Robert M. La Follette School of Public Affairs
Wednesday, September 16, 2020

Study finds persistent increase in antidepressant use among students at school during shootings

Sam Trejo Sam Trejo

In the years following a fatal school shooting, children attending the school where the shooting occurred experience a substantial increase in antidepressant use, according to a study by La Follette School Assistant Professor Sam Trejo and colleagues published in the Proceedings of the National Academy of Sciences (PNAS).

The study represents the largest analysis to date of the effects of school shootings on an important indicator of youth mental health: the use of prescription antidepressants.

“The societal costs of school shootings are typically quantified in terms of the individuals who are injured or killed.” said Trejo. “But our study shows that there’s more to the story—it’s important to think about not just the direct victims but also those who are indirectly affected, especially given the large private and social costs of mental illness during childhood.”

The research team, led by Maya Rossin-Slater, matched a database of school shootings compiled by The Washington Post with information on prescriptions filled by pharmacies located within five miles of the affected schools. Rossin-Slater is an assistant professor of medicine at Stanford University.

In the two years after a fatal shooting, child antidepressant use increased by 21.4 percent. These negative effects were larger in areas with fewer mental health providers like social workers and psychologists who focus on behavioral, rather than pharmacological, interventions.

Trejo and colleagues found that there was no effect on youth antidepressant prescriptions for pharmacies located farther than five miles from a school shooting. In addition, they found no change in prescribing rates of other types of medication for youth in the affected areas, implying that the effects observed are not a result of increased interactions with the health-care system overall.

Relative to the average U.S. school, schools that experienced a shooting had higher average enrollment, were less likely to be private, were more likely to be a high school, and had a higher average share of students who qualified for free or reduced price lunch, they found.

“Exposure to a single, fatal school shooting leads to worse mental health among local youth for years,” Trejo and colleagues wrote. “These lasting impacts are consistent with the development of chronic mental health conditions for which clinical practice guidelines recommend long or indefinite treatment.”