January 20, 2023

Threat assessment of youth at-risk of committing school violence should focus on ‘leakage’ in communications

Psychiatrists from the Wayne State University School of Medicine presented a workshop on “Firearm Violence in Schools” at the annual meeting of the Academy of Consultation-Liaison Psychiatry.

The team recommended to meeting attendees last November in Atlanta that careful threat assessment of young people believed to be at risk of committing gun violence in schools can avert violence when it focuses on specific behaviors—especially communications by the at-risk youth via personal conversations, texts or social media.

The presentation gained the attention of the American Psychiatric Association, which spoke with one of the presenters – Professor Rebecca Klisz-Hulbert, M.D., a child psychiatrist who has assessed young people in the Detroit area at risk for school violence.

Rebecca Klisz-Hulbert, M.D.

The workshop, held Nov. 11, was submitted by graduates of the WSU/Detroit Medical Center Psychiatry Residency, who invited Dr. Klisz-Hulbert to add expertise as a child psychiatrist and consulting school psychiatrist. She presented with the department’s Associate Professor Gerald Shiener, M.D.; Shazadie Soka, M.D. Res ’22; Ashika Bains, M.D., Res ’20; and resident Katherine Kelley, M.D.

“Feedback was very positive, as few psychiatrists feel well-prepared to appropriately manage these types of threat assessments,” Dr. Klisz-Hulbert said.

She is featured in the related article “Threat Assessment Can Help Prevent School Violence, But Reliance on a ‘Profile’ Doesn’t Work,” included in the January edition of the American Psychiatric Association’s Psychiatric News.

“If you look across all of the school shootings, what is common is the idea of ‘leakage,’” she told Psychiatric News. “These kids have communicated their intent (to commit violence) whether through in-person conversations, social media, text messages, or some other manner. This is increasingly what schools pay attention to.”

Dr. Klisz-Hulbert is program director of the Child and Adolescent Psychiatry fellowship program at WSU/DMC, the Department of Psychiatry and Behavioral Neurosciences vice chair for Child and Adolescent Liaison Services, and director of Child and Adolescent Public Psychiatry and Community Outreach.

“While I have done threat assessments in the past on occasion, the demand has increased significantly since the Oxford school shooting in 2021,” she said. “Similarly, outpatient psychiatrists and those working in crisis settings have increasingly been called on to assess the potential risk for children identified by the school as having made a threat. Colleagues have told me that they feel ill-prepared to complete such assessments and unsure of how to best intervene.”       

Dr. Klisz-Hulbert has presented similar training to local school districts and the Michigan Association of School Social Workers. She has been a consulting school psychiatrist for numerous districts in metropolitan Detroit for more than 10 years.

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