A Review of: The Virginia Tech Massacre: Strategies and Challenges for Improving Mental Health Policy on Campus and Beyond, edited by Aradhana Bela Sood and Robert Cohen

[Author Affiliation]Jeffrey I. Hunt. Division of Child and Adolescent Psychiatry, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island.ISBN: 978-0-19-539249-4. New York: Oxford University Press, 2015. 265 pages.Address correspondence to: Jeffrey I. Hunt, MD, Division of Child and Adolescent Psychiatry, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, E-mail: Jeffrey_hunt@brown.edu"Our current healthcare system is not in the business of planting trees but it should be." This was a statement made late in the book, The Virginia Tech Massacre: Strategies and Challenges for Improving Mental Health Policy on Campus and Beyond in response to the limited focus of the policy response in Virginia after the tragedy. Thirty-three people died as a result of Seung-Hui Ho's actions on April 16, 2007. In the year that followed, the Virginia General Assembly aggressively responded by enacting more sweeping reforms in mental health than had occurred in the previous 30 years combined. More than100 bills were introduced during the 2008 session and ∼$42,000,000 was appropriated for mental health care services. Unfortunately, the desired changes in mental health services did not come to fruition. The bills were limited to crisis stabilization rather than prevention, and the money allocated in 2008 was cut in 2009 as the recession deepened. There was a lack of policy makers who understood the complexities of the mental health system and the need to fund primary prevention and early intervention services in order to develop systems with the potential to avert future mass tragedies. Unfortunately, as the authors point out, policy makers' careers do not last long enough to see the "planted trees" bear fruit.This book was undertaken to examine the mental health systems in university settings and, more broadly, in the United States. The intended audience was broad, but the book will be of most interest to policy makers, those working in college mental health, and all mental health practitioners who are faced with threat assessment in their daily clinical work. The initial chapters focus on the numerous failures of the system, specifically relating to lost opportunities to prevent Seung-Hui Cho's actions. The later sections discuss contemporary college mental health care services and identify successful approaches as well as barriers to providing care. A global review of how mental healthcare is delivered in the United States and in other developed countries reveals that there are few, if any, model systems. The final and most sobering section discusses the challenges facing policy makers to ensure that well thought out, evidenced- based mental health programs that also emphasize prevention are in place and -most importantly - that they are adequately funded.The lead authors/editors are well suited for their identified goals. Dr. Sood is a senior child and adolescent psychiatrist who was appointed to an expert panel by the governor of Virginia at the time, Thomas Kaine. The panel included eight members from different professional backgrounds who were tasked with reviewing both how and why Seung-Hiu Cho committed the murders, and the response of the Virginia commonwealth to the shootings. The panel was also to make recommendations to improve laws, policies, procedures, systems, and operations of agencies including those for mental health. Dr. Sood was intimately involved in all aspects of the panel and, in particular, had personal access to Cho's family members and the involved faculty and administrators at Virginia Tech. (Cho's family authorized the release of their son's health and education records, and they willingly participated in multiple interviews by the Virginia Tech Panel). The co-editor of the book, Dr. Cohen, is an expert in policy and program development.Although much of the story about Seung-Hui Cho's progression from a "fragile, solitary, and silent young man who inspired sympathy" to the dark, ruminative, and rageful murderer he became has been reported in the press, the book provides greater insight into the failings of the mental health system prior to and during his time as a college student at Virginia Tech. …