Source: Adobe Stock concept/515328534 purchased

Mass murders have become very common in the U.S., and the numbers are on the rise. Can we understand their commonalities, define risk factors, create prevention plans, and reduce the number of mass murders going forward?

The Vulnerability of Soft Targets

There are almost weekly mass shootings in the U.S. We all want to know how to prevent these tragic events. To do that, we need to understand the phenomenon. Many mass shooters in the U.S. often seek out "soft targets" where there is less likelihood of an immediate police presence, such as restaurants, churches, schools, stores, and businesses. By understanding what targets are vulnerable, we can be more alert to potential danger and devise better protection plans and faster action when one of these events takes place.

Workplaces are examples of soft targets. Workplace violence is often perpetrated by a disgruntled employee, especially when there is an impending dismissal or disciplinary action; these employees have demonstrated unwanted or disruptive behavior over a period of time, which caused other employees and managers to feel concerned. If these behaviors go on long enough and are serious enough, these employees might be considered for discipline or dismissal. However, if management and HR departments identify problems early, they might consider referring such employees to an employee assistance program (EAP) while the disruptions are minor. One might consider mandatory classes or treatment in order to keep their job as a first step before disciplinary actions are taken. For example, on April 10, 2023, a terrifying workplace mass murder occurred at a Louisville downtown bank. An employee about to be dismissed entered the bank where he worked and killed or wounded a number of his coworkers. His parents are now saying that he had mental health problems, and they had been trying to get him help. Perhaps more access to mental health services through an EAP could prevent a future terrible event.

Another "soft target" is schools. A previous student of the Covenant Elementary School, in Nashville, TN, is an example. She chose to target the school she attended years earlier, partly because there was less security, partly because she may have experienced trauma there, and partly because she knew the school's layout. The shooter horrifically murdered three children and three school employees. Police arrived and quickly confronted and killed the shooter, potentially saving many lives.

The Uvalde school shooting presents a stark contrast, with effective responses taking more than an hour. Perhaps police departments could evaluate, ramp up and practice quick responses to active shooter calls. Active shooter drills are now becoming more widely used. However, it is important not to traumatize children with active shooter drills by having mental health professionals available as well as police.

Families are also "soft targets." In February of this year, a 52-year-old man killed six people, including his wife and siblings, in Tate County, Mississippi. In families, there are often multiple incidents of non-lethal violence before someone attempts to take the lives of loved ones. It is important to get family members the mental health services they need at the first sign of disruption and aggression. Teaching family members problem-solving and communication skills is a good strategy. Police officers are the most likely to be aware of homes where there is conflict and violence. Partnerships between mental health professionals and police departments for "at-risk" families are becoming more popular and can be very effective.

Even though many colleges have campus police, classrooms and dorms can be "soft targets," as well. In 2023, a mass murderer shattered the peaceful campus of Michigan State University with horrific gunfire. Three students were killed and five people were wounded, despite a quick police response. The shooter was a young man who had grievances and felt rejected by his peers. He was likely a troubled young man with difficulty getting along with others. Perhaps better ways to identify and provide services for those with violent inclinations are crisis mental health services without stigma on campuses. Perhaps they could consider drop-in centers with a variety of resources, including counselors. Students may benefit from seminars on identifying warning signs of violence and what to do about them.

These horrible mass murders will continue until we, as a society, understand and actively use our knowledge of risk factors to help those in great distress to get assistance for their life problems and, when necessary, to have the courts and police remove their guns. The issues around involuntary hospitalization are also very complex and need review nationwide.

Gun control is a popular topic, and it has been in the news for the last several years. Another popular solution is to increase access to mental health services. Additionally, professionals and the general public need to be educated about the risk factors for violence so that preventive services can occur.

Research on Violence Risk Factors

To reduce the senseless shootings of innocent people in the U.S., we must understand the violence risk factors and know how to provide services to prevent future violence. There have been 130 mass shootings in 2023 thus far. Never have we seen such an enormous number of mass shootings. The work of multiple researchers has identified some of the common characteristics of mass shooters. Knowing the characteristics of most mass shooters can help us understand how to reduce this enormous number of violent acts, especially in schools, churches, and businesses where the public gathers. The research on this topic has been ongoing for a decade or more and needs to be continued, widely known, and understood. The following are some examples of findings.

Jillian Peterson, an associate professor of criminology at Hamline University, and James Densley, a professor of criminal justice at Metro State University, created a database and studied every shooter since 1966 with four or more victims. They found multiple characteristics that affected most of those who committed mass murders. Reviewing this and other research is helpful.

1. The majority of mass shooters experienced early childhood trauma.
2. Most mass murderers were in social or emotional crisis, often due to rejection by and grievance toward a person or group.
3. Many mass shooters had suicidal ideation or ruminations.
4. The majority showed obvious warning signs of problems with aggression toward others.

Other research has also identified similar risk factors for violence, which solidifies our understanding of violence risk factors and can be used to provide preventative services. They include:

1. Childhood trauma that has not received trauma treatment.
2. Severe mental health problems, including depression, suicidality, personality disorders, and past aggression.
3. That a person at risk may be in a severe social or emotional crisis.
4. The youth or adult has been rejected by their peer group, potential life partner, family, or institution, causing the youth to develop a grievance against others.

The “Adverse Childhood Experiences” research found an association between childhood trauma and poor life outcomes for traumatized young people. The questionnaire, developed through the joint research of Kaiser Permanente, a prominent healthcare company, and the Centers for Disease Control and Prevention (CDC), identified the number and type of traumatic events a person experienced in childhood by surveying a large number of adults. The questionnaire gives each item a score of “1” if present. A score of more than five is correlated (associated with) poorer social, behavioral, emotional, and medical outcomes in adulthood. Further, there is also research that those with childhood trauma that receive effective treatment are more likely to have positive outcomes in adulthood than children that experience trauma and do not receive effective treatment.

Knowing violence risk factors is important so that effective treatment and services can be instituted long before a terrible and violent event or other negative life outcomes occur. Effective treatment should include a combination of individual and family therapy, developmentally appropriate skill building, trauma treatment, assistance to increase success in school, coordination of care among agencies, scheduling and supervising youth activities, educating parents on healthy parenting, and eliminating domestic violence and child abuse.

Source: Kathy Seifert/Adobe Stock family Counseling

Recommended Solutions

Training providers in child-serving agencies about effective assessment and behavioral health treatment for youth exhibiting behaviors that harm others is extremely important. Often, a variety of services are needed.

Research on school environments has demonstrated that punishment does not reduce the reoccurrence of severe youthful misbehavior and aggression.

An additional risk factor for violence is that severe trauma-related behavior problems often begin between ages 5 and 13 and continue into adulthood. The problems of these youth as they go through life are often complex. Therefore, the earlier that effective multi-disciplinary treatment for youth and their families is provided, the more effective it can be. Youth at risk for violence have more complex problems than those with less severe problems. The Office of Juvenile Justice and Delinquency Prevention (OJJDP) research determined that higher intensity and variety of services are often needed to effectively treat youth with severe behavioral problems and aggression. Reducing the stigma of mental health difficulties, increasing services to troubled youth rather than suspending and expelling youth from the structured, prosocial atmosphere of schools, and providing adequate services for children and teens to be academically, emotionally, and socially successful in school often results in better youth outcomes.

Restricting gun ownership has been suggested as a way to reduce America’s violence. This solution is complex. For example, one in four mass shooters was forbidden from possessing firearms, yet somehow, they obtained legal guns. Additionally, If you are going to restrict gun ownership through “Red Flag” laws, it should be done using what is known about the most accurate risk factors for violence. We do not need to restrict gun use by people who will never commit a violent crime. Additionally, a single risk factor is insufficient to “accurately predict” who might use a gun inappropriately and violently. The combination of known violence risk factors will give the legal system good predictive evidence for the risk of violence. If we are going to restrict people’s rights, “red flag” laws must be accurate about the risk factors. Risk assessments in the research world today are only 80 to 90 percent accurate. Personal judgment about the risk of violence without training about risk factors is only about 50 percent accurate (chance levels). We need to encourage and do the research to be accurate about risk factors.

Source: Kathy Seifert/licensed Adobe Stock 224506002

Everything above can be effectively enacted. However, it takes money, understanding the research on this topic, coordinating agencies, and planning to establish programs to assess and treat severe behavior problems and mental illnesses, including trauma-related disorders.

More effective treatment for children who have experienced trauma and/or mental illness means researching what works best for whom, investing in training for effective services, creating a universal system to identify who needs which services, and making these services available to all children, teens, adults, and their families while they live in a healthy home atmosphere. This would be an expensive expansion of Medicaid and other services, but it would also reduce the costs of the negative outcomes of crime and violence in adulthood. There is research that outpatient services at $10,000 to 20,000 per student per year are more effective and less expensive than placing teens in institutions at $100,000 to $125,000 per year.

For example, if every moderately to severely traumatized child with moderate to severe behavioral health problems received the assessment, services, and treatment needed to alleviate their trauma and the delays in development caused by that trauma, they would be less likely to have negative outcomes as teens and adults. This is an expensive solution, but one that is necessary. Are taxpayers willing to pay that price to save their families, children, and grandchildren?