Thank you so much for attending our panel discussion today. My name is Dr. Margaret McKeithern. I'm a child analysis and psychiatrist at Walter Reed National Military Medical Center and also on faculty there. Just a reminder at the end, when we have a question and answer period, if you could please go up to the microphone. The session is being recorded, so any questions that you ask will also be recorded. Or if you don't feel comfortable, you can just let us know the question, and we'll repeat it. I'm going to have the other panel members introduce themselves, please. My name's Barrett Young-Hans. I'm a high school teacher with seven years of experience. My name's Dr. Brittany Baumgardner. I am a staff pediatrician at the National Capital Consortium at Walter Reed. Good afternoon. I'm Dr. Chelsea Young-Hans. I'm a fourth year resident, almost out the door, at Walter Reed National Military Medical Center and will be starting a CAPS fellowship this summer. Thank you, everyone. So as you know, the talk today is titled A Psychiatrist, a Teacher, and a Pediatrician Walk into a Bar, a Multidisciplinary Approach to Active Shooter Drills in Schools. Unfortunately, as we know, there has been an increase in gun violence in the US, and shootings in many different areas has almost become a daily occurrence. And certainly, this is also occurring in our schools and has prompted active shooter drills. Our talk today is going to really address, from different perspectives, how those drills are affecting students, and also to discuss what we can do to maybe mitigate some of that. We certainly know that the drills may increase anxiety in some students, and maybe anxiety also in the teachers and other staff members. As we always have to say, the opinions expressed in this presentation are those of the presenters and do not reflect the official policy or position of the National Capital Consortium Psychiatry Residency Program, the United States Navy, the United States Army, Uniformed Services, University of the Health Sciences, the Department of Defense, or the United States government. None of us have any relevant financial relationships to disclose. These are the learning objectives for today. First, to understand the impact that gun violence has on school-age children and also the community. To recognize some of the pitfalls and consequences of our active shooter drills. To demonstrate an understanding of recommendations from the National Organizations of Pediatrics, Psychiatry, and Education as relates to active shooter drills. Provide some examples of how to talk to children and parents regarding active shooter drills. And then offer some policies and procedures that could potentially reduce the harm created by active shooter drills. One thing I would like to add is that last night I did have the opportunity to watch the first airing of the CNN documentary on the Uvalde shooting. And it is something that I found very helpful to view and I would actually recommend it. It gives insight, I think, into what the parents have experienced and what the surviving children may have experienced. And actually, in a way, it was timely for me to watch prior to today's talk. This just lists our agenda, and certainly with the introduction, problem formulation, and overview. And then each of the speakers will be speaking. And then afterwards, we'll have an open panel for questions and discussion. I wanted to start with this slide because when I found it, it was very sobering. And I will admit, I've been hearing in the media how much gun violence, that gun violence was the number one cause of death of children and adolescents in the US. And at first, I was wondering, is that really true? And then I found an article in JAMA that actually did reference that. So since about 2020 until now, death by gunshot wounds has actually surpassed death by accidents. And again, I just found that to be a very sobering fact. So from 2013 until about 2021, there have been 848 incidents of gunfire on school grounds and resulting in about 188 deaths and 392 people wounded. Unfortunately, we know that there have been several shootings on school grounds since that time. But the proportion of children that are shot and killed on school grounds is actually is less than are shot and killed by other means. And even though only, even though children, excuse me, even though children comprise 22% of the population of the US, they account for approximately 25% of the total population of the US. Approximately 25% of the victims in mass shootings. This graph, again, is very sobering. But it shows starting from 2013 until 2021, 2022, there has been a significant increase of gunfire at preschools and K through 12 schools. Now, one thing, the death of being killed in a school shooting is approximately one in a million annually. But dying in a motor vehicle accident is one in 114. However, we certainly know that when there are shootings in schools and there are casualties, that it is very, very traumatic for both the student body, the community, and first responders. Only about 0.2% of gun deaths a year occur on school grounds, which I guess in some ways is a good statistic. But certainly any death on a school ground or in any other environment is a terrible tragedy. The CDC states that the victimization rate for a single victim school-associated youth homicide is 0.03 per 100,000. And multi-victim school-associated homicide is 0.008 per 100,000. However, again, it's a tragedy any time it occurs. But that gives us an idea of how big the problem is. So at this time, we will have Mr. Junghans will begin his presentation. Thank you. So welcome. Thank you again for coming to our presentation. My name is Barrett Junghans. Before I came up here, I overheard my wife say, and I quote, oh god, I forgot to vet what Barrett was going to say before he got up here. So I think we're in for a good time. I also believe this is the first time in my entire career where anyone has willingly showed up to hear me speak, unlike the 8 AM classes when high school students are no longer paying attention. So again, thank you. There are a few aspects of this presentation that I want you to leave here knowing. First, I need you to know that being in school is paramount to our students' success and education. And this is going to take some of you back to high school. And this is going to take some of you significantly further back to high school. But the learning objective for the day is to better understand the detrimental impacts that school shooting drills, school shooter drills, have on our school-age students. The way we're going to do this is first by understanding the cost of the drills, then look at the monetary impact our drills have on our students and our schools, the justification around schools why schools around the country use active shooter drills. We're also going to look at the problems with active shooter drills to begin with and how students perceive fear in our schools. And finally, all of this culminating in what the role of chronic absence is in our schools. So in order to understand the detrimental impacts active shooter drills have on our schools, one must first understand the unquestioned importance of being present in school. Significant research has been conducted showing a direct correlation between being present in school and scores on tests being lower for those students who are not. Absenteeism is one of the most common inhibitors in student success and learning. And understanding absenteeism allows for students to identify key factors of our students that keep them from learning. As demonstrated earlier, fear, but not only fear, is something that our school-age students unfortunately deal with sometimes on a daily basis. They also have to deal with anxiety and motivation for being in school as well. So how do our schools increase inadvertent anxiety for our students? They do so by overt security measures and through active shooter drills that are practiced regularly throughout the schools, around schools. Unlike fire, chemical, and storm drills, all of these drills are completely different from active shooter drills. For example, fire drills are supposed to, students are supposed to line up orderly and quietly and then their absence or lack thereof is taken when they're at their place where they need to go. I don't know if you remember drills like this, I don't know if you remember drills like this, but they are hardly quiet and they are hardly traumatic. I just did one a couple of weeks ago and the students were genuinely excited. I think an interesting study would be calculating the sheer joy on our students' faces when they realized that a test for the day was not going to happen anymore because of the fire drill. Contrast that with an active shooter drill, where students are taught to stay quiet, stay out of sight, fight back, hide, and if they don't, they can die at the hands of a gunman. The amount of post-drill conversation that takes place just to decompress from drills like this greatly impact our students' ability to learn, and not only our students, but also our teachers. Significantly, differentiating between two different types of drills is important for understanding the rest of this presentation. Lockdown drills are where students where the school is told to lock the door, turn the lights off, and hide, possibly fight back if need be. Active shooter drills, we lock the door, we hide, we tell students to fight back if need be. All of this is taking place while stage bodies and gore is being introduced with police intervention and taking place simultaneously. As I go through this presentation and as I finish this up, I want you to think back to the difference between a fire drill, where students are cheering, and active shooter drills. Active shooter drills in schools not only have potential psychological impacts on our students, there's also significant monetary impact. These costs can vary widely depending on the frequency and scale of the drills, as well as the personnel involved. However, a study conducted in 2008 by the National Education Association and Every Town for School Safety found that an estimated $2.7 billion goes into the school safety industry. Moreover, in a chronically underfunded state program, the argument can be made that this is a serious misallocation of resources when many schools in many states are crying out for their mental health of students and the acquisition and retention of highly skilled professionals. Furthermore, the actual implementation of these drills can disrupt the regular school day, potentially impacting our students' learning and productivity. Now, why do we do these drills to begin with? On the screen are two quotes. The most important goal of an active shooter drill is to save lives by empowering and preparing those involved. I want you to think about this for a minute. On the second quote down, 95% of schools have said that they reported that they have drilled. So roughly 95% of our students have been exposed to some type of active shooter drill, being exposed to potential stressors. All for the goal of these drills to be an untestable hypothesis with exceptionally real consequences. In a data-driven industry such as education, the oversight here is extremely contradictory. As a classroom teacher, I collect data from students measuring success, growth, or whatever adjective you want to give it two to three times every day. Yet as a nationwide school system, we implement harmful practices for our students with the impossibility of receiving measurable feedback. It's an untested premises resulting in very real consequences. As an educator teaching high school students who do not sit still for more than about five minutes at a time, I feel it's my duty to do a quick review. Remember, active shooter drills involve realistic scenarios, loud noises, simulated gunfire, and evacuation processes. These elements can induce fear and anxiety among students. The constant focus on potential violence can create a heightened sense of danger. This leads to stress and emotional de-stress. Conducting frequent active shooter drills can disrupt the learning environment on a regular basis. And the argument can be made that these drills may not significantly enhance school safety, but instead a more comprehensive approach such as addressing underlying issues related to mental health, bullying, and improving a school climate might be more effective in preventing violence. Over-emphasis on active shooter drills may divert attention and resources from addressing these broader concerns. Frequent interruptions, increased security measures, and emphasis on emergency preparedness may divert attention and resources from academic activities potentially impacting students' academic performance. On the next slide, there are multiple quotes that I would just like you to take roughly a minute to read. A minute is kind of standard for high school students. They don't necessarily read as quickly as some of us in here. But I think we'll be able to do this. And I'd like you to take specific focus on the second quote. So all of these quotes are especially enlightening to the views of staff and students alike, but I focus on the second quote by a senior in high school because I think it's significant. Okay, she woke up the next morning not wanting to go to school. This one event, a practice, traumatized the student so much that she no longer wanted to attend school. The goal of an educator and a school is to create a safe learning environment conducive to promoting high learning outcomes for our students by giving them as many learning opportunities as we can throughout the day. Yet this one event hindered this student's ability to even want to come to school anymore. Unfortunately, this one all too common simulation in America's schools completely reversed the student's views on schools that she no longer wanted to attend. To put this student's trauma into perspective, as stated earlier, she was at greater risk of injury driving to school than actually being in the building during a mass shooting. An APA study from 2018 showed that less than 1% of gun violence at schools in the US is categorized as a mass shooting, yet 75% of youth ages 15 to 21 cite mass shootings as a primary concern for their stress. That same stress that is a key factor in relating to absenteeism and decreased student achievement contradictorily instead of taking steps to mitigate student stress, schools actively play a vital role in contributing to student success, excuse me, student stress, fear or anxiety by exposing students to stressful simulations and situations. This is not to argue that school safety in a safe learning environment are insignificant to student success. Conversely, it is to suggest that there are ways of the ways of going about keeping students safe might not be the actual perception that our students see. For example, many schools have commenced increasing their security measures, such as metal detectors when entering the school, security cameras, and of course drills. But this can increase student perception and fear at school resulting in them not wanting to be in the building. While schools do their best to encourage student safety, many students see visible security measures intrusive to their learning. Imagine being a student, walking into a school, and every day being met with an overwhelming display of security apparatus, cameras silently observing your every move, metal detectors, and drills. These measures, while designed to provide our students a sense of safety, can instead increase an atmosphere of constant anxiety and fear. Our students should be focused on their education, personal growth, and building positive relationships with their teachers and peers. However, they are constantly reminded of the potential dangers and threats that are lurking in their lives. For example, if you are a student who is experiencing anxiety and fear, and you are constantly reminded of the potential dangers and threats, it becomes increasingly difficult for them to feel safe and secure with their own learning environment. It's the sad reality that instead of being havens of knowledge and growth, our schools are increasingly becoming spaces that evoke fear and uneasiness. Moreover, these security measures, especially the practice of active shooter drills, can inadvertently amplify the notion that violence is an imminent and ever-present threat. They send the message that our schools are vulnerable, which in turn breeds fear. We must find a delicate balance between ensuring the safety of our students and maintaining an environment that fosters a safe learning environment, trust, and open communication. There's a plethora of research demonstrating the effects of absenteeism on students' performance in schools. Research suggests that students who miss school score lower on tests, increase their chances of failing classes, reduce their graduation rate, and fail to attend their college classes regularly, which perpetuates the cycle in the future. I will not read this whole slide to you as well, but there is unbelievable amount of research showing how important it is to be in school. Chronic absentees, chronically absent students in one year are often chronically absent in another year. Previous year's absences impact following year's test scores. And finally, we even have more proof that during the COVID-19 pandemic, there was significant evidence found of student learning loss, which is to say when educational progress does not occur at the same rate which is historically done in comparison to past years. Needless to say, when schools inadvertently increase fear, anxiety, or stress, our students suffer. Students need to feel safe in school in order to learn. When students feel secure and protected within the school environment, they're better able to focus on their studies, engage in classroom discussion, and form positive relationships with peers and teachers. Feeling safe fosters a sense of belonging and emotional well-being, which in turn enhances their cognitive abilities and academic performance. A secure and supportive atmosphere encourages students to take risks, ask questions, and express their thoughts without fear of judgment or harm. By prioritizing safety in schools, we create an environment where students can thrive, explore, and potentially, and explore the potential and acquire the knowledge and skills necessary for their personal and academic growth. Unfortunately, current practices regarding active shooter drills in schools inhibit some students' ability to learn. All kids deserve the right to learn because education is the key to empowerment, personal development, and equal opportunities, without which none of us are sitting in this room today. Thank you. Good afternoon, everyone. I'm Brittany Bumgardner, and I will be presenting the pediatric perspective on active shooter drills. So today, I will be discussing school safety drills and how these practices relate to child development, the concept of assent and consent, and the unique accommodations needed for effective execution of school safety drills. We will also review recommendations from the American Academy of Pediatrics and discuss methods for families to address such issues with their children. So why are children involved in safety drills? Before we discuss this, we need to take a step back to look at the purpose of exercises and drills. Safety drills are systematic practice routines designed to prepare students, staff, and first responders for emergency situations. The goal is not to highlight potential dangers or the severity of a crisis, but to familiarize everyone with proper protocols to ensure safety. Participants in these drills have varying responsibilities according to their roles. Students simply need to just learn and follow instructions given by teachers and school personnel, while teachers and school staff should lead students through the safety protocols, ensure student safety, and coordinate with first responders. While first responders need to respond effectively and efficiently to whatever the threat is. And like Barrett had mentioned, there are various amount of different kinds of drills that students are exposed to regularly. So we'll just compare the two real quick. These include fire drills, lockdown drills, and high-intensity shooter drills. Each have their own unique procedures and level of intensity. Looking at fire drills, we all should be very familiar with fire drills, but they're relatively straightforward. These drills are announced ahead of time. Students are escorted by an adult to a pre-designated area and wait, quietly sometimes, until they're told that the drill is over once the first responders complete their own responsibilities. And then they're escorted back to the classroom and simply continue their day. Lockdown drills can be used and have been used for cases such as active shooter situations. They're fairly similar to fire drills. They're announced ahead of time. Typically, students don't leave the room, but they remain in place, but they move from the classroom to an area where they cannot be seen. So away from windows, doors, et cetera. And they simply remain quiet until a drill is announced that it is complete. High-intensity active shooter drills are a completely different beast. These drills use deception. Sometimes they use real weapons. They can use simulated gunfire. A lot of times, theatrical makeup can be used on the volunteer victims. And the acting active shooter may even use force and aggressive behavior around children. So why is there such a difference between the first two drills and the last one? Fire drills and lockdown drills are relatively straightforward. We don't need to burn the school down to simply show that fire is bad and dangerous and that we should be able to follow those instructions. So why are we acting out an active shooter drill just to prove that these situations are also dangerous? The question we need to ask ourselves are, are these lockdown drills actually useful? Or are they just scary? To answer this question, we'll need to review child development and why the involvement in children in these types of drills is different. So children's physiological and emotional understanding of and response to traumatic events differs from adults. Their comprehension of danger varies by age group. From preschool to high school, their understanding involves needing adult guidance to discern danger, to independently identifying and responding to probable threats. Children in preschool and kindergarten, they show a fundamental grasp of the concept of danger. They really need adult supervision to distinguish between what's safe and not safe. They can recognize commands like get out, hide out, keep out. While early elementary students still need some guidance as to what is dangerous and what is safe. And upper elementary students, they are gradually learning what is and what isn't safe, but may need continued guidance from adults. They start to around this time comprehend the rationale behind school safety drills, and they can simply understand all safety directions and instructions. Middle school students evolve a little bit more. They could differentiate between what's likely and what's probable in danger. And then high school students can understand most emergency safety measures and can apply them correctly to specific situations. Children's emotional and developmental understanding of and response to traumatic events differ too. Their limited ability to understand the nature of the disaster can lead to stress, fear, anxiety, inability to cope, and exaggerated response to media exposure. Their response to traumatic events can be varied from developmental regression, withdrawal, cleanliness, tantrums, and other somatic complaints. Simply like abdominal pain or wetting the bed. Simulations have been proven to be helpful in various other situations. I'm sure we all remember the days when we did simulations for codes in the hospital with other healthcare providers. We've seen adverse responders in crisis situations, but there still has not been enough research on the usefulness of simulations with children. Their response to the traumatic events can be varied. I'm sorry. The determination of what is actually generally age appropriate for our children and what is likely to be traumatizing when conducting a live crisis exercise is something that needs to be really determined at a national level. In the context of safety drills, it is important that children are informed about the drill itself. Most of us in this room understand the concept of consent. Consent is given by individuals of legal age, typically 18 years old, but assent on the other hand refers to a child's expression of agreement to participate. This, in most cases, in the medical setting, but it can be obtained around the age of seven. Active consent or active consent from a legal guardian and assent from the adolescent should generally be required for live high intensity exercises. Children who are of age and developmental ability to provide consent or assent for procedures that may cause modest physical discomfort or emotional distress, like donating blood in a blood drive may be permitted to provide consent and assent and to participate in these activities. Adolescents who have been appropriately briefed and are capable of providing consent and assent may still not disclose personal vulnerabilities and may underestimate the distress that participation may ultimately cause. In the context of safety drills, both assent and dissent should be respected. In the context of safety drills, both consent and assent should be respected. Consideration should also be given to individuals with physical, sensory, cognitive, and mental health disabilities as their needs during drills may differ. We should also be considering the school composition. Even if these drills are conducted at high schools, they still may impact younger students. I don't know if you've ever been to, at least my high school, it was right down the hill from a middle school and so we got to see everything that the high schoolers were doing. So there's still that, even if you separate it, there's still an impact from younger children. The American Academy of Pediatrics published a policy statement in September 2020 regarding live crisis drills and exercises. They provided 11 different recommendations and we'll briefly kind of go through each one. The first is to eliminate children's routine involvement in high-intensity drills and exercises. Children should only participate in crisis exercises if they directly benefit them or their peers and not solely for the benefit of adult professionals. High-intensity drills aimed at training adult responders should use alternatives like mannequins or adults acting like children or be conducted outside school hours. The second is to obtain active consent and assent of adolescent volunteers. Adolescents who volunteer for high-intensity live exercises should be thoroughly informed about what they entail, including potential emotional reactions, especially for those with undisclosed vulnerabilities like anxiety or past trauma. They should also be reassured that there's no obligation to volunteer. Active consent from capable youth or legal guardians along with adolescent assent is generally necessary for such exercises rather than passive consent. The third is that school personnel or other adults present during the drill should remain vigilant for psychological distress. Minimizing children's distress during any exercise is essential. Realistic simulations involving real weapons, gunfire, graphic makeup depicting injuries, or aggressive behaviors by the role-playing shooter may cause trauma and require careful justification. Children participating should be told that they could stop at any point if they're feeling physical or emotional distress and be allowed to take breaks as needed. An adult supervisor should be observing children's reactions and periodically check on them throughout the exercise. Regardless of the nature of the exercise or drill, distress can still occur, so adults should carefully monitor children and adult reactions under the oversight of an experienced team member and provide support services as necessary. The fourth is to eliminate deception in drills and exercises. Parents, students, and staff should be notified about these drills. Deceiving students, staff, and families into thinking a drill is real or misrepresented in injury or death is harmful, unethical, and cannot be justified as a method to evaluate responses under high stress. The fifth is to focus on teaching skills rather than simulating distressing crisis events. The objective of live exercises and drills is to teach and test skills in more pressured situation to promote competence rather than focusing on failures. Planners should make it clear that learning objectives differ for adults and children and that drills aim to teach specific safety behaviors, not just to stress potential dangers or the seriousness of a crisis. The sixth is to make accommodations that are based on children's unique vulnerabilities. Active shooter drills, in most cases, should be conducted calmly and systematically, similar to fire drills, focusing on the safe movement of students and staff within the school building. Terms like lockdown, shelter in place, or safety drills are recommended over active shooter drills to avoid causing any sort of distress. Children with heightened vulnerabilities may require special accommodations, including excusing them from the entire drill itself. And then parents and guardians should be informed at the start of the school year about upcoming drills and also be invited to share any sort of concerns that they may have. Number seven is to seek and incorporate student input. So school staff should consider including student input in safety discussions and drill planning. Students can offer valuable insights into potential risks, vulnerabilities that adults might overlook, and effective ways to prepare peers for drills while minimizing their distress. And then adults should also debrief with students after the drills to gather their feedback and suggestions to improve future exercises. Number eight is to obtain multidisciplinary input into exercise and or drill planning. Number nine, emphasize the role of prevention, as well as number 10, promote legislative advocacy, will be further discussed by Dr. Jan Hans. And finally, number 11, conduct research on the impact of exercises and drills. There is a need for research funding to assess the objectives, effectiveness, and potential unforeseen outcomes of crisis preparedness activities involving children. Strategies that may cause significant distress or other unintended consequences, like high-intensity live exercises, should be evaluated prior to implementation, especially when there's a lack of evidence about their effectiveness. Especially now in our current climate, with the increase of active shooting incidences in the country, it's important to be open and discuss these events with our children. When discussing active shooter drills and gun violence with children, it is essential to first reassure children and really explain that the possibility of school violence exists, but the probability remains low overall. Number two is to talk openly using the ORS technique. You may know this very well as a motivational interviewing tool, but it actually works really well with children too. So asking open-ended questions, being affirming, using reflective listening, and also summarizing what the discussion was with the children is very helpful. We should also keep explanations developmentally appropriate. We should also review the safety procedures that were given during school, so their understanding as well as what could happen at home. And then we should also just keep an eye out on the children's emotional state. Watch for changes in behavior, appetite, or sleep patterns that may indicate anxiety or stress. And then finally, limit television and social media viewings of this event. I've provided two great resources that you could pass on to your families. The first one is from the National Center for School Crisis and Bereavement. It's an excellent, excellent resource. And then the next one is the National Association of School Psychologists. Both of them have handouts and helpful videos and tools that you could use to simply pass on to your families. Here are my references. And I will now pass it off to Dr. Janhans. Thank you. So we've had some really amazing non-behavioral health expertise. So I'll round us out now with some behavioral health, hardly expertise, but at least some ideas moving forward. So we're going to talk about some community studies that were done regarding mental health and active shooter drills. And then I want to talk about, so what are we going to do about it? How are we going to fix this? And how are we going to move forward with this? How do we put in proactive safety measures in our schools that aren't active shooter drills? And what is your role as a psychiatrist in your community? So both my colleagues have talked about how hard it is to study this. And they've talked about how little data shows true implications of active shooter drills. And so why is this so hard to study? So despite their prevalence, little is known about the effectiveness of these drills in terms of keeping students safe. Several factors include the heterogeneity of drill procedures implemented, ethical considerations of experiments, and lack of universal criteria make evaluating these drills really difficult. For example, one study in 2016 notes that the most important goal of an effective active shooter or crisis drill is to teach students to listen, follow the instructions of the nearest adult, but suggests that active shooter simulations do a really poor job of this. In contrast, a report issued by the National Association of School Psychologists and National Association of School Research Officers argues that the most important goal of an active shooter drill is to save lives by empowering and preparing students and staff to respond quickly and responsibly in the event of an active shooter. Given the nature of active shooter incidences, it's nearly impossible to study the direct impacts of drills on safety during these horrific events. Instead, most researchers opt to observe compliance with emergency procedures during drills and learn from surveys of safety and anxiety levels from those involved in those drills. Some of these studies demonstrate significant improvements in students' ability to complete emergency protocols. So this includes locking doors and turning off lights, while others do not, challenges with maintaining silence and staying out of sight. Some find that participants report feeling less anxiety and greater preparation immediately following drills, while others find diminished perceptions of school safeties and concerns that now could-be shooters know what the school's response strategy is. Perhaps more troublesome than the current lack of scientific consensus on active shooter drills is the lack of research on long-term consequences and wider community impacts like trauma and mental and physical health impairments. Given that active shooter incidences are rare, with student homicides happening on average just once every 6,000 years in a given school, any potentially common and far-reaching impacts of drills are particularly important to understand, especially as parents, students, educators, and medical professionals express growing concerns. So I have one pretty decent study to talk about with you, after I got done saying exactly how hard it is to study this. So Everytown for Gun Safety did a study. They partnered with Georgia Tech to study changes in social media conversations in 114 schools spanning 33 states. They took a look 90 days before an active shooter drill and compared it with 90 days post-drill. This included drills in a mix of elementary, middle, and high schools. In this study, researchers used natural language processing techniques and advanced statistical analysis to understand the changes in these conversations, analyzing almost 28 million tweets and 1,400 Reddit posts related to these school drills in these 114 schools. These were some of the tweets that they pulled out from their study. Results revealed that social media posts displaying a 42% increase in anxiety and stress from pre- to post-test. So those were words like afraid, struggling, and nervous. They also included a 39% increase in depression, and those were triggered by words like therapy, cope, irritability, and suicidal following drills. This trend was sustained at least 90 days following drills and spanned diverse school districts and different drill tactics. Individuals expressed more social and personal concerns, so there was a 33% increase in concerns about friends, a 14% increase in concerns about social situations, and a 108% increase in concerns about work. There were fewer positive sentiments and more requests for help following drills. Everytown and Georgia Tech's study further suggests that active shooter drills significantly impact mental health, regardless of whether they're implemented in elementary, middle, or high schools. However, each school level faces unique challenges. Stress and anxiety are highest among high school communities in the 90 days following, so that was about a 52% increase, while depression levels remain consistent within this age group. Middle school students, parents, and teachers experienced the greatest increase in depression, so 55% increase. Stress and anxiety also increased at about 48%. And then elementary school communities experienced an increase in stress and anxiety at about 28% and depression at about 30%, but these were a little less dramatic than what was seen in the middle and high school populations. These differences may reflect the reality that the majority, almost 75%, of gunfire on school grounds does occur in high schools or college campuses. For high school communities, drills may induce stress and anxiety over the potential reality of an active shooter. For middle school communities, they may induce a sense of hopelessness for what the future educational experiences might look like. For elementary school communities here, we're mostly looking at parents and teachers as usually students are a little too young to meaningfully participate in social media, but drills may be upsetting in their own right, impact mental health a little less because active shooter incidences themselves usually happen less in this population. Regardless of education level, active shooter drills appear to induce multiple mental health concerns within still-developing children and teens, a pattern that stands to greatly impact the next generation's psychological well-being for many years. So what are we going to do about it? So here's hopefully the light at the end of a dark tunnel of what we've talked about. So starting at a federal level, let's talk about gun safety policies and gun safety laws. While federal law requires background checks for all gun sales by licensed gun dealers, it does not require background checks for guns sold by licensed sellers like non-dealers who sell guns online or at gun shows. This loophole enables people with felony convictions, domestic abuse restraining orders, and other people with prohibiting histories to buy weapons, no questions asked. The loophole should be closed to require background checks on all gun sales, not just on the sale of firearms from licensed dealers. The most common federal background check legislation would simply require that an unlicensed seller meet a buyer at a gun dealership and they would run the background check in exactly the same way as they would from that seller. Ninety-nine percent of Americans live within 10 miles of a gun dealer. It's easy and convenient to get a background check. There are nearly 59,000 unique gun dealers across the country, which is four times as many McDonald's and nearly twice as many U.S. post offices. Gun owners are already accustomed to this process because they do it every time they buy a weapon from a seller. Same risk laws allow a judge to temporarily remove a person's access to weapons when there's evidence that they pose a threat. They also include due process protections that meet the standards set by the Supreme Court. Judges enter an emergency short-term order after a family or law enforcement gives evidence that the person poses an immediate risk to themselves or to others. One study found that households that locked both firearms and ammunition were associated with a 78 percent lower risk of self-inflicted firearm injuries and an 85 percent lower risk of unintentional firearm injuries among children and teens compared to those that locked neither. Another estimated that if half of the households with children that have at least one unlocked gun switched to locking all those guns, one-third of youth gun suicides and unintentional deaths could be prevented, saving 251 youth a year. Eighty percent of shooters under the age of 18 got the gun from their home or the home of friends and family. Twenty-three states, including D.C., already have some form of secure storage law in place. And lastly, raising the minimum age to buy semi-automatic weapons can help block gun sales to teens. Data shows that 18- to 20-year-olds commit gun homicides at triple the rate of adults 21 and older. The shooter at Marjory Stoneman Douglas High School in Parkland, Florida, was 19 years old. Under federal law, he could not have bought a handgun at a store, yet he was legally allowed to walk in and buy an AR-15 assault rifle he used in the shooting because Florida law did not prohibit residents between 18 to 21 from buying long guns. Florida has since changed that law, and it prohibits the sale of firearms to all people under the age of 21. So moving more to a state and community level programs and implementation techniques. State legislatures and schools should create and fund school-based threat assessment programs. These programs offer members of the school community the ability to share concerns that another member of the community may be at serious risk of harming themselves or others. They establish multidisciplinary teams of school staff that respond when a student is in crisis. These teams receive information about a potential threat by a student, assess the threat, and design interventions to prevent violence. A 2018 Department of Homeland Security report stated that preventing violence by detecting and addressing these red flags is actually more effective than any physical security measure. In order for threat assessment programs to be successful, they must have three key components. They need to identify students at risk to themselves or others by establishing resources like an anonymous tip line or social media monitoring to identify these potential threats. These programs can be effective, including identifying students at risk of self-harm. Still they have to upload student civil rights and ensure that there's not a disproportionate impact on historically marginalized students. They need to address student access to guns as part of their interventions, and they need to invest in school-based mental health services by hiring a sufficient number of psychologists, social workers, nurses, and counselors to work in schools. These programs are widely recommended for preventing school violence, and in fact several studies have found schools that have used these threat assessment programs see as few as 0.5 to 3.5 percent of students attempt to or actually carry out their threat. None of these threats were to kill, shoot, or seriously injure someone. Studies also show that schools with these programs see fewer suspensions, expulsions, and lead to fewer arrests. In addition to enacting secure storage laws, policymakers and educators should encourage a culture of secure gun storage by increasing awareness of secure storage practices within your school communities. For years, Moms Demand Action has run a program called Be Smart. This program focuses on fostering conversations with adults about gun storage to facilitate behavior change and address the hundreds of unintentional shootings committed and experienced by children every year. The acronym SMART stands for Secure Guns in Homes and Vehicles, Model Responsible Behavior, Ask About Unsecured Weapons in the Home, Recognize the Role of Guns in Suicide, and Tell Your Peers to Be Smart. Governors, federal and state departments of health and education, legislature, nonprofit organizations, and local officials should also work together to develop and fund programs that increase the awareness of the need to store firearms securely. Schools should distribute information to parents about the importance of secure gun storage. School officials are already doing this in L.A., San Diego, Houston, Denver, Clark County, Nevada, throughout all of Tennessee. Thus far, school districts comprising nearly 3 million students have done this task. As part of an effective threat assessment program and management strategy, and to promote successful student outcomes and violence reduction overall, schools need to ensure that students have sufficient access to professionals who can provide mental health services. School-employed mental health professionals serve as a critical resource for students as they navigate the education system and the challenges of emotional and social development. These professionals may also be the first to know when students are experiencing problems or when they're at risk of turning to violence. They can then guide students through emotional or behavioral problems and serve as a key point of intervention and insight for threat assessment programs. The National Association of School Psychologists similarly found the student to psychologist ratio to be 1,300 students to one psychologist. This is two to three times higher than the recommended 500 to 700 students. To protect our schools and ensure that threat assessment programs are effective, legislature needs to fund and schools need to prioritize hiring an appropriate number of mental health professionals in schools. Supportive and trusting school environments are the strongest way to prevent school violence. When communities are focused on student well-being, schools can be places of care and compassion for the challenges that kids face. They can also create conditions for preventing school shootings and other violence. Given the evidence that most school shooters are current or former students and that they nearly always show warning signs, the locus of school violence prevention has to center around schools. One means of creating safe schools is to support them becoming community schools, the focal point and the heart of their community. Many organizations recommend schools utilize district, state, and federal funding to help partner with the community members to move beyond the normal confines of school, particularly in communities that experience high rates of gun violence. Community schools work with local partners to provide valuable services that uplift an entire community. They not only become centers of education, but fulfill a broader purpose of contributing to stable, healthy, and safe neighborhoods. In schools facing high levels of violence in and outside of the school building, a community school might fund programs like creating safe passages to and from school, granting alternatives to out-of-school suspensions, providing family counseling, increasing access to mentoring both in and out of school, and incorporating restorative justice into discipline policies. One example of a partnership between schools and a promising community program is an initiative that offered cognitive behavioral therapy for at-risk young people on the West and South sides of Chicago. Participation in the program reduced violent crime arrests by 50%, and juvenile justice readmission by 80%. Zero-tolerance policies are those that, in an earnest attempt to make school safe and orderly, can end up punishing students who exhibit behavior that actually requires compassionate intervention. In addition, these policies can create a threatening climate that instills fear and erodes student trust, reducing the chances that students will share information when they're actually concerned about a classmate. The zero-tolerance approach has also had a profoundly negative effect on students of color. Schools need to review their discipline policies to make sure that they're not unduly punishing students for normal adolescent behavior, nor creating a climate that reduces the willingness of students to share concerning information. They also need to make sure that staff are trained on appropriate ways to manage their classroom and implicit biases. So what is your role as a psychiatrist? You are a subject matter expert in trauma-informed care. That requires you to get involved in your community. Even if you're not a child and adolescent psychiatrist, you see teachers, staff, parents, and law enforcement that are still affected by these drills. You may see an increase in stress-related responses or insurgents in trauma symptoms leading up to or surrounding drills. Help to enforce and create community schools. Get involved in state and federal legislation. Because again, you are the subject matter expert in trauma-informed care. Counsel and educate your patients on safe gun storage, if not for themselves, for their children, their family, their friends, and their community. And lastly, understand your local extreme risk laws. And don't be afraid to use them if you are concerned about someone. So these are a few resources. The top is particularly for psychiatrists. And then the bottom are also resources for just generally everyone, as well as a really great article about what are extreme risk laws and kind of in the area, what states are using them. Wonderful. Well, I thank you all so much. And I'm hoping that we have some really stimulating discussion following this. Well, I certainly want to thank all of our panelists for their remarks. And I would also like to give a special thanks to Dr. Junghans, who invited me to moderate this panel, and who really all three of the panelists put in so much work. And I really just want to say thank you for the efforts and really for a wonderful presentation. Do any of the panelists have anything else that you'd like to add before we go into questions? So we're open for questions. And if anyone has any questions, comments. Thank you guys so much for doing this talk. I was kind of surprised at the map of how many states have laws that require these kinds of drills. And I kind of feel like that happened and I didn't notice. Do you happen to know if they consulted with pediatrics or child psychiatry? Who was at the table when these decisions were made? I'm just curious if anybody has any knowledge about that. Yes, that's the problem. We weren't invited to the table. And I think the other problem, too, is that what one state, what their definition of a lockdown drill or what their requirement is doesn't look the same in another state. So they may both say that they're requiring lockdown drills or active shooter drills, but there's no clear, concise definition from state to state or even within a state. Like one community may say, oh, we're complying. We're doing a drill. But it doesn't look the same in the next community over. So I think that's also the problem that we have is everyone's doing something completely different. And I'd just like to add that that's the whole reason why the AAP, the American Academy of Pediatrics, came out with their policy statement was to hopefully address that, hey, we actually do have thoughts and opinions about this. Please ask us and invite us to the table. Hi, this question is for Mr. Younghans. As a teacher, how receptive are schools to psychiatrists coming to schools in their community and reaching out to provide information? Just from a teacher perspective or an administrative perspective, how receptive are they? I have seven years of experience, a principal's license, and I have never met a school psychiatrist in any of the schools I've worked in. I know that they are present in the communities. I know that they are actively trying to get people to come help out. But I've yet to see anyone ever physically in the building. So I think schools are very receptive to the idea. I do think there's a lot of monetary issues involved with employing a school psychologist in schools, as well as, yeah. I would say there's just a lot of monetary issues where schools are struggling to get teachers to begin with, justifying expenditures on something that is vital to the lifeblood of the school, but not a teacher. I was just wondering from a perspective of getting involved in the community, not necessarily being hired from the school, but reaching out with information or asking about how they do their active shooter drills, would they be receptive to hearing what the psychiatrist has to say? And I know it's different school to school, so that might be an impossible question. I would hope. But I would say, to an extent, I think that data kind of suggests otherwise. Like they said, they aren't being asked to give input on these things. It was shocking to me doing this that, as an educator, I know what other educators do. We receive feedback from students every single day, over and over and over and over again. And then we get to some drill that has no measurable feedback, but yet 95% of schools across the country are reporting doing this with no feedback on it. It was shocking to me to learn that. Thank you so much. I would like to add one thing. I think as a child psychiatrist, that reaching out to communities, and certainly there's limitations on time, but maybe just volunteering to go to a school or to interact with the school. My experience is from talking to schools is that they would be very interested. But I also think it's a matter of being able to carve out that time and to maybe become involved with the schools that are in your community. Thanks, Jo. Hi, I have a question for the audience first. How many of you have attended an active shooter drill? OK, so not a lot, but some. I am a child psychiatrist who worked at a community mental health center. I saw some young kids, first or second grade, who were definitely traumatized by shooter drills in their school. They were really terrified. We had an ALICE training. And for those of you in the audience not familiar with ALICE trainings, they're much more get-in-your-face kind of experiences. And the person who led it was our chief security officer, who was a former inner city cop. And many of the clinicians were traumatized. The clinicians were also traumatized by an incident that had happened at our community mental health center. We had a very large adolescent boy wield a couple of knives, and the local police came. And to stop him, they actually had to tase him four times, which blew our minds that he could still move after the third tasing. And that was also very traumatizing to the staff. So somebody needs to change these laws requiring it. I want to congratulate you on this wonderful topic. And the wide variety of speakers we've had today, I think it's just amazing. Mine is more of a comment than a question, because I don't think there is any answer to that. But I'm going to ask it anyway. Maybe I'm wrong. There is an answer. I've lived in this country from 1981 till now. That's 40-plus years. When I came in, I never heard of school shooting. I did not hear of any school shooting for decades, first couple of decades. And suddenly, every time I open the CNN news, every week somebody is informing me, oh, there was something here, and there was something there. Has anybody figured out what changed in our country? Why the sudden spurt has started, and it shows no signs of going down the numbers or even stopping? Gun laws were the same before. In fact, they're becoming more and more stringent. The Second Amendment was still there when I came in this country, and still exists today. And it will never go away. And all the states I hear are coming up with more and more stringent laws. Why are there more shootings now than ever before? And I'm not putting anybody on a spot. I know there is no answer. But if somebody came up with that answer, at least we could tackle the main reason why that's happening, rather than trying to control it. Thank you. Before I go, it looks like you had a comment in response. You go ahead. I want to highlight the thing that drastically changed was the assault weapons ban. We had a ban on assault weapons, and then that went away. And then there's been so many mass shootings as a result. So I think that that's the biggest change that has happened in terms of mass shootings, not necessarily gun violence. Because mass shootings make up a small percent of gun violence. But anyway, that's my two cents, as someone who's like, I'm a mom who demands action. I have my own stuff, but I'll respond to this a little bit. I grew up in a place where everybody's arm to the teeth. And it's considered weapons are like jewelry that people have. There's no school shootings there. There's other types of shootings, but no school shootings. So I think there's something there, but I don't know what it is. Your discussion, I mean, it kind of leaves you helpless, feeling helpless. But it kind of got me into this journey on my laptop, as you guys were talking, and digging deep into. So two things came to mind. The Army has struggled. Prior to 2000s, military service was protective, if you look at the data. That may have to do with some of the epidemiological methods. But nonetheless, then it starts to go up. So the Army is struggling with this, and they come up with this intervention called the Army Resilience Training. So anyone who's been in the Army has had to go through that. And there's no evidence for that. And some external review of that showed that it might be harmful and possibly unethical to force people to go through that without evidence. But there's some theoretical basis for that, at least. So it's cognitive, therapy-based, hunting the good stuff, reducing, catastrophizing, stuff like that. So there's some theoretical basis for that. So the question I have for you guys is, what are the theoretical basis for this, for these type of training or events? Anything you guys came up with during your research? Yeah, so the ALICE program that one of our audience members had brought up does have, it is endorsed by the Department of Homeland Security. So there are some programs that have endorsement from large federal entities. That, though, was implicated for workplace violence and then was thus kind of extrapolated into schools and other places. So potentially inappropriate in that extrapolation. But there is implications for kind of how we see a fire drill in trained behavior, right? So that we theorize that if something like this were to happen, we have some sort of trained behavior that you don't have an entire group of people that is left without any sort of practice in this kind of whatsoever. And I think that we have, especially the AAP, Everytown also has some information on this as well. But there is a benefit to drills. There is a lot of benefit to drills. It's just the type of drills and the way that they're doing it. So by removing children and bringing in communities, law enforcement, and having teachers involved, not as simulations, that has a lot of benefit to it. And so I think it's kind of this spectrum, right, of we've gone kind of maybe way far in one end to give us the most realistic experience whatsoever to feel like we're the best prepared. But what are the implications of that? And if we shift this spectrum a little bit more and maybe reduce the participants in this, maybe we might actually get something then that provides people with the knowledge and the experience and the training that is most helpful. So the how matters. And I guess since we're dealing with children here, the who matters too, because they're at different developmental stages and you've got to, you know, so as part of my journey through chat GPT on this topic, this is more of a reflection. I thought of, you know, when I was flying here, they made me go through the cabin safety routines and they were teaching me how to put my seat belt on and how to put the oxygen, et cetera, et cetera. I usually pay attention to those and I read the safety card and I look at the, and I'm ready to go. 70% of people apparently ignore those things. But nonetheless, I was thinking that what the pediatrics, you know, the checklist that you went through sounds like they're focused on actual skills, which is good. I would be highly upset if the airline created some artificial turbulence for me and traumatized me. I appreciate the other stuff. So I think that's the how there, it really needs to have some sanity in it. You know, the fact that they're surprising kids, I would be very upset if they did that to my children. So I guess the advocacy on your checklist is super important because I think in the midst of what the army did, reaching out for whatever, with all these school shootings, I think states decided they're just going to do something. You know, with this idea that something's better than nothing and that's not really always true. Sometimes nothing is better than something bad. So thanks for your presentation. There was also a wonderful quote that we came across when we were doing some research about preparing your children for house fires without having to burn down your house, which I thought was enlightening to active shooter drills. We do them exactly as they are allegedly happening. Why? Yeah, I think with the history and especially, it sounds like most of these live, the high-intensity active shooter drills really started around 9-11. I think everyone just kind of freaked out, to be honest, simply, and wanted everyone to be best prepared and how best to prepare people than to involve the people who are actually going to be involved, right? But no one actually took the steps back to say, well, why? Why are children actually being involved? They're just kind of being little pawns in this little game, but they're children, they're vulnerable, and no one's going to speak out for them. So I think that's really the main point. Are these extreme active shooter drills in certain areas of the United States? I mean, certain cities? Because I'd never heard of these, you know, with the makeup and everything? No, they're pretty wide-fetched. So I'm married to this one, in case that wasn't apparent. And, you know, his family comes from a family of educators. And so even within kind of a smaller, rural Indiana town, his mother, who was a master teacher, was actually pulled from a classroom, donned up in makeup, and sent back in to pretend to be dead, and then was not actually told when the drill was over, and was left locked in a classroom for hours. So no, I don't think there's a rhyme or reason as to what this is happening, right? If a small, rural community is doing this, you know, it's kind of to each his own, right? It's not standardized. Yeah. Just a follow-on question to what Dr. Amin was talking about. But what is your guys', like, hypothesis of why we're continuing to do more harm than, like, have benefit, especially when we have other alternatives, you know, to, like, lockdown drills and less high-intensity interventions that are probably as or more effective? I mean, I think it's just, it's a high-risk situation, right? Like, I don't think anyone wants children to die, and so I think everyone just wants to be the best prepared. And I think people are fearsome of, like, well, you can't just replace them with a mannequin, but you can. They want it to be as real as possible, and so they can make real-time decisions and be the best prepared in those scenarios since they are, you know, overall rare. But I think that's mainly the reason. I think it's just such a high-risk situation. I also feel like mental health has really taken off, even just in my experience within the last couple years of when I first started teaching. I don't think people really thought about mental health as a common thing in our schools. Like, I remember sitting in professional training where we're being taught, like, depression's a real thing, and, like, kids have anxiety, and this was within, like, the last five, six years. So I do think that's also now we are realizing that these drills evoke fear and promote students not being in school, which inhibits their learning. So I'm hoping it catches up, but... Basically, primary prevention is a lot harder than doing these drills. And the thought that came to my mind was that, as was said at the beginning, the medical community, the child psychiatric community, the pediatric community weren't consulted. And so I think that that speaks to, again, that there's a way that there can be more collaboration, because I know that there are a lot of us in both fields that would be, you know, willing, you know, if you asked us to be on a board, or, I mean, not you, but if the schools asked us, or maybe just getting out there and saying, you know, I'm interested, I'm available, you know, those kinds of things, the advocacy. Please. Hi, I just wanted to make a comment about the experience that I had in, like, a traumatic active shooter drill at my high school. And for context, I went to high school in Central California, so only, like, about an hour east of here. And I lived in, like, a rural city, and our high school was across the street from a police station. And so while other high schools in our city would get a lot of threats of, like, for example, like, bomb threats, like, shooter threats, like, any sort of threats, our high school wouldn't because of, like, the presence of the police station, like, right across from the school. But I remember one day, we had an active shooter drill, and it was right after lunch. So right when the bell rang to get from lunch to your next period, that's when they decided to have the drill. And the only people who knew about the drill were, like, the higher level administrators, so even our teachers didn't know about it. And they, their justification was to, like, to have it at that specific time, was to prepare for, like, an event where, you know, like, you never know, like, when a shooting would happen. It could happen at the most inconvenient time. But I remember that our high school, we were used to having, like, a large, like, police presence on campus. But that particular day, there were, like, fully armed, like, fully decked out police officers just, like, roaming the halls. And I remember they had, like, I don't know what guns they were, but, like, really big guns on their back, which, like, we would never see. And everyone was just really confused as to what was happening. And then all of a sudden, like, as we're all, like, going to class while there's, like, a bunch of chaos going on, like, people start, like, screaming. And then, you know, we're, like, oh, my God. Like, everyone's immediate thought was, like, oh, this isn't a drill. This is, like, a real-life, like, shooting situation. And I remember a bunch of us, like, went into random classrooms, like, to seek safety. And even, like, the teachers, they didn't know that it was a drill either. And there was, like, obviously widespread panic. And at the high school level, you know, like, everyone had phones. Everyone was contacting their parents. The parents didn't know either. And so what that had caused was a lot of parents, obviously, like, came to the school to, you know, find their kid. And so they had called, like, the fire department, paramedics, like, police officers, things of that nature. And no one was able to get into the school, like, to go through, like, the full drill because, you know, there were so many parents there. Like, there was just so much chaos going on. No one knew what was happening. And afterwards, a lot of parents were extremely angry, for good reason, about the way that they organized this drill. And a lot of the parents wanted the school to at least inform the parents that a drill was happening, like, beforehand and to get that consent from the parents before having, like, their children participate in something. And that caused, like, a lot of discussion about, like, oh, well, if the school wants to make it so that the students don't know, to, like, prepare for, like, a real situation so that people, you know, take it seriously, all of that stuff, then there's no way of, like, fully preventing students from not knowing if their parents know and their parents, like, spoil it for them, like, things of that nature. And so that just caused a lot of, like, discussion. And after that, the school just decided to, like, never do active shooter drills again. But I just remember that was, like, a very, like, scary time, obviously, like, being a student in that situation and even, like, the months afterwards, like, trying to find the best way to create, like, a scenario or, like, a drill that would be, like, beneficial for everyone instead of, like, traumatic. But I was wondering for, like, the panelists if you know about schools that decide to go, like, towards the parent side of, like, trying to consent or trying to formulate consent from, like, the parent's perspective for these children. I don't know if we know any, like, specific examples, but it's both a recommendation from the AAP and a recommendation from Everytown, which is a large nationwide entity, that consent from the parents is obtained and that parents have frequent discussions with their child leading up to the drill if a drill is deemed necessary. Because, right, like, who knows the kid better than the parents, right? So they're able to, in their language, with their own family values and their own moral system, be able to walk through what a drill is going to look like, what they should expect. And then also there's a lot of education about, quote, unquote, debriefing, right? So are then, are we coming, circling back after the drill and our parents and teachers and administrators sitting down and talking with students about their experience, what they felt, what did they think, and kind of debriefing afterwards. Both are really important. So I think, sure, maybe obtaining consent from the parents is, in theory, a better step than probably what you experienced. But the whole point is that then families are sitting down and having real discussions about this, right? Like, that's the point. And to piggyback off of that, unfortunately, our student, not all of our students have that support to talk with their families about. A lot of times, kids just go home and go to their rooms and don't process what happened in a healthy way. Like, I'm sure in your scenario, did you have a debrief session? It sounded like just chaos. It was honestly just chaos. There were talks of having a school-wide assembly to talk about everything. But it was just a big mess afterward. And another issue that actually came after that was that on top of the stress and the trauma of the active shooter drill, a lot of students felt triggered when they saw the police officers fully decked out. And that comes from a plethora of different factors of a lot of people in our community have experienced police brutality and violence from police. And seeing them in that scenario, it was just very, very terrible planning. And it caused so many different negative consequences. And I think from there, the administrators kind of realized that they messed up with how they went about everything. Being locked in a room with high school students and not being able to explain anything that's going on is the worst, just the absolute worst. Because they know they have their cell phones. We talked about social media earlier. 90% of the time, they know things before I even know what's going on. And then they just assume that it's real or anything's really happening. So not being able to actually give them answers sets up this whole, like, this very traumatic experience. Thank you. And I'm going to piggyback on what you just said. I'm actually a preschool director. And we think a lot about safety and so forth. Because, of course, our kids can't really participate in any of this, thank goodness. I have had our police department come in and do a live shooter training with the police and invited any of the staff who would like to watch to come in just so that they could participate, not to participate, but to observe what would happen using our police department. But I'm just curious, in your research, did you ever come across, I feel like, I think what you all are talking about is really important. And we need to keep the focus on the children. But I'd like to take it to the teachers for just a minute. Because is there anybody really coming up with good methodologies and ways to talk about this with the teachers so that they can be more effective in the classrooms? That's my question. Yeah, so Everytown came out with a proposal to utilize trauma-informed care when setting up drills, kind of like what you said when you remove children and just have staff and emergency personnel in the community. And so bringing in mental health and behavioral health specialists to kind of essentially, like we were talking about with students, but prepare teachers and then also do educated, well-informed debriefings afterwards, as well as provide education for administrators and emergency personnel to see warning signs in teachers and staff who may have experienced prior trauma and what that may look like in real time to help assist those teachers in either stepping out of the drill or in real time providing care. So there is some discussion on that. But I do think you bring up a really great point, is that when we take the children out of it and when we do preparations with teachers, what resources are we giving them to do that? And what language and what tools are we equipping them to explain this to children and to be able to be the role models that they may not get at home, right? So if mom and dad aren't going to prepare them and debrief them, then that sole responsibility lands on our teaching staff. And so are we equipping them with the tools and the resources that they need to be able to do that in an appropriate way? How did your event go? Was it well received? The training exercise, was it well received or? Yeah, a number of the teachers opted to come and watch because they were curious on a daily basis. I mean, not that we ever expected it to happen. Our community and our school is, but we have a lot of families from Central and South America who have experienced a lot of violence. They're very anxious when it comes to violence. So it was, and that also means that we're also playing popular. So it was, we have those conversations. I'm actually a social worker, right? Like, you know, I'm sensitive to things like this. But I But there still is a lot of, I feel like it's sort of like all the work that's being done. Like all this focus we're putting on the community. The fact of the matter is, it's the grown-ups that need to take care of it. And we're not giving the grown-ups the resources. So, I was just curious. I have come across everything. And the national data that we pulled for this, that bar graph that was in the beginning, when you look at last year's data, it was K-12. And so, in one year, we now had to add preschools to our national data because there's now violence in preschools. So, I don't want to count you out of the conversation because, you know, you're part of the conversation now, unfortunately, that we've had to even expand what that looks like. Well, I just wanted to say thank you to everyone for attending. Thank you to our wonderful panel. And I think this has really started or continuing. Hopefully, these conversations can continue. So, thank you very much and have a good evening.

active shooter drills

psychological impact

student anxiety

trauma

developmental limitations

American Academy of Pediatrics

skill training

parental consent

Everytown for Gun Safety

mental health resources

gun safety policies

threat assessment teams

community involvement