Schools are back in session. For many, attention is turned toward new clothes and school supplies, updated syllabi, bus schedules, and after-school activities. But for some—school staff, families, and policymakers alike—attention is turning to school security and safety, and with that attention comes heightened concern over school shootings.

Firearm deaths of American children and adolescents have been declared by the US Surgeon General to be a public health crisis. In 2019, firearms surpassed motor vehicle accidents as the leading cause of death for American children and adolescents. Indeed, more than 90 percent of firearm deaths of school-age children across developed countries occur in the United States.

But are schools really the epicenter of the risk? According to the CDC, in a study of 23 years of data, only 1.2 percent of firearm homicides of school-aged children occurred in school settings and more than 92 percent of those were single-fatality incidents. Estimates of the probability of any given school experiencing a shooting (of any type) is once every 1,455 years, with the probability of experiencing a fatality once every 3,250 years. Further, the belief that a typical school shooting is a mass casualty event, occurring in classrooms and hallways, may be more stereotype than archetype: many school shootings occur outside of the school building and involve limited or no injuries. While we may tend to imagine school shootings occurring in a particular way, such shootings and their perpetrators are heterogeneous: there is no accurate “profile” of a school shooter or a school at risk of a school shooting. School shootings are rare and defy easy categorization but remain undeniably and intrinsically horrific.

Given this heterogeneity, the question then becomes: how best can school leaders and policymakers allocate their finite resources to security without sacrificing everything else needed to help their schools thrive as a place of learning, growth, and community? Preparing to prevent or respond to frequent low-severity threats versus rare high-severity threats is a longstanding problem for policymakers. And, in the context of school violence, the emphasis on deterring and responding to major attacks in school security discourse can come at the cost of a lack of prioritization on prevention.

Left of Boom Is Better Than Right of Boom

Imagine a person preparing to engage in a violent attack moving along a timeline. In military contexts, and increasingly with respect to school shootings, the moment of attack is referred to as the boom. In an active shooting, this is the time when measures like lockdown procedures, Stop the Bleed, and armed response occur. “Right of boom” is after the event: when the survivors are treated at hospitals, families grieve, professionals come in to provide Critical Incident Stress Management and Psychological First Aid, and communities find themselves transformed forever. “Left of boom” is the window of time before an attack when a person is building up a grievance and planning their act of targeted violence. Intervention left of boom is the opportunity for prevention.

As an emergency psychiatrist, I have worked extensively with individuals, groups, and communities right of boom, supporting people in the moment of crisis and through the course of PTSD. You do not need my lived experience to know that no matter how good we can be helping survivors, prevention—that is, developing and applying tools and systems to stay left of boom—is infinitely preferable. Behavioral Threat Assessment and Management (BTAM) is one of the best tools available to successfully prevent incidents because it focuses on identifying people at risk for violence and intervening early. It is an evidence-based strategy for investigation and intervention to prevent acts of targeted violence with its origins in understanding attempted assassinations of high-profile targets.

…behavioral threat assessment and management (BTAM) professionals need to accumulate and interpret an array of evidence about a person of interest. As BTAM thought leader Jeff Pollard has said, we have to collect the dots to connect the dots.

BTAM uses diverse teams of subject matter and operational experts to recognize and reduce violence risk before the attacks happen. People at risk for violence are identified for further investigation based on direct or indirect threats. The case is then reviewed by a multidisciplinary team which may include educational, behavioral health, and law enforcement professionals. The elements of an investigation vary but can include interviews of the person of interest, interviews of others with knowledge of threats or other concerning behaviors, as well as other information, including academic, social media, and other records as appropriate. Structured professional judgment tools are then applied to encourage comprehensive assessment and reduce risks of subjective bias. As in clinical medicine, individualized plans are developed based on those assessments to address dynamic risk and protective factors with a preference for intervening early when less coercive tools are possible.

In 2019, the United States Secret Service identified multidisciplinary threat assessment and management—another term for behavioral threat assessment and management—as the best practice for preventing future mass shootings in school settings. Since there are no risk factors for violence that, in and of themselves, are necessary and sufficient for violence, BTAM professionals need to accumulate and interpret an array of evidence about a person of interest. As BTAM thought leader Jeff Pollard has said, we have to collect the dots to connect the dots.

BTAM can be thought of as a blend of behavioral health and sciences, criminology, and operational expertise (in this case, school operations) blended and held together with tools from intelligence. (Intelligence in this sense relates to methods and systems to obtain and interpret fleeting, nuanced, and potentially unreliable information in a rapidly evolving, high-risk scenario; think three-letter federal agencies, not IQ testing.) Done properly, BTAM is a tool that is evidence-based, effective, ethical, and equitable—even if awareness of the tool seems lacking.

BTAM is case-specific: it is focused on individuals who have come to the attention of related professionals based on communication or behavior. It is a tool for assessing and managing people at risk, not populations. Vitally, BTAM is not just a tool for stopping attacks but for providing the support and scaffolding to help that person at risk pivot away from a pathway to violence and towards a pathway to recovery.

Best practices for using BTAM in K-12 school settings have been developed by the US Secret Service, Virginia’s Comprehensive School Threat Assessment Guidelines, and others. Best-in-class operational guidance for applying BTAM across all settings has also been developed by the FBI’s Behavioral Analysis Unit 1, and professional associations including the Association of Threat Assessment Professionals champion for related research and practice. While BTAM has been developing as an approach and practice for nearly 50 years, it has only come to greater visibility over the past decade.

Many school security strategies are anchored to deterrence. Many deterrence practices presume that school shooters fear death, but many school shooters are suicidal and may not be deterred by common security strategies. Metal detectors, surveillance cameras, and hardened entrances only shift perimeters and change potential points of skirmish. While these measures can be an essential element in securing schools, focusing exclusively on deterrence will inevitably be an incomplete strategy.

None of these specific tools mentioned are, however, likely to help at a football game, as students wait for buses, let alone mitigate the risks that occur outside of school hours or after a suspension or graduation. Since BTAM teams seek to understand the person at risk (who may or may not be a student) not only in the context of the school but also across their life, within their family and their community, it can be a critical tool in mitigating some of the 98.8 percent of firearm homicides that happen outside of schools. In an era when public health dollars, like education dollars, are not infinite, it seems reasonable to prioritize tools that work across scales and settings.

…BTAM provides a tool that lets communities and schools work “left of boom,” providing a tool more effective than a bucket of rocks or other more sophisticated technological measures that schools have implemented.

BTAM is not a complete means to prevent attacks and should not be used in isolation. It too has limitations and downsides. Targeted violence in K-12 settings remains a relatively rare phenomenon and variability amongst assailants is significant; they are outliers amongst outliers. As has been noted, there is no profile of a school shooter. So while structured professional judgment tools can be of assistance in an evaluation, the process still requires skilled review and monitoring by appropriate professionals—which can be resource-intensive for some schools. Additionally, because threat management relies on bystander reporting of people at potential risk for violence based on direct or indirect threats, this strategy can be ineffective in schools where there is low trust in school leadership. It also will never identify 100 percent of people at risk for targeted violence, so complementary approaches and tools are necessary. Finally, there may be risks to not carrying out BTAM appropriately. A recent civil case found that a school district where a shooting took place was liable for substantial damages after they failed to appropriately operate a multidisciplinary team (including qualified mental health professionals), and then failed to develop or adhere to appropriate processes, including monitoring students after interventions, documentation of case reviews and communication amongst the team, communication with the family, and haphazard modification of evidence-based tools.

Ultimately, BTAM provides a tool that lets communities and schools work “left of boom,” providing a tool more effective than a bucket of rocks or other more sophisticated technological measures that schools have implemented. While there is a blossoming multibillion-dollar industry of school security technology, many of these approaches are unsupported by research and practice—some are more performative than effective and reek of security theater. Instead, BTAM relies on a multidisciplinary approach, bringing together stakeholders from the school, mental health, law enforcement, and other agencies and organizations to assess the credibility of a threat once identified and the likelihood of it being carried out before determining an appropriate management strategy (e.g., supervision of the threatening person, connecting them with resources in the community) to prevent that from happening.

The Machine That Goes Ping!

Several years ago, I attended a charity ball representing my crisis center, seeking to connect with potential donors. Standing in front of my table, adorned with pamphlets, pens, and other promotional tchotchkes, I stood ready to discuss our services: community engagement through a hotline, mobile crisis services, and a walk-in center. In my eyes, these are excellent services from a team I have now proudly served for over 14 years.

Driving home that night, musing at how all the foot traffic seemed to go towards the literal lights, bells, and whistles of other tables, I thought of a scene from Monty Python’s The Meaning of Life. In one scene, two obstetricians walk into an empty delivery room and, disappointed with its barren appearance, call immediately for various pieces of equipment, including “the Machine That Goes Ping!” and command staff to “get the most expensive machine in case the administrator comes.” Throughout all of this, the needs of the patient are ignored at best and patronizingly dismissed at worst.

BTAM is competing with the Machine That Goes Ping for vital and finite resources.

A few years ago, as I gave a talk on BTAM at a security conference, I noted audience members walking to the back of the room to peruse vendors’ tables featuring AI-enhanced video cameras, metal detectors, microphones that detected gunshots or screaming, and software tools claiming to monitor student computers for concerning signs. The parallels were not lost on me. Technology draws attention, and while technological tools can be lifesaving, they should not distract from what our focus should be: identifying people at risk for violence and developing meaningful ways to help them pivot to a pathway to recovery and safety.

BTAM works. It has been identified by education and security professionals alike as a best practice, providing meaningful prevention and interventions that can be collaborative and benevolent rather than punitive—or imparting the moral and psychological injury that might result from expecting teachers to shoot a student in order to stop an attack. But BTAM is not flashy. It is not an arch metal detector at the school entrance (creating a bottleneck outside the school) or an entrance with ballistic glass that parents see every time they need to drop something off for their child. It is not the hopeful theory that an armed warrior-teacher can potentially end an attack quickly by engaging in a firefight with the assailant—even when trained law enforcement has been unable or unwilling to do so again and again. And, it is not the AI-enhanced video surveillance that may be able to say when an armed person has arrived (but does not itself stop the attack from happening).

BTAM is competing with the Machine That Goes Ping for vital and finite resources. In the eyes of school leaders, legislators, and the general public, technological tools like arch metal detectors, thickened glass, video surveillance, and AI-enhanced social media monitoring may attract more attention. They are tangible, they are not a process: and they are loaded with lights and whistles, both metaphorical and concrete. Parents and school boards see the security measures at the entrance of the school and may be appropriately reassured by seeing them, but they will likely never see the vital work BTAM programs do every day because when it is done right, it occurs almost entirely behind the scenes.

Defining Goals

School leaders need to make crucial decisions in finding and allocating scarce resources. Perhaps the most essential question is understanding what the ratio is between resources allocated to hard security and right of boom measures (e.g., locks, cameras, drills, Stop the Bleed, SROs) and soft but strong security measures which work left of boom (e.g., Behavioral Threat Assessment and Management, mental health resources, school psychologists, and threat management specialists). Whether the ratio is measured by hours spent on teacher continuing education, FTE allocations, dollars spent, or communication with families and community leaders, school administrators need to understand how their budget is currently apportioned. And then they need to decide what the right ratio should be and what their strategy is to correct the imbalance in the coming years. I doubt that there is a magic ratio for this; it will vary from district to district and should shift and adapt as the problem of targeted violence evolves and best practices for school safety improve.

School leaders need to be able to articulate clear plans on how they reinforce meaningful connections between students, between students and school staff and faculty, and between the school system and parents. If there is no trust, “see something say something” becomes futile because nobody wants to share what they see or hear. Is the school system supporting its K-12 BTAM program and building relationships with community partners to meaningfully support students outside of the school walls and beyond their time at school?

Defending Against Fear and Danger

Gene Deisinger, a thought leader in the field of Behavioral Threat Assessment and Management, once told me that fear and danger are different things. Ultimately, schools and threat professionals must attend to both: they are both real needs of the people we serve. However, they require different interventions and must be assigned different priorities. Physical security measures are essential, but insufficient. Preparation is not prevention. But BTAM makes prevention possible by offering a proactive approach to preventing violence by addressing underlying risks and supporting individuals beyond the immediate school environment. BTAM is not the only tool for keeping our schools safe, but it may be one of the most essential tools.

ABOUT THE AUTHOR

John “Jack” Rozel is a professor of psychiatry and law at the University of Pittsburgh and a member of the Regional Gun Violence Research Consortium. He divides his time between emergency psychiatry and violence work.