We Found Another Big Piece of the School Shooting Puzzle–An Antibiotic for Suicide

As many of you know, since the killing of our daughter Alaina at Marjory Stoneman Douglas High School, in Parkland Florida on Valentines Day, Kelly and I have been searching, studying, & looking for solutions to eliminate the national scourge of school shootings. When it comes to solutions that are focused on school safety and proven to work, we are finding pieces of the puzzle all over the place.  This past week we discovered a BIG piece of the puzzle, one that could fundamentally “change the game” for early identification and intervention.  We were introduced to Dr. Kelly Posner (@posnerkelly) and the work she leads in the field of suicide prevention as Director of the Columbia Lighthouse Project at Columbia University.   

 

Dr. Kelly Posner Gerstenhaber is a professor at Columbia whose work is saving lives in forty-five nations on six continents. The President of the American Psychiatric Association noted her work “could be seen as really a watershed moment, like the introduction of antibiotics…” The U.S. Department of Defense (Dr. Franklin’s quotes) called her work “nothing short of a miracle,” is central to their National Strategy, and stated, “her effective model of improving the world will help propel us closer to a world without suicide.” The CDC noted that her work is “changing the paradigm in suicide risk assessment in the US and worldwide.” After being commissioned by the FDA to develop their scientific methods of suicide risk identification, the FDA has characterized her work as “setting a standard in the field.”  Dr. Posner Gerstenhaber is about to receive The Secretary of Defense Medal for Exceptional Public Service, the highest level of award a civilian can get for impacting the nation.  Here is a recent interview (2/22/2018) with Dr. Posner on CNN:

 

 

Enter the Columbia Lighthouse Project

Let me share a bit of Dr. Posner’s work.  The Columbian Lighthouse Project and the Columbia-Suicide Severity Rating Scale (C-SSRS) is in use in the U.S. Marine Corps, which has seen a 22% reduction in suicide.  It has helped to reduce the suicide rate by 65% over the first 20 months in the Tennessee programs of the nation’s largest provider of outpatient community behavioral health care, and reduced the suicide rate in Utah, the first decrease in suicide in almost a decade and helped to reverse an alarming, and previously increasing trend.

 

How Does the Columbia-Suicide Severity Rating Scale (C-SSRS) Work?

The Columbia-Suicide Severity Rating Scale (C-SSRS) supports suicide risk assessment through a series of simple, plain-language questions that anyone can ask. The answers help users identify whether someone is at risk for suicide, assess the severity and immediacy of that risk, and gauge the level of support that the person needs. Users of the C-SSRS tool ask people:

  • Whether and when they have thought about suicide (ideation)
  • What actions they have taken — and when — to prepare for suicide
  • Whether and when they attempted suicide or began a suicide attempt that was either interrupted by another person or stopped of their own volition

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Public School Discipline: Equal Opportunity Offenders

U.S. Education Secretary Betsy DeVos met with supporters and critics of an Obama-era directive on school discipline on Wednesday.  Secretary DeVos is considering changes to the directive and possibly repealing the guidelines outlined therein.

That 2014 directive, issued jointly by the U.S. Departments of Education and Justice, put school districts on notice that they could be found in violation of federal civil rights law if they create and enforce intentionally discriminatory rules.  However, and perhaps more importantly, school districts could also be at risk of violating federal civil rights laws if their discipline policies lead to disproportionately higher rates of discipline for students of different racial groups.  This risk was present, even if their discipline policies were written without discriminatory intent.

There is an excellent article titled, DeVos Meets With Supporters, Critics of Discipline Rules as GAO Says Racial Disparities Persist written by Evie Blad (@evieblad) covering the meeting and the testimony shared by both proponents and opponents of the directive, over at the Rules for Engagement Blog at Education Week.

Evie writes,

At the heart of the debate of the discipline guidance is why those differing discipline rates occur and the role of the federal government in addressing them. Also at issue: whether schools’ efforts to limit “exclusionary discipline,” such as expulsions and suspensions, have helped students feel more supported or have too severely limited teacher discretion in disciplining students.

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Over 75% of Mass Shooters Communicate Prior to Their Attacks

US-Mass-Attacks-2017

In what I view as further support for state and Federal “Red Flag” legislation allowing law enforcement to seek an “Extreme Risk Protection Order” sometimes referred to as a “Gun Violence Restraining Order”, a report released today from the National Threat Assessment Center (NTAC), part of the United States Secret Service, sheds new light on mass attacks carried out in public places. The NTAC studied 28 incidents that were carried out at 31 sites in 2017 (see map).

Highlights from the report include:

  • Over three-quarters (79%) made concerning communications and/or elicited concern from others prior to carrying out their attacks. On average, those who did elicit concern caused more harm than those who did not.
  • Nearly half were motivated by a personal grievance related to a workplace, domestic, or other issue[s].
  • Over half had histories of criminal charges, mental health symptoms, and/or illicit substance use or abuse.
  • Nearly two-thirds of the attackers experienced mental health symptoms prior to their attacks. The most common symptoms observed were related to psychosis (e.g., paranoia, hallucinations, or delusions) and suicidal thoughts.
  • All had at least one significant stressor within the last five years, and over half had indications of financial instability in that timeframe.

 

The key findings from the report, “support existing best practices that the U.S. Secret Service has established in the field of threat assessment. They highlight the importance of gathering information on a person’s background, behaviors, and situational factors; corroborating the information from multiple sources; assessing the risk the individual poses for violence; and identifying intervention points to mitigate that risk.   I’ve been discussing these intervention points with members of the NTAC to better understand what we can do to protect our children from threats at school. (more…)

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