School shootings are a distinctly American phenomenon. Unfortunately, the public focus is either on the mental state of shooters or on the availability of guns.

In fact, mass shootings by people with serious mental illness represent less than 1% of all annually gun-related homicides in the United States. (1) The overall contribution of people with serious mental illness to violent crimes is only about 3%. When these crimes are examined in detail, an even smaller percentage are found to involve firearms. Criminals and angry teenagers and adults use guns.

Still, there is reason to be concerned about the mental health of our young citizens. Most are doing well, but at least one in three are not. At least one in four have experienced neglect and / or abuse at some point in their lives and are predisposed to violence in later life.

The United States ranks 18th of 21 Western countries in overall child wellbeing. American children are clearly falling short intellectually. They rank 23rd in science, 17th in reading and 31st in math achievement out of 32 Organization of Economic Cooperation and Development countries. (2) These include Shanghai, China (1st in all), Finland (1st, 2nd and 6th), South Korea (6th, 2nd and 4th), Canada (8th, 6th and 10th), Germany (13th, 20th and 16th) and Poland (19th, 15th and 25th).

The Centers for Disease Control's 2016 Youth Risk Behavior Survey found that nationwide 6% of students missed at least 1 day of school during the past month because they felt unsafe in school.

Overall child deaths in the United States greatly exceed those in comparable nations, largely because of thevalence of gun deaths. Of each 1 million children in the United States, 6,500 die of all causes annually in the United States compared to 3,600 in Germany and 2,500 in Japan.

In Chicago, more than 440 school-age children were shot in 2012; sixty died. "I think people in Chicago have almost gotten numb to the statistics," said Dexter Voisin, a researcher at the University of Chicago. "For every kid who is killed, about 100 kids witness a murder or are victims of nonfatal injuries, robberies, muggings and gang-related incidents."

Mental health professionals are all too familiar with the use of guns in suicides and homicides, but focusing on the mental state of shooters misses the point. Criminals and angry persons use guns. No one would shoot anyone if handguns and automatic weapons were not readily available. The latter are military weapons that have no place in civil hands.

No mental health interventions will ever prevent the vast majority of shootings in our homes, on our streets and in our schools. Strict gun control laws that reduce the availability of guns will. At the same time, the mental health of our young citizens does cry out for attention. We child and adolescent psychiatrists have an obligation to make both of these facts known.

1. Knoll, James L. & Annas, George D. (2016) Mass Shootings and Mental Illness. Washington, DC: American Psychiatric Association Publishing.
2. https://www.cdc.gov/healthyyouth/data/yrbs/results.htm
3. https://www.newswithviews.com/Wooldridge/prosty467.htm

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