THE BLOG
02/15/2013 05:16 pm ET Updated Apr 17, 2013

Prevention First: A Physician's Prescription for Safer Schools

These days, it seems like our leaders in Washington have trouble finding common ground. However, the State of the Union address on Tuesday and the Republican response offered a welcome moment of agreement. Both President Obama and Senator Marco Rubio called for urgent action to reduce violence in our schools and communities. It's certainly true that Republicans and Democrats may disagree on the steps we should take, but I was pleased nonetheless that both sides are considering the problem with the seriousness it deserves.

The debate is different this time. December's unspeakable tragedy at Sandy Hook Elementary School has focused the nation's attention on safety -- and rightly so. Every morning, some 60 million American parents check homework, stuff backpacks, zip up jackets and send their beloved children into the care of our nation's schools. Parents are demanding that our leaders do everything in their power to ensure that those kids return home, every day, safe and healthy.

There are no shortage of ideas on the subject, and the debate has been robust. But I'd argue that our national conversation has been missing one essential element: a physician's focus on prevention.

I have served as a practicing pediatrician in Philadelphia and in Camden, New Jersey, but you don't have to be a doctor to know that an ounce of prevention is worth a pound of cure. It's cheaper and more effective to stop violence before it starts.

The key to prevention is understanding the source: who are these disengaged, disconnected and frequently mentally ill young people who are involved in so much violence in our schools and neighborhoods?

In bucolic communities like Columbine, Aurora and Newtown, this crisis of disengaged youth may show up as a senseless, massive shooting. In neighborhoods like Compton, Richmond, Chicago and North Philadelphia, it may be school dropout, gang involvement and drive-by shootings. Either way, the problem will continue to haunt our civic life until we make prevention a priority.

Early detection and treatment is the key. We need to reach troubled children when problems first emerge, while there's still time to guide them back on the right track. And because young people spend so much time in school, that's where the first inklings of trouble are often detected -- and it's why schools are essential places to focus prevention resources.

Every school should have the resources it needs to provide comprehensive health services, where nurses, counselors and other experts can diagnose problems, whether mental or physical, and get kids the help they need. And whether at a school-based clinic or in another setting, every student should get a behavioral health check-up, just like they get a physical check-up before starting the school year.

School counselors are an especially important part of the solution. In California, we have about one counselor per 1,000 students--the worst ratio in the nation and four times the recommended standard of 1 counselor per 250 students. The best counselor in the world can't keep tabs on 1,000 students, and we can't expect them to.

The research shows clearly that counseling delivers a wide range of benefits, including improved academic performance, reduced classroom disruptions and fewer disciplinary problems, all of which lead to calmer school climates, emotionally healthy students, and reduced violence on campus. Access to school nurses is credited with decreasing absenteeism and improving graduation rates. And comprehensive approaches to providing health services that include counselors, nurses and other experts have proven effective at preventing youth suicide and reducing violence in schools and communities.

Californians are enthusiastic about prevention-oriented approaches to reducing school violence. According to a survey of 1,200 California voters, 72% say we should emphasize strategies that focus on prevention generally, compared to just 22% who say the right approach is preparing to respond to violence with more metal detectors, fences and armed security guards. Moreover, 84% of survey respondents favored increasing the number of trained counselors in schools (including 55% "strongly support") and when asked whether placing counselors or armed police in schools was the more effective strategy for preventing violence, more than two-thirds picked counselors over police (67% to 26%).

If the social science research and public opinion isn't enough to convince you, consider the views of young people themselves -- those most affected by the issue of school violence.

These young people gathered in Los Angeles shortly after the Newtown tragedy to deliver a strong message to policymakers: don't let Sandy Hook turn our schools into fortresses. Yes, take common-sense steps to ensure that schools are ready to respond to emergencies, but don't sacrifice education in the name of security. A different group of students subsequently released a video sharing their personal experiences with school counselors and urging California to improve our woefully inadequate student-to-counselor ratio.

The youth advocates in these videos wisely caution against a rush to place more armed guards in schools. After all, Columbine, Virginia Tech and Ft. Hood all had armed guards, but they weren't able to prevent tragic acts of violence. In the years following the Columbine massacre, the federal government spent more than $900 million to pay the salaries of school police and offset other security costs, but all this new spending didn't fix the problem. Instead of continuing down the same path, we should refocus our energies and investments in prevention.

I'm pleased that prevention-oriented approaches to school violence seem to be getting some traction. When I testified before Congress earlier this month, I was pleasantly surprised that members responded enthusiastically to my calls for a focus on mental health services. And more important, President Obama's plan to reduce school violence specifically highlights the role that school counselors can play.

These are positive developments, but it's just a start. To effectively prevent violence in schools, we need a complete approach. We need not only improved emergency response strategies but also better tools and resources to identify kids and adults who need help -- so we can get them the care they need or get them off the streets if they pose a serious danger to themselves or others.

These are the strategies The California Endowment will be emphasizing over the coming weeks and months. What would you do to make schools safer? Join the conversation at www.CalEndow.org.

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