As the U.S. reels from another school shooting, much of the public discussion has centered on the lives lost: 19 children and two adults. Indeed, the massacre at Robb Elementary School in Uvalde, Texas is the second deadliest such incident on record, after the shooting at Sandy Hook Elementary School in 2012.

Since the Columbine massacre in 1999 in which two teenagers killed a dozen students and one teacher, at least 185 children, educators and others have been killed by gun violence at American schools, according to figures compiled by The Washington Post.

But this death toll captures only one part of the immense cost of gun violence in American schools. We have studied the long-term effects of school shootings on the health, education and economic futures of those who survive such incidents. Our research shows that despite often escaping without physical harm, the hundreds of thousands of children and educators who survive these tragedies carry scars that affect their lives for many years to come.

In a 2020 study, we analyzed 44 school shootings that took place in the U.S. between 2008 and 2013 to assess the impact the incidents had on students’ mental health. Using a unique data set documenting antidepressant prescriptions in the surrounding areas, we found that antidepressant use among youth near schools that experienced shootings increased by over 20% following the event.

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