Examining Mental Health and Recovery Following School Shootings

Abstract

This dissertation examines the mental health impacts of school shootings in the United States, with a particular focus on the effects on subpopulations, gaps in existing research, and the importance of incorporating survivor perspectives into study design, interpretation of findings, and dissemination. Since 1999, over 380,000 students have been exposed to firearm violence while at school, yet the broader mental health consequences remain underexplored. The first study synthesizes the existing literature on school shootings and mental health, reviewing 84 studies published across various databases. The scoping review reveals that post-traumatic stress symptoms (PTSS) and depressive symptoms are the most commonly studied outcomes, with a concentration on a few major shootings, particularly Virginia Tech and Northern Illinois University. The review also identifies key gaps, including a lack of diversity in study populations, limited longitudinal data, and an over-reliance on quantitative outcomes. It advocates for more inclusive research that incorporates qualitative methods and longitudinal data to better understand the long-term mental health consequences of school shootings. The second study examines the mental health impact of the 2022 Robb Elementary School shooting in Uvalde, Texas, using data from the Behavioral Risk Factor Surveillance System (BRFSS). This quasi-experimental study assesses the number of poor mental health days in the past 30 days among adults exposed to the shooting compared to those unexposed, based on interview timing relative to the event. Findings show a modest increase in poor mental health days across the general population, with a significant 6% increase for Hispanic individuals (IRR = 1.06, 95% CI: [1.00, 1.12]), highlighting the need for subgroup-specific research on secondary trauma. The third study is qualitative and engaged 13 survivors of school shootings to identify research priorities and resource needs. Participants, including former student survivors and family members, represent survivors from 10 different shootings across the U.S. between 1997 and 2022. The study highlights three key research areas: (1) the long-term mental health impacts of school shootings, (2) the need for research on broader outcomes beyond traditional mental health metrics, and (3) the importance of diversifying research approaches to capture the varied experiences of survivors. Together, these studies emphasize the need for a more nuanced and inclusive approach to studying the mental health impacts of school shootings. By addressing critical gaps in the literature and prioritizing survivor-centered research, this dissertation contributes to improving interventions and support systems for survivors.