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TUESDAY, Nov. 6, 2018 (HealthDay News) -- As Mark Barden let go of the hand of his young son, Daniel, and the boy boarded the bus for school on the morning of Dec. 14, 2012, he had no idea it would be the last time he would see his child alive.
Hours later, the 7-year-old lost his life in the horrific mass shooting at Sandy Hook Elementary School in Newtown, Conn. Twenty children and six adults were killed by a mentally disturbed 20-year-old who then killed himself.
Six years later, Barden is working to prevent future horrors like the one that claimed his son, saying such tragedies are preventable if one knows the warning signs.
His group, Sandy Hook Promise, has trained more than 3.5 million youth and adults to recognize and respond to signs that a person is at risk for harming either themselves or others.
"Through that work, we've been able to prevent numerous mass shootings and dozens of suicides," Barden said.
Barden will present his program at the American Academy of Pediatrics' annual meeting in Orlando, Fla., this week.
"Think about what happened in the tragedy in Newtown, where this individual had been giving off warning signs for over a year-and-a-half, had been planning that event for over a year-and-a-half," Barden said. "I lie awake thinking about all the ways this could have been prevented."
Know the Warning Signs
Four out of five school shooters told someone about their violent plans prior to the event, according to Sandy Hook Promise.
Red flags that someone could be planning to harm themselves or others, according to the program, include:
- A strong fascination or obsession with firearms or previous mass shootings.
- Excessive over-reactions to minor offenses, which can signal a lack of ability to self-regulate emotions or control anger.
- Trouble with their education, including a sudden drop in grades or gestures of violence toward school.
- Feelings of being picked on or persecuted by others.
- Extreme feelings of isolation or withdrawal.
- Bragging about access to firearms.
- Making overt threats of violence.
- Talking about or making plans for suicide.
Suicidal thoughts and feelings are a key part of these mass shootings, said Dr. Robert Sege, a pediatrician with the Floating Hospital for Children at Tufts Medical Center, in Boston.
"Many of these mass tragedy events have a suicidal element for the perpetrator," said Sege, who co-authored the AAP's firearms policy statement. "Look out for the signs of suicide -- people who stop making plans for the future, who talk about dying, who start giving away things because they won't need them anymore. Most often people who attempt suicide have given very broad hints to people in advance."
All of these warning signs are part of a threat-assessment model originally developed by the Federal Bureau of Investigation in the aftermath of the 2007 Virginia Tech shooting, which Sandy Hook Promise has adapted for elementary schools, Barden said.
The signs are taught in "Say Something," a Sandy Hook Promise program for middle and high school students that focuses largely on social media, Barden said.
"We have more case studies than I'd want to admit of folks who have ended up taking their life who had been talking about it on social media and left hundreds of social media impressions that everybody in their network had seen, and didn't know what to do, or didn't think it was serious, or thought they were looking for attention and didn't take action," Barden said.
A program for younger children, "Start With Hello," discusses how to recognize loners and reach out to them.
"We teach them how to tell the difference between healthy alone time and someone who is constantly marginalized," Barden said. "We teach them how to reach out to those folks in fun and comfortable ways."
The perpetrator of the Newtown tragedy, Adam Lanza, was chronically isolated, Barden noted.
"Another thing that keeps me up at night is maybe one more conversation with someone like my little Daniel, who used to reach out to kids, could have changed that entire story," Barden said.
Children who see the warning signs are encouraged to reach out to a trusted adult, he explained.
'Red Flag' Laws Save Lives
Sege said that adults can then contact their school's security officer. They also should see if they live in a state with a "red flag law," in which police can remove firearms from a person thought to be of imminent danger to themselves or others.
"The first state to enact a red flag law was Connecticut, and they've been able to show a reduction in suicide in Connecticut," Sege said. "At several of the recent mass shootings, there have been people who said they were worried about this person and they knew they had access to military-style weapons."
Sandy Hook Promise also has started an anonymous tip line available at 1-844-5-SAYNOW or www.saysomething.net.
The tips are referred to crisis centers staffed by trained professionals, Barden said.
"They don't just throw it over the wall to law enforcement. They know how to triage information and act appropriately," he said.
"In our trainings, we acknowledge that any one of these warning signs in a random situation certainly may not be a cause for concern, but if there's anything that causes concern it's better to have an unfounded tip than the other way around," Barden said. "Less than 1 percent of the tips that go to the call center are going to be anything serious or life-threatening, but for the 1 percent that might be, it's well worth it."
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SOURCES: Mark Barden, founder and managing director, Sandy Hook Promise; Robert Sege, M,D., Ph.D., pediatrician, Floating Hospital for Children at Tufts Medical Center, Boston