In June 2002, a literature review of immediate, intermediate and long-term mental health services after school-related violence was conducted, exposing significant gaps in current knowledge and practice. While a number of immediate response protocols detailed actions taken at schools, such as student and teacher interviews and parent meetings, no evidenced-based practice or substantive evaluation was found related to this area of inquiry.

Expert Panel Recommendations

In August 2002, a strictly structured focus group was held with a panel comprised of education, mental health, law enforcement and school safety experts who have been first responders and organizers of intermediate and long-term mental health recovery services after incidents of school-related violence. To achieve a variety of perspectives, teachers, administrators, school police and school mental health personnel who represented urban, suburban and rural school districts from geographic regions across the United States were included. What all panelists had in common was experience with school-related violence and its aftermath.

The purpose of the focus group was to determine areas of agreement and disagreement among the experts about what mental health services should be provided in schools in the aftermath of violent incidents. The dearth of research and evaluation in this area underscored the importance of gleaning the experience, knowledge and collective wisdom of the expert panel members. For maximum effectiveness, the RAND/UCLA Appropriateness Method (RAM) was used to facilitate and guide the discussion and the process of rating intermediate and long-term mental health practices. The RAM is a well-established standardized approach for determining appropriateness of care based on analysis of existing empirical literature and the judgment of an expert panel.

Although the focus group spanned a two-hour period, the group could not attend to all issues, roles and responsibilities that are important factors in responding to school-related violent events.

For example, the vital roles of principals, superintendents and boards of education were not addressed. Nor were issues of school climate and culture a topic of discussion. Despite the limitations of time and attention, the following panel recommendations form a foundation of expert knowledge and experience in intermediate and long-term mental health recovery practices. Issues deemed important but not addressed in the focus group of expert panelists will be covered in subsequent portions of this guide.

Highlighted topics in this section summarize areas of the expert panel members' substantive dialogue, such as:

* Recipients of services
* Roles of school and community personnel
Role of school counselors, school psychologists and school social workers
Role of school nurses
Role of teachers
Role of community mental health agencies and additional mental health staff
* Location of intermediate and long-term mental health services
* Mental health screening
* Training of school-based and community mental health staff

The overall findings of the focus group are reported here as areas of "consensus" unless otherwise indicated.