By PAMELA GOULD

Shooters responsible for the tragedies at Columbine High School, Virginia Tech and Aurora, Colo., didn't wake up one morning and decide to become mass murderers, Germanna Nursing Dean Mary Gilkey said.

Their killing sprees resulted from a long series of events that culminated in tragedy.

The lesson, she said during an interview Monday, is that people need to get involved.

They need to pay attention to family members, friends and strangers. And they need to assert themselves to offer help and show concern.

In an age of nonstop electronic communication, people aren't really listening, Gilkey said.

Beyond inattention, one of the biggest barriers is stigma, she said.

People don't hesitate to suggest that someone get help for a physical ailment, but they don't act when they suspect someone is struggling with a mental-health issue, be it as simple and commonplace as depression, anxiety or substance abuse, she said.

In today's high-stress economy, Gilkey said national statistics suggest that each year one in four people will suffer some type of mental-health crisis and that failure to show concern adds to the downward spiral some people are on and can result in irreversible consequences such as death.

That's why learning how to recognize such crises and offer help is so important, she said.

Germanna Community College recently launched a "mental health first aid" course that offers a five-step plan developed in Australia that follows the acronym ALGEE:

A--Assess for risk of suicide or harm to others

L--Listen nonjudgmentally.

G--Give reassurance and information.

E--Encourage appropriate professional help such as from a counselor or doctor.

E--Encourage self-help and other support strategies.

The shooters responsible for the deadly rampages at Columbine High in April 1999 took weeks to prepare, and media reports say the man believed responsible for Friday's theater shootings in nearby Aurora, Colo., had been planning for months.

Likewise, the Virginia Tech student who launched an assault on classmates and faculty in April 2007 had shown signs of trouble years before he killed 32 people and himself.

Gilkey feels all of those shooters were crying out for help long before they turned violent.

"The biggest barrier is whether people want to be a stigma buster," Gilkey said. "I think that's what we need."

Pamela Gould: 540/735-1972
Email: pgould@freelancestar.com