What Have We Learned About Preventing School Shootings?

On November 30, a 15-year-old sophomore at Oxford High School in Michigan killed four students and injured seven others. Both the student and his parents are presently incarcerated and charged with numerous crimes.

In the days following this tragic event, questions arose regarding what the parents and school might have done to prevent this from happening. The parents are facing charges of involuntary manslaughter and a federal lawsuit, perhaps the first of others to follow, has been filed against the school district alleging that more could have and should have been done.

Warning signs and preventive actions.

With each school shooting we again find ourselves asking ourselves what can be learned in terms of warning signs and actions that could be taken. The September Mental Health Matters column in AJN, which I co-authored with Arlene Holmes—whose son James was responsible for the mass shootings in Aurora, Colorado, in 2012—highlighted warning signs that might indicate potential violence by someone experiencing mental health problems.

What can be learned from the events that unfolded in Oxford that could be applied to a similar scenario, perhaps heading off another tragedy? The following checklist compiled by Sandy Hook Promise, a nonprofit organization that aims to educate youth to […]

2021-12-15T11:43:26-05:00December 15th, 2021|mental illness, Nursing|0 Comments
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Children’s Mental Health Crisis Reveals Holes in System

You don’t have to look far for evidence that the mental health of children and adolescents has been entering a crisis in recent years, one exacerbated by the unusual conditions imposed by Covid-19.

The June 18 Morbidity and Mortality Weekly Report (MMWR) from the CDC reported:

During February 21–March 20, 2021, suspected suicide attempt ED visits were 50.6% higher among girls aged 12–17 years than during the same period in 2019; among boys aged 12–17 years, suspected suicide attempt ED visits increased 3.7%.

Photo by Yasser Chalid/Getty Images

As noted in a recent Washington Post story, “Emergency departments have meanwhile become a tattered safety net for adolescent mental health care.”

In this month’s AJN, Betsy Todd summarizes some of the current issues seen by school nurses and other health care professionals like nurse practitioners (NPs), who often feel overwhelmed by the intensity of the suffering and need they are now seeing in many children.

Systems pushed to their limits.

Todd notes that existing systems are proving woefully inadequate to the growing need, with wait times increasing to see child psychiatrists, therapists, and other experts, and pediatric hospitals in several states reporting “sharp increases in ED visits for anxiety, depression, […]

2021-09-03T12:37:10-04:00September 3rd, 2021|mental illness, Nursing, pediatrics|0 Comments
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For the Mentally Ill in Crisis, Someone Safe to Call for Help

A troubling encounter.

by julianna paradisi

Although it happened over two months ago, I’m still haunted by the memory, particularly during this cold, harsh winter following on the heels of a politically tumultuous summer and fall.

I’ve run the same loop along the Willamette River in Portland, Oregon, for years. This particular morning, a young man walked some 20 feet ahead of me on the sidewalk. He carried by its neck a 1/2 gallon jug of apple juice. Unexpectedly, he tossed an opened box of granola bars, with several individually wrapped bars inside, to the ground and kept walking.

He stopped abruptly at the same time I stopped to wait on the curb for traffic to subside so I could cross to the other side of the street, which is what I routinely do on my route.

We were now six to eight feet apart. From my peripheral vision I noticed him turn and face me. Because we’re in the middle of a pandemic, I was wearing a mask; this and my proximity seemed to disturb him. I stepped away a few paces, giving him more space.

Over my shoulder he said, “You’re a bitch.” I ignored him. He stepped closer, and repeated more loudly, “You’re a […]

2021-02-25T10:54:11-05:00February 25th, 2021|mental illness, mental illness|0 Comments
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Practicing the ABCDEs of Self-Care in Pandemic Times

While talk of the surge in COVID-19 cases continues, what has been less audible in the national discourse is the surge in mental health distress that will be with us long after the pandemic is gone. Many of us who have enjoyed relative psychological well-being are feeling inundated with near-pathological levels of anxiety, uncertainty, anticipatory grief, and real or secondary trauma.

Here are ABCDEs of self-care to keep yourself and loved ones emotionally—and physically—well.

ABCDEs of Self-Care

About

Stay informed as you need to regarding the pandemic, but then promptly pull yourself away and unplug. Initiate what we call a “sensory diet” to limit anxiety-provoking exposure to TV and radio news, social media, print materials, etc., beyond what you must know for yourself, your family, and/or your job. Fearful news can be addictive. Don’t overindulge!

Body

Many people, when asked how they can best care for themselves to stay well, say something on the order of “handwashing, masks, social distancing….” Sure, all that! But we also need to respect the healthy things our mother tried to teach us. How about exercise and fresh air (even if it’s just a three-minute brisk walk around the block), adequate sleep and decent nutrition? Honoring our bodies now will help us stay healthy and […]

2021-01-21T11:10:16-05:00April 13th, 2020|infectious diseases, mental illness, Nursing, wellness|0 Comments
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We Can Do More to Prevent Patient Self-Harm in the Hospital

“Phone cords, plasticware, and pens – all items found on a typical hospital unit and all seemingly benign.  Yet unchecked, each can be used by a patient to cause self-harm.”

As our health care system jettisons more and more psychiatric inpatient beds, it seems that the old “medical psych” units are becoming a thing of the past. These were the units where a person with significant mental health problems stayed after surgery, or after a medical event. The fact that these patients had at least two serious health challenges—one mental, the other physical—was routinely acknowledged, and medical psych units were staffed with nurses expert in both types of care.

Self-harm on nonpsychiatric units: a closer look at who and how.

Today, patients with serious mental illness are routinely “housed” on medical or surgical inpatient units. Some of these patients have a history of self-harm, and nonpsychiatric hospital units are not designed to keep them safe.

In “Preventing Self-Harm in the Nonpsychiatric Health Care Setting” in this month’s AJN (free until December 10), Kim Liberatore from the Pennsylvania Patient Safety Authority shares some of her organization’s data on patient self-harm events in nonpsychiatric settings. […]

2019-11-22T09:47:57-05:00November 22nd, 2019|mental illness, Nursing|1 Comment
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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