In the days and hours leading up to the Nov. 30 mass shooting at Oxford High School in Michigan, a chilling series of events underscored the need for better screening for mental illness and safer gun storage.

“Unfortunately, what we find in these terrible, tragic acts is the kids who engage in this behavior have gone undiagnosed and untreated for years,” said James O’Dea, PhD, Vice President of Hartford HealthCare’s Behavioral Health Network. “Often they have been bullied or taken advantage of over time, and these awful acts represent solutions that for whatever reason make sense to them.”

The school shooting, which killed four students and injured seven others, is a stark reminder that there are often red flags leading up to these unthinkable acts, including undiagnosed or ignored mental health conditions.

Here are just some of the disturbing details that experts say could have brought more attention to 15-year-old high school sophomore Ethan Crumbley, who has been charged with terrorism and four counts of murder:

  • Crumbley’s parents, who have been charged with four counts of involuntary manslaughter each, allegedly gave him a semiautomatic handgun as an early Christmas present.
  • Soon after the purchase, Crumbley allegedly posted a picture of the gun on an Instagram account with the words “Just got my new beauty today. SIG SAUER 9mm” with a heart-eyes emoji.
  • Drawings and messages allegedly found by one of Crumbley’s teachers included a semiautomatic handgun, a bullet, a person who was shot and bleeding with phrases “the thoughts won’t stop. Help me”; “blood everywhere”; “my life is useless”; and “the world is dead.”
  • The day before the shooting, a second teacher allegedly witnessed Crumbley searching for ammunition on his phone and reported it to school officials.
  • On the day of the shooting, Crumbley and his parents were summoned to the school office. After discussing the accusations, school officials allegedly informed them that he needed to begin counseling within 48 hours but allowed him to stay in school. Shortly after, Crumbley emerged from a bathroom and went on a shooting spree in the halls of the schools.

One law enforcement official said there was clear evidence the shooting was premeditated and that the shooter was “looking forward to it.”

The massacre resulted in the shooting deaths of Madisyn Baldwin, 17; Tate Myre, 16; Hana St. Juliana, 14; and Justin Shilling, 17, and left the town, state and nation in mourning – once again.

Although Dr. O’Dea stressed he is not defending these senseless acts in any way, he said behavioral health care, especially for children, has been under-supported, under-resourced and under-funded for some time, contributing to a present-day crisis. Combine these factors with a pandemic and guns that are readily available, and you have the recipe for tragedies like what happened in Michigan and closer to home at Sandy Hook Elementary School in Connecticut.

“We can often identify significant mental health issues that weren’t identified or weren’t treated,” Dr. O’Dea said. “We know that early screening, early identification and early treatment have the best possible outcomes.”

That message may be resonating with the Connecticut legislature. Co-chairs of the Children’s Committee, Rep. Liz Linehan, D-Cheshire, and Sen. Saud Anwar, D-South Windsor, said they are considering legislation that would increase the number of training programs for social workers and psychiatrists, looking at intermediate and long-term plans to ensure psychiatrists are paid fairly and considering how to improve reimbursement rates, according to a report on NPR.

They will also look at the connectivity between pediatricians’ offices and mental health providers, as well as ways to improve Access Mental Health, a referral program pediatricians can use if they are presented with a child showing mental health symptoms that they do not feel they have the specialty to handle.

The Connecticut Hospital Association has been working with legislators on measures that would expand outpatient services in communities and resources in schools to help prevent the need for a visit to the emergency department or so that they can continue receiving the proper level of care once they are discharged.

“This is a proactive step. No child should have to be in crisis to access help,” said Dr. Javeed Sukhera, Chair of Psychiatry at Hartford HealthCare’s Institute of Living and Chief of Psychiatry at Hartford Hospital.

“Early intervention is so important in mental health, yet we have designed systems a bit backward. This is an opportunity for us to change things,” Dr. Sukhera said. “Working together, we can create a coordinated behavioral health system that centers on those we serve.

The school shooting in Michigan has sparked the closure of 60 other schools in that state based on copycat threats and grief. It’s also ignited widespread media coverage on top of an already large number of children and teenagers adversely impacted by the COVID-19 pandemic, which has brought feelings of isolation, depression and anxiety.

Dr. O’Dea recommends that parents:

  • Encourage their children to talk about how they feel, and ask questions.
  • Answer questions straightforwardly. If you don’t have the answer, admit it and try to get it for them later.
  • Acknowledge their fears, but reassure them that these incidents are not common, and they are safe. For example, many schools have security measures in place to stop something like this from happening.
  • Point out the positive. The first responders to the shooting were heroes, much like the 9/11 firefighters.
  • Limit their exposure to tragic events in the media, especially television. If they are exposed to media reports or graphic images, try to be there with them so you can explain to them what they are seeing, hearing or reading. If you don’t, they could become confused and frightened.