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National Council Report Proposes Action Items for Providers in Wake of Mass Shootings

August 07, 2019

In the wake of mass shootings in Gilroy, California; El Paso, Texas; and Dayton, Ohio, the Medical Director Institute (MDI) of the National Council for Behavioral Health on Tuesday released a lengthy report on reasons, contributing factors and actional solutions surrounding mass violence through the lens of behavioral health.

“Mass Violence in America: Causes, Impacts and Solutions” cautions against assuming acts of mass violence are due to mental illness and calls for a multifaceted community response to the issue.

“For many law enforcement officers, clinicians, teachers and others, a lack of knowledge has prevented them from developing a coordinated plan to prevent mass violence,” National Council president and CEO Chuck Ingoglia said in a news release. “Previously, we have done our best to prepare for the aftermath. With this comprehensive plan, we finally have a roadmap to preventing and reducing it.”

To develop the report, MDI convened a two-day meeting of experts from all corners of behavioral healthcare last October in Chicago. The panel was comprised of: clinicians, administrators, policymakers, researchers, educators, advocates, law enforcement, judges, the FBI, and parents. A technical writer and co-editors served as recorders of the meeting and compiled literature submissions from panelists, as well as additional research for background material.

The report disputes the theory of mental illness being a major contributing factor to mass violence, noting that individuals with serious mental illness are responsible for less than 4% of all violence and less than one-third of mass violence. The report further states that “assuming acts that seem incomprehensible to the average person are due to mental illness results in millions of harmless, nonviolent individuals recovering from treatable mental health conditions being subjected to stigma, rejection, discrimination and even unwanted legal restrictions and social control.”

“Simplistic conclusions ignore the fact that mass violence is caused by many social and psychological factors that interact in complex ways; that many, if not most, perpetrators do not have a major psychiatric disorder; and that the large majority of people with diagnosable mental illnesses are not violent toward others,” the report adds.


Action items

The MDI’s panel included several recommendations for stakeholders in its report. Healthcare organizations were encouraged to:

  • Establish multidisciplinary threat assessment and management teams that incorporate security, HR, legal and law enforcement
  • Implement ongoing quality improvement measures around issues of violence risk assessment, as well as threat assessment and management
  • Train staff in lethal means reduction
  • Prepare staff members for vicarious trauma and compassion fatigue, providing resources for self-care rituals and support for staff needs

The report also includes practical recommendations for schools, communities, judicial and law enforcement institutions, legislators and government agencies, researchers, and those who work with media. Action items listed focus on enhancing threat/risk assessment, avoiding measures, such as high-stress security drills in schools, that can themselves cause trauma, and establishing stronger partnerships and working relationships between various stakeholder groups.

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