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Chapter: Psychiatric Mental Health Nursing : Abuse and Violence

Community Violence

The National Center for Education Statistics (NCES), Institute of Education Sciences (IES), and the Bureau of Justice jointly publish an annual report about school crime and safety.



The National Center for Education Statistics (NCES), Institute of Education Sciences (IES), and the Bureau of Justice jointly publish an annual report about school crime and safety. The most recent data published are for the 2005–2006 academic year. Fourteen homicides and three suicides occurred at school in children aged 5 to 18, or 1 death per 3.2 million students. There were 1.5 million nonfatal crimes among children 12 to 18 years old, includ-ing theft and violent crimes. Eighty-six percent of all schools reported one or more serious violent incidents, theft, or other crimes on school property, or a rate of 46 crimes per 1000 students. Among high school (grades 9 through 12) students, 14% reported fighting on school property, 13% carried a weapon to school, 4% consumed alcohol at school, and 5% used marijuana on school prop-erty (NCES, 2008).


In an effort to combat violence at school, the CDC has been working with schools to develop curricula that emphasize problem-solving skills, anger management, and social skills development. In addition, parenting programs that promote strong bonding between parents and chil-dren and conflict management in the home, as well as mentoring programs for young people, show promise in dealing with school-related violence. A few people respon-sible for such violence have been diagnosed with a psychi-atric disorder, often conduct disorder. Often, however, this violence seems to occur when alienation, disregard for others, and little regard for self predominate.


Bullying is another problem experienced at school, including verbal aggression, physical acts from shoving to breaking bones, targeting a student to be shunned or ignored by others, and cyberbullying involving unwanted emails, text messages, or pictures posted on the Internet (McGuinness, 2007). Nearly one third of U.S. students report they experience bullying, either as a target or as a perpetrator. More than 16% said they’d been bullied occa-sionally, whereas 8% reported being bullied at least once a week. The frequency of bullying was highest among sixth through eighth graders. Children who were bullied reported more loneliness and difficulty making friends, and those who bullied were more likely to have poorgrades and to use alcohol and tobacco. Children with spe-cial physical health-care needs are bullied more often, and children with a chronic emotional, behavioral, or develop-mental problem are more likely to be both a bully and a victim of bullying (Van Cleave & Davis, 2006).


Hazing, or initiation rites, is prevalent in both high school and college. Forty-eight percent of high school stu-dents reported belonging to groups that involved hazing activities. Forty-three percent reported being subjected to humiliating activities, and 30% reported hazing that involved illegal activities. Seventy-one percent of the stu-dents subjected to hazing reported negative consequences such as fighting; being injured; hurting other people; doing poorly in school; difficulty eating, sleeping, or concentrat-ing; and experiencing feelings of anger, confusion, embar-rassment, or guilt (Lipkins, 2006).


Exposure to community violence tremendously affects children and young adults. When children witness vio-lence, they experience stress-related symptoms that increase with the amount of violence they see. In addition, witnessing violence can lead to future problems with aggression, depression, relationships, achievement, and abuse of drugs and alcohol. Addressing the problem of vio-lence exposure may help to alleviate the cycle of dysfunc-tion and further violence.


On a larger scale, violence such as the terrorist attacks in New York, Washington, and Pennsylvania in 2001 also has far-reaching effects on citizens. In the immediate aftermath, children were afraid to go to school or have their parents leave them for any reason. Adults had diffi-culty going to work, leaving their homes, using public transportation, and flying. One year later, 1 in 10 New York area residents suffered lingering stress and depres-sion as a result of September 11, and an additional 532,240 cases of PTSD had been reported in the New York City metropolitan area alone. In addition, people reported higher relapse rates of depression and anxiety disorders. There was no increase of PTSD nationwide as a result of individuals watching the attacks and associ-ated coverage on television, however, which had been an initial concern. Three years later, in 2004, the prevalence of PTSD was 12.6% among Manhattan residents living near the World Trade Center. Risk factors for PTSD among these residents included being injured, witnessing horrific events, being exposed to dust cloud, and assist-ing with evacuation, rescue, and recovery work in the aftermath (DiGrande et al., 2008).


Early intervention and treatment are key to dealing with victims of violence. After several instances of school or workplace shootings, counseling, referrals, and ongoing treatment were instituted immediately to help those involved deal with the horror of their experiences. Since the 2001 terrorist attacks, teams of physicians, therapists, and other health professionals (many associated with uni-versities and medical centers) have been working with survivors, families, and others affected. Despite such efforts, many people will continue to experience long-term difficulties, as described in the next section.


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