school-related impacts of being victimized, the ways in which peer victimization indirectly affects children's academic performance by psychological and environmental distress remain poorly understood, especially in China.

OBJECTIVE

We sought to investigate how peer victimization negatively impacts academic performance via the serial mediation effects of environmental and psychological distress among migrant versus non-migrant children in China.

PARTICIPANTS AND SETTING

Participants were selected by multistage stratified cluster sampling, and data were collected with a cross-sectional survey administered in Nanjing and Guangzhou, China. The sample included 1747 students in Grades 4 to 9 (boys = 54.7 %, mean age = 11.7 years).

METHODS

Structural equation modeling and group comparison analysis were conducted to examine the hypothesized model.

RESULTS

Children's experiences with peer victimization significantly affected their academic performance and in relationships partially mediated by environmental distress (i.e., perception of school safety), followed by psychological distress (i.e., anxiety) (95 % CI: [-0.010, -0.001], B = -0.005, p < .01). The serial mediation model applied to non-migrant children only (95 % CI: [-0.026, -0.001], B = -0.008, p < .05), however, whereas environmental distress exerted a single mediating effect on the association between peer victimization and academic performance among migrant children only (95 % CI: [-0.125, -0.044], B = -0.076, p < .001).

CONCLUSION

Environmental and psychological distress exerted serial mediating effect on the association between peer victimization and academic performance. School-based comprehensive intervention programs designed for migrant versus non-migrant children are recommended.

K-12 School Shootings: Implications for Policy, Prevention, and Child Well-Being

Schools should be considered safe spaces for children; children need to feel secure in order to grow and learn. This article argues that when a school shooting occurs, the harm goes beyond those who are injured or killed, because the presumption of security is shattered, and the mental and emotional health of the students is threatened. There are many interventions for preventing these attacks at the school, state, and federal levels. This article explores evidence behind some of these interventions and describes the delicate balance in implementing interventions without introducing undue stress and anxiety into a child's everyday life.

Impact of a School-Based, Multi-Tiered Emotional and Behavioral Health Crisis Intervention on School Safety and Discipline

Schools across the United States are struggling with how to formulate comprehensive and effective programs to address the mental health needs of students and to promote school safety. This study, funded as part of the National Institute of Justice Comprehensive School Safety Initiative, employed a randomized controlled study design to evaluate the impact of a multi-component package of crisis prevention and response interventions on school safety and discipline outcomes, including suspensions, office discipline referrals, bullying reports, juvenile justice referrals, threat assessments, and follow-up procedures. Forty schools participated, all in a culturally diverse Mid-Atlantic, US school system spanning urban, suburban, and rural areas. The Emotional and Behavioral Health-Crisis Response and Prevention (EBH-CRP) intervention is a comprehensive training, organizational, and support protocol for school and community stakeholders aimed at increasing competence in preventing and responding to student EBH crises using multiple evidence-informed strategies that address emotional and behavioral health concerns across the continuum of supports. Results indicate that the EBH-CRP intervention had a significant positive effect on suspensions, office discipline referrals, and juvenile justice referrals for secondary schools. In addition, the intervention had positive effects on the number of bullying reports overall, with a particularly strong impact on primary schools. The intervention also had positive effects in maintaining more use of threat assessment and follow-up procedures. Although the intervention had a significant positive effect on secondary school-level suspensions, there was no impact on racial/ethnic disproportionality rates for this outcome. Implications for school safety prevention are discussed.

Building Schools' Readiness to Implement a Comprehensive Approach to School Safety

Research consistently finds that a comprehensive approach to school safety, which integrates the best scientific evidence and solid implementation strategies, offers the greatest potential for preventing youth violence and promoting mental and behavioral health. However, schools and communities encounter enormous challenges in articulating, synthesizing, and implementing all the complex aspects of a comprehensive approach to school safety. This paper aims to bridge the gap between scientific evidence and the application of that evidence in schools and communities by defining the key components of a comprehensive approach to school safety and describing how schools can assess their readiness to implement a comprehensive approach. We use readiness and implementation data from the Safe Communities Safe Schools project to illustrate these challenges and solutions. Our findings suggest that (1) readiness assessment can be combined with feasibility meetings to inform school selection for implementation of a comprehensive approach to school safety and (2) intentionally addressing readiness barriers as part of a comprehensive approach may lead to improvements in readiness (motivation and capacity) to effectively implement a comprehensive approach to school safety.

Is More Necessarily Better? School Security and Perceptions of Safety among Students and Parents in the United States

The use of security measures within schools has increased dramatically over the past few decades. These proliferations are often touted by teachers, school administrators, politicians, and the public as necessary for improving student safety. Though research in this area is growing, we know little about how increased use of school security measures relates to both student and parental perceptions of school safety. Using data from wave one of the 2002 Educational Longitudinal Study, the current study investigates the relationship between the use of security measures in schools and student and parent assessments of safety. Findings from multi-level models indicate that school security measures are, generally, related to decreased perceptions of safety by both parents and students. Implications of these findings are addressed.

Automated Risk Assessment for School Violence: a Pilot Study

School violence has increased over the past ten years. This study evaluated students using a more standard and sensitive method to help identify students who are at high risk for school violence. 103 participants were recruited through Cincinnati Children's Hospital Medical Center (CCHMC) from psychiatry outpatient clinics, the inpatient units, and the emergency department. Participants (ages 12-18) were active students in 74 traditional schools (i.e. non-online education). Collateral information was gathered from guardians before participants were evaluated. School risk evaluations were performed with each participant, and audio recordings from the evaluations were later transcribed and manually annotated. The BRACHA (School Version) and the School Safety Scale (SSS), both 14-item scales, were used. A template of open-ended questions was also used. This analysis included 103 participants who were recruited from 74 different schools. Of the 103 students evaluated, 55 were found to be moderate to high risk and 48 were found to be low risk based on the paper risk assessments including the BRACHA and SSS. Both the BRACHA and the SSS were highly correlated with risk of violence to others (Pearson correlations>0.82). There were significant differences in BRACHA and SSS total scores between low risk and high risk to others groups (p-values <0.001 under unpaired t-test). In particular, there were significant differences in individual SSS items between the two groups (p-value <0.001). Of these items, Previous Violent Behavior (Pearson Correlation = 0.80), Impulsivity (0.69), School Problems (0.64), and Negative Attitudes (0.61) were positively correlated with risk to others. The novel machine learning algorithm achieved an AUC of 91.02% when using the interview content to predict risk of school violence, and the AUC increased to 91.45% when demographic and socioeconomic data were added. Our study indicates that the BRACHA and SSS are clinically useful for assessing risk for school violence. The machine learning algorithm was highly accurate in assessing school violence risk.

Surveillance or Safekeeping? How School Security Officer and Camera Presence Influence Students' Perceptions of Safety, Equity, and Support

PURPOSE

Target hardening, or increasing the use of security measures, is a frequently used response to perceived safety concerns in schools. Studies are mixed as to their effectiveness on students' perceptions of safety and little is known about their influence on other aspects of school climate, particularly for minority students. This study will examine the association between observed security measures in secondary schools and students' perceptions of safety, equity, and support.

METHODS

School climate surveys were completed by 54,350 students from 98 middle and high schools across the state of Maryland beginning in Spring 2014. Concurrent observations of the school physical environment, including security measures (i.e., officers and cameras), were conducted by trained outside assessors. Multilevel regression analyses examined the association between school security officers and cameras and students' perceptions of safety, equity, and support, while controlling for school and neighborhood characteristics. Cross-level interactions explored differential effects of security measures for Black students.

RESULTS

Greater use of security cameras inside the school was related to lower perceptions of safety, equity, and support. A moderate level of security camera use outside the school was related to higher student perceptions of support. Security officer presence was associated with higher perceptions of safety. For black students, cameras were associated with elevated perceptions of safety and support relative to white students.

CONCLUSIONS

Our findings may suggest that outside cameras and security may be perceived by students as safekeeping, whereas inside cameras may evoke feelings of being viewed as potential perpetrators who need surveillance.

Perceived school safety, perceived neighborhood safety, and insufficient sleep among adolescents

OBJECTIVES

To examine whether perceptions of school safety and neighborhood safety are associated with insufficient sleep during adolescence.

DESIGN

The Florida Youth Substance Abuse Survey (FYSAS) is a cross-sectional study of adolescents.

SETTING

The state of Florida.

PARTICIPANTS

Middle-school and high-school students (n = 7,958) attending public schools in 2017.

MEASUREMENTS

Based on National Sleep Foundation recommendations, sleep was categorized as insufficient (less than 7 hours) or sufficient (7 or more hours) using self-reports of average sleep duration on school nights. Self-reports of perceived safety at school and perceived safety in one's neighborhood were modeled as predictors of insufficient sleep in logistic regression models when accounting for several covariates.

RESULTS

Adjusting for model covariates, the odds of insufficient sleep among adolescents who feel unsafe both at school and in their neighborhood are 129% greater relative to adolescents who feel safe in both contexts. In comparison, the odds of insufficient sleep among adolescents who feel unsafe only at school are 39% greater relative to adolescents who feel safe both at school and in their neighborhood, and the odds of insufficient sleep among adolescents who feel unsafe only in their neighborhood are 71% greater relative to adolescents who feel safe both at school and in their neighborhood.

CONCLUSIONS

The findings of this study indicate that efforts to improve the safety of salient social contexts in which adolescents develop may reduce the likelihood of insufficient sleep faced by a large portion of school-aged children.

School Security Measures and Longitudinal Trends in Adolescents' Experiences of Victimization

Although school security measures have become a common fixture in public schools across the United States, research on the relationship between security and adolescent victimization is mixed, with very few studies examining trends in adolescent victimization across time. Using two waves of data from the Educational Longitudinal Study 2002 (N = 7659; 50.6% female; 56.7% White, 13.3% Black, 13.5% Hispanic, 11.3% Asian American, 5.4% other race), results from a series of multi-level models demonstrate that adolescents in schools with more security measures report higher odds of being threatened with harm, and no difference in odds of being in a physical altercation or having something stolen over time. Although prior research has established racial disparities in using school security measures, results demonstrate inconsistent patterns in the extent to which adolescents' race conditions the relationship between security and victimization. The findings are discussed in light of existing theoretical and empirical work, and implications for both research and practice are offered.

School Sense of Community, Teacher Support, and Students' School Safety Perceptions

This study examined the association between two characteristics of school climate (sense of community and teacher support, measured both at the individual and at the school level) and students' feelings of being unsafe at school. The study involved a sample of 49,638 students aged 10-18 years who participated in the 2010-2012 California Healthy Kids Survey. Using hierarchical linear modeling (HLM), our findings revealed that, at the individual level, students perceiving higher levels of sense of community and teacher support at school were less likely to feel unsafe within the school environment. At the school level, sense of community was negatively associated with unsafe feelings, whereas there was no association between school-level teacher support and feelings of being unsafe at school.

Lesbian, gay, bisexual, and transgender youth: Limited representation in school support personnel journals

Many lesbian, gay, bisexual, and transgender (LGBT) youth experience harassment and discrimination in schools and these experiences lead to increased negative social-emotional outcomes. Youth who can identify at least one supportive adult at school report better outcomes than youth who cannot identify a safe adult. Yet, many educators report feeling uncomfortable or unprepared to support LGBT youth. One reason for educators' discomfort may be that content related to issues unique to LGBT youth is sometimes missing or covered minimally in university training programs. We hypothesized that LGBT content may be covered minimally in school support personnel journals, as well. This study analyzed eight school support personnel journals across the disciplines of school counseling, school nursing, school psychology, and school social work for LGBT content published between 2000 and 2014 to gain a better understanding of the visibility of LGBT issues in the research. Results suggested that there has been a lack of presence of LGBT issues in journals across disciplines. These results also suggest a need for an intentional focus on issues relevant to LGBT youth in school support personnel journals. Thus, the article concludes with an introduction to two articles in this special topic section, including Russell, Day, Ioverno, and Toomey's (in this issue) study on teacher perceptions of bullying in the context of enumerated school policies and other supportive sexual orientation and gender identity related practices and Poteat and Vecho's (in this issue) study on characteristics of bystanders in homophobic bullying situations. The broad goal of these three studies is to increase visibility of critical LGBT issues in school support personnel journals.

Understanding Teachers' Responses to Enactments of Sexual and Gender Stigma at School

Although teachers may be in a position to address enactments of sexual and gender stigma among their students, little is known about their motivations to intervene in such situations. We surveyed secondary school teachers in the Netherlands, assessing how beliefs, norms, and self-efficacy were related to their intentions to intervene in two hypothetical situations that involved bullying of lesbian/gay or gender non-conforming students. We found significantly stronger intentions to intervene among teachers who were more confident in their abilities to intervene successfully and who had stronger beliefs that intervening in the situation would produce a positive outcome.

Safety assessment in schools: beyond risk: the role of child psychiatrists and other mental health professionals

This article presents an overview of a comprehensive school safety assessment approach for students whose behavior raises concern about their potential for targeted violence. Case vignettes highlight the features of 2 youngsters who exemplify those seen, the comprehensive nature of the assessment, and the kind of recommendations that enhance a student's safety, connection, well-being; engage families; and share responsibility of assessing safety with the school.

Anaphylaxis in the young adult population

It is critical that clinicians treating young adults understand the presentation and management of anaphylaxis. The most common trigger for anaphylaxis in this population is food. The prevalence of food allergy is growing, with 8% of US children and adolescents affected. All patients at risk for anaphylaxis should be prescribed epinephrine autoinjectors, as epinephrine is the only life-saving medication for a severe anaphylactic reaction. The presentation of anaphylaxis can involve multiple organ systems (eg, mucocutaneous, respiratory, cardiovascular, gastrointestinal) and, as such, patient education is needed to assist in prompt recognition. Appropriate training of patients and caregivers about how to identify anaphylaxis and what to do in an emergency is critical. Training of school and college staff also is essential, as 1 in 4 first-time reactions occurs outside the home. Additional counseling for adolescents at risk for anaphylactic reactions should address increased risk-taking behavior, decreased adult supervision, dating, and the transition of disease management from an adult to the patient.

The physical and psychosocial environments in Swedish schools: quality aspects and relations to pupil-injury determinants as perceived by school principals

The study investigated relations between the quality of the physical and psychosocial environments in Swedish schools and pupil-injury determinants as perceived by school principals. Data came from a representative sample of public-sector Swedish schools. Schools were divided into four classes on the basis of the types and magnitudes of environmental problems they experienced. Associations between problems and type of school, type of district, and degree of importance attributed to various pupil-injury determinants were measured. Two schools in three were classified as having no environmental problems, and one in 20 as having both types. Significant associations were found between type of problem (environmental load), type of district and perceptions of some injury-inducing factors. Improvements to the school environment may benefit pupils' education and development as well as their safety and well-being. The study provides an aid for the setting of priorities in these respects.