Parental perceptions of child and family mental health and behavioural adjustment following a mass school shooting in Serbia

ObjectiveStudy examined parental perceptions of their own and children’s mental health and behavioural responses among parents who were not directly or indirectly exposed to the 2023 school shooting in Serbia.MethodsThe study sample included 1,927 parents. The questionnaire assessed pre-event child mental health characteristics and support utilisation, parental threat perception, emotional distress, functional disruption of daily routines, observed child emotional and behavioural changes, help-seeking behaviour, and perceived access to mental health support.ResultsPrior to the shooting, 11.7% of children had a psychiatric diagnosis. Following the shooting, 85.2% of parents reported moderate-to-high concern for child safety, 38.7% reported marked difficulty sending children back to school, and 48.0% reported difficulty controlling intrusive thoughts about child victimization. Most parents observed no emotional or behavioural changes in their children; this finding should be interpreted as an absence of parent-observed changes rather than clinically defined resilience, given the reliance on parental report alone. However, children with pre-existing difficulties showed significantly higher rates of post-event worsening. Mothers reported greater distress and impairment than fathers across all domains. Post-event utilisation of formal mental health services was low (3.8% for children, 2.9% for self).ConclusionFindings suggest that mass school shootings may be associated with substantial parental distress and functional disruption even without direct or indirect exposure. The gap between epidemiological estimates and low pre-event diagnosis rates raises concern about possible under-recognition of child mental health needs. Low help-seeking highlights the importance of accessible, non-stigmatising psychosocial support, particularly school-based psychoeducation, rather than formal clinical treatment alone. Findings should be interpreted in light of methodological limitations.