School-Based Violence Prevention Can Work
Mahoney, Diana, Clinical Psychiatry News
The spate of high-profile school shootings in recent years has brought youth violence to the forefront of the nation's consciousness.
According to the results of a nationwide survey of high school students conducted by the Centers for Disease Control and Prevention, nearly 36% of the respondents reported being in a physical fight one or more times in the year preceding the survey. Additionally, 18% of the students reported carrying some type of weapon--including 5.4% who reported carrying a gun--on one or more of the 30 days preceding the survey (MMWR 2006;55[SS-5]:1-108).
The consequences of such violence are disturbing. In 2004, 5,292 young people between the ages of 10 and 24 were murdered, primarily with firearms, and more than 721,000 received emergency department treatment for injuries sustained as a result of violence, according to data from the CDC's Web-based Injury Statistics Query and Reporting System (WISQARS) published online in July of this year (www.cdc.gov/ncipc/wisqars).
Research also indicates that children and adolescents who exhibit persistent violent behavior are at increased risk for a range of co-occurring psychosocial problems. In a profile of violent youth published in the American Journal of Public Health, behavioral scientist Phyllis Ellickson, Ph.D., and her colleagues at the Rand Corporation, Santa Monica, Calif, examined the prevalence and correlates of violence among a diverse population of 4,500 high school seniors in California and Oregon. They determined that violence was correlated with substance abuse, nonviolent delinquency, academic issues, and poor mental health.
Additionally, 28% of the persistently violent students had a history of selling drugs, and persistently violent students were eight times as likely as their nonviolent peers to have committed nonviolent felonies. About 80% of the youth reporting a history of violent behavior exhibited multiple psychosocial problems (Am. J. Public Health 1997;87:985-91).
Youth violence is a significant public health problem, but it is not an intractable one.
In his 2001 Surgeon General's Report on Youth Violence, Dr. David Satcher stressed that our nation has the knowledge and the tools needed to address the problem. "Many effective intervention programs exist to reduce and prevent youth violence," he wrote. "The United States is well past the point where anyone can claim that 'nothing works' to prevent youth violence or to modify the destructive life courses of youths who are either engaged in or appear to be headed for lifestyles characterized by violence" (http://www.surgeongeneral.gov/library/youthviolence/report.html).
The findings of a recently published meta-analysis of interventions targeting youth violence confirm Dr. Satcher's contention. Prepared by the Task Force on Community Preventive Services--a nonfederal task force supported by CDC scientists--the systematic review uncovered "strong evidence" that school-based violence prevention programs result in significant reductions in violent behavior among at-risk youth.
Specifically, the authors wrote, "we found an average 15% reduction of violence among the school-based programs reviewed, which has the potential to contribute large societal benefits" (Am. J. Prev. Med. 2007;33:S112-13).
The authors looked at universal school-based programs designed to teach all students in a school or school grade--versus at-risk or violent students exclusively--about the problem of violence and its prevention or about skills intended to reduce aggressive or violent behavior, such as emotional self-awareness, emotional control, self-esteem, positive social skills, social problem solving, conflict resolution, and team work. The various programs were built on a variety of intervention models, including informational, cognitive-affective, and social skills building. …