4.1 LOOKING BACK AND MOVING FORWARD ON THREAT ASSESSMENT AND MANAGEMENT IN SCHOOLS: RESEARCH EVIDENCE, IMPLEMENTATION BARRIERS, AND NEXT STEPS

For almost 20 years, behavioral threat assessment and management procedures have been used to evaluate and monitor children’s risk for violence in schools. Recent tragic school shootings where students underwent a threat assessment and then perpetrated a violent attack, however, have raised questions about these procedures for evaluating risk. This Institute will examine the state of the evidence on threat assessment and management in K-12 schools in the United States, including the 11 questions for threat assessment, the challenges with implementation fidelity, and patterns across school culture and student demographics. Nancy Rappaport, MD, and Sarah Goodrum, PhD, will help participants understand the history of, context for, and strategies within threat assessment and management in K-12 settings, using research evidence and case study examples. The effective implementation of threat assessment and management remains challenging, due to a lack of staff capacity, guardian support, information sharing, and cross-agency collaboration. These challenges highlight the reality that threat assessment and management cases are not solely school or clinical problems; they are also community problems. Thus, communities need to adopt a public health approach to violence prevention (ie, provide education and intervention at primary, secondary, and tertiary levels), where behavioral threat assessment is one tool within a continuum of integrated prevention and intervention strategies for children in crisis. Psychiatrists can support a public health approach to violence prevention through practice and partnership with families, schools, and communities. Tangible strategies and resources for assessment and management within a public health model will be discussed, including memorandums of understanding (MOUs), response management planning, and system checks.