In classrooms across the country, teachers are going back to school to learn how to spot symptoms of mental illness among their students.
It's all part of an effort to prevent incidents such as this week's shooting at an elementary school in Georgia, which could have ended in disaster were it not for the quick thinking of school bookkeeper Antoinette Tuff. Suspect 20-year-old Michael Brandon Hill told Tuff he was mentally unstable and had nothing to live for, but she calmed him down, and convinced him to surrender.
Mental illness also played a role in the December shooting deaths at Sandy Hook Elementary in Newton, Conn., and the massacre at Columbine High School in Colorado 14 years ago.
The teacher training program, created by the American Psychiatric Foundation (AFP), is called "Typical or Troubled?" From custodians to counselors, school staff members are taught how to spot behaviors that may appear to be typical of teenagers, but may in fact be signals of troubling thought patterns.
Among the symptoms teachers are instructed to look for: persistent sadness, irritability, withdrawal and even a major change in eating habits. Teachers in 21 states and the District of Columbia will receive a bookmark listing the warning signs to keep handy.
When a student is determined to suffer from several of the symptoms, the child's family will be contacted and the teen will be referred to a specialist.
Program organizers say the student's privacy will be protected.
"It's not like you are going to put a scarlet letter around the kid and pull them out of class and everyone is going to know this is a child with mental illness," said Steve Leifman, a judge who serves as chair of the Florida Supreme Court task force on mental health and is also an AFP member.
Leifman became a large supporter of "Typical or Troubled?" after seeing thousands of crime suspects suffering from mental disease end up in his courtroom and then in jail. He said the jail would become a holding pen for people who should have been receiving treatment. Miami-Dade County has the largest percentage of mental illness of any other urban area in the United States, almost three times the national average.
'We cannot have a repeat of Virginia Tech'
It was Leifman who recommended "Typical or Troubled?" to Miami-Dade County school administrators. Superintendent Alberto Carvalho will start training teachers in the county next month.
"We cannot have a repeat of Virginia Tech, of Columbine or Newtown, Connecticut," he said. "Nobody wants to be that one community."
According to a recent Gallup poll, 59 percent of Americans believe mental health services would be most effective in promoting school safety. One-third said they would prefer more armed security guards.
The program has few critics, but some say it should not be linked to a group that receives money from pharmaceutical companies. American Psychiatric Foundation Executive Director Paul Burke says the APF retains control over all of its public education program, content and materials.
"It is APF policy that no supporter or funder has any influence over the content of any APF public education program," he said.
Encouraging kids to get counseling
Miami-Dade County resident Justin Volpe told NBC News he wishes "Typical or Troubled?" had been around when he was in high school, struggling with signs of a mental illness. According to the American Psychiatric Foundation, 90 percent of people who develop a mental disorder show warning signs during their teen years.
"I was acting out, always wise with people, constantly causing problems," Volpe said of his teenage mood swings. He turned to narcotics, he said, to "self-medicate" against the uncontrollable feelings, including depression exacerbated by the death of a friend.
Drug use led to an arrest and that's when Volpe said he received court-mandated rehabilitation, including psychological therapy. To get better, he said, he took medications, started eating healthy foods and put in many hours of counseling.
Volpe is now married with a young son and working as a mental health counselor. He has a message for children who try to hide their need for psychiatric counseling: "What I want to do if I talk to these kids is let them know, 'Do the work now, if not you're going to end up in jail, you're going to end up in hospital and if you really mess up you could end up dead.'"
"Mental illness is like having diabetes," Volpe said. "It doesn't mean you're mentally challenged. It doesn't necessarily mean a bad thing. I'm mentally ill and I have a very productive life."