In wake of shooting, mental health experts offer advice to parents

Last month’s school massacre in Uvalde, Texas, cast a spotlight on the psychological consequences of bullying and family dysfunction, after family members and friends of 18-year-old gunman Salvador Ramos said he had been bullied, had a strained relationship with his mother and had repeatedly started fights.

Investigators are still trying to determine the motive of the shooting, and it may never be known what turned Ramos into a man capable of murdering 19 children and two teachers.

But mental health experts say that although bullying and family dysfunction rarely lead to extreme violence, they can result in emotional trauma that can have lifelong consequences. Parents can help prevent difficulties from spiraling out of control by looking for signs of problems, listening respectfully to their kids, and seeking professional help if needed, experts say.

“If your child who's normally very talkative and buoyant and engaged becomes quiet and secluded — no matter what age — any major change that goes on for about two weeks is bordering on being too long and something should be done about it,” said Teresa Taylor Williams, a psychotherapist based in Manhasset.

Multiple media reports indicate that Ramos had been bullied in junior high and high school, in part because of a stutter and lisp, and he regularly got into fistfights with classmates and threatened them.

Dr. Victor Fornari, director of child and adolescent psychiatry at Cohen Children’s Medical Center in New Hyde Park and Zucker Hillside Hospital in Glen Oaks, Queens, warned against attributing the shooting to the psychological effects of Ramos apparently being a target of bullies.

“It’s quite oversimplified to think of him just in terms of his stuttering and his bullying,” Fornari said.

Fornari said there’s a complex mix of factors that may make it more or less likely that a child will turn to violent behavior or develop a mental health disorder.

Potential risk factors include a genetic predisposition to a mental health disorder, exposure to drugs in utero that can affect brain development, a history of abuse, and homelessness, he said.

“Protective factors” that can temper risk factors include good maternal nutrition during pregnancy, a nurturing childhood with loving caregivers and no mistreatment, and a stable home, Fornari said.

Being bullied "enters into the range of a psychological risk factor," he said. "But it’s only part of the person’s story."

Some kids who grow up in very difficult circumstances, with multiple risk factors, can thrive, while some children who grow up in a nurturing environment with few if any risk factors can end up with psychological problems, he said.

'One person can make a huge difference'

Multiple media outlets reported that Ramos had a strained relationship with his mother.

Dr. Gabrielle Carlson, a professor of psychiatry and pediatrics at the Stony Brook University Renaissance School of Medicine, and a child and adolescent psychiatrist with Stony Brook Medicine, said many kids are vulnerable and live in dysfunctional families, “and they don’t go out and kill a bunch of elementary school students. There is obviously something in the equation here we don’t know and understand.”

Shari Lurie, senior director of mental health services for South Shore Child Guidance Center in Freeport and EPIC Long Island in East Meadow, said even if a child has a difficult relationship with a parent, other adults can offer critical psychological support.

“I really believe even if a kid has one person in their life who will listen to them and who is a shoulder for them to cry on, and who lets them know they’re of value no matter what is going on with the other adults in their life, that one person can make a huge difference,” she said.

Carlson said if a child has a poor relationship with parents and few or no friends, that makes it more difficult to handle bullying, or any of the types of challenges that every kid faces.

“The vulnerable kid often has problems with self-control,” she said. “They cry easily or get angry easily or they shoot their mouths off easily or whatever. The [bullies] know that, so what they do is provoke the vulnerable kid to shoot off his mouth or get upset or whatever it is, and then it’s gotcha, gotcha. … You really can drive a child to do things he wouldn’t have started out doing by torturing them to death.”

That often snowballs, leading to more bullying, Carlson said.

Lurie said bullying on social media exacerbates the problem, because “there’s no escape. Now if you’re bullied, there’s no going home and being safe. You’re all over Instagram, Facebook and TikTok.”

Carlson said children and parents have complained to her of schools not doing enough to stop bullying. There may be signs on the school walls saying bullying isn’t tolerated, but oftentimes “teachers turn a blind eye” to it, she said.

Kids often don’t want to formally report bullying, because they fear they’ll get branded as a “tattletale,” which is why it’s important for teachers to intervene when they observe it, she said. 

Lurie said teachers may not always be able to tell if a child is being bullied or is enduring emotional problems. South Shore and EPIC are developing a program to educate teachers on what to look for and how to react, she said.

Parents' pivotal role 

Williams said it’s critical that parents establish early on that their children should feel comfortable opening up about any problems they’re having. Kids often don’t want to admit someone is bothering them, she said.

“If you don't have open communication and have established a relationship with your child that it's OK to share, then you're going to have a problem,” said Williams, a social emotional learning consultant to school districts, including several on Long Island.

Lurie said parents should be on the lookout for moodiness, loss of appetite, difficulty sleeping, drops in academic grades, lack of socializing with other kids and other changes in behavior.

“You definitely want to listen to your child and be able to let them talk and say what they need to say about what’s going on, refrain from telling them it’s not so bad, other kids go through it, everyone lives through it,” she said. “Some parents say those things. It’s really not helpful, and your kid will not come back and talk to you.”

Kathy Rosenthal, a social worker and senior vice president for programs at the Huntington-based Family Service League, advised parents “to help kids manage expectations.” Kids scroll through their social media feed and see that everyone is seemingly happy, so they “come up feeling short,” she said.

“As parents, we have to help them understand life is not easy,” she said. “No one gets a free pass. No one, not one single person, walks through this life without challenges, hurts, being victimized, going through a difficult time.”

Rosenthal said parents looking for mental health resources should start with their schools, where there are social workers, psychologists and others who can provide support.

Lurie said demand for mental health services for children spiked during COVID-19, because of increased anxiety, children losing loved ones to the disease and other factors. Sometimes when parents seek help from professional therapists outside of schools, there may be waiting lists, she said. 

Williams said when parents do find professional help, they need to be willing to be part of the solution.

“They also need to do the work and recognize that whatever’s happening with their child is a cooperative approach and experience,” she said. “It’s not just bringing them into my office, plopping them down and saying, ‘Fix this.’ Which I have had parents do.”