Let’s treat these mass shootings like the public health crisis that they are

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President Trump was correct when he said that neighbors and classmates of the Stoneman Douglas High School shooter knew that he had serious problems.

He even signaled his intentions — just like other mass shooters have done in the past. People should always report threats to the police, and law enforcement officials in this case were alerted, yet were unable to stop the shooter from acting.    

{mosads}What we need in our country —in addition to law enforcement — is a public health system that detects early warning signs and responds beforehand to prevent these events.


We already have a public health system that performs these exact actions to contain other contagious problems.

It works by interacting with high-risk persons and their communities to prevent events. By building out the capacity of our existing public health system to address violence, we could efficiently reach all corners of the country.

Public health systems can be effective at detecting those at risk of violent behavior because they are expert at getting close to persons at high risk. 

Health workers around the world do this type of work every day, detecting and preventing many serious and difficult to find problems during their early stages — from AIDS toEbola to violence.

In the case of violence, community health workers are embedded in communities where violence might take place.

They are trusted by family, friends, and acquaintances of those at risk, so they can help interrupt situations when someone is showing warning signs of being violent. The health sector can reach those at risk of being violent, interrupt any plans for violence, and help at risk persons deal with whatever issues that drive their unhealthy behavior.

Law enforcement should continue to have a prominent role in reacting to warning signs.  However, health approaches can add much to what police, FBI, and other law enforcement already do.

In cases where a person is thinking of committing a violent act and wants help, he may not want to turn to the police; this is where a trusted and professional public health worker and system can help. 

In cases where a person close to someone at risk of perpetrating violence is uncomfortable or they fear calling the police on someone close to them based on suspicion a professional and local health worker provides a life-saving option.  

In the most recent case, there were plenty of warning signs. Reports indicate that the mother of the Florida shooter called the police on her son. One of his online messages was reported to the FBI. He was known to have violent behavioral problems and was expelled from school for behavioral reasons.

Despite all of these warning signs, he was not stopped. That’s because there are limits to the ability of law enforcement to act beforehand to stop lethal events, since they cannot arrest someone who has not done anything illegal.   

A public health system could have been confidentially notified about behaviors of concern at so many points in his life, by his family, school classmates, or even by law enforcement.  

Any of these people, upon witnessing or experiencing troubling behavior, would have had somewhere to turn to get help, without threat of ruining someone’s life over a false report — and with the hope of helping a troubled person, in addition to preventing loss of life of others.

Moreover, health workers assigned to scour social media for any warning signs could have come across his posts vowing to be a “professional school shooter.”

Today, health workers are already scouring social media for warning signs of street and youth violence, and detecting concerning posts about mass shootings is an obvious extension of this work.  

The warning signs from the most recent Florida mass shooter were, of course, not unique.

The Orlando shooter had been fired from his job for joking about bringing a gun to work, was violent with his wife, posted threats on social media, and had been under investigation by the FBI on two occasions.

The Newtown shooter had profound behavioral issues and mental illness.

The Sutherland Springs shooter was violent with his wife and made threats to his family and in the workplace.  

The Virginia Tech shooter displayed disturbing behavior and writing and was under court ordered treatment for mental illness.  

The Columbine shooters displayed disturbing writing and posted threats online.  

If health workers had been made aware of the any of these shooters the end result of these tragedies may have been different.

We are not doing all we can to stop mass shootings. Prevention is the bread and butter of public health.   

Gary Slutkin, M.D., is the founder and CEO of Cure Violence and a Professor of Epidemiology and Global Health at the University of Illinois at Chicago School of Public Health.

Tags Crime Donald Trump Murder Public health School shooting Violence

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