Today marks the one-year anniversary of the most deadly and violent school shooting in American history. It was April 16, 2007, just after 7 a.m., when Virginia Polytechnic Institute and State University student Seung-Hui Cho killed two other students in a campus dormitory. By the day’s end, Cho would claim 33 lives, including his own.

Since the tragic event, much has been learned and put into practice in the areas of campus safety and mental health.

University officials across the country have become increasingly involved in the application of mental health treatment. Faculty, administrators and residence life coordinators are looking more assertively for signs and reporting incidents with greater frequency.

Since the Virginia Tech shootings, nearly nine out of 10 respondents to a recent survey indicated that their college or university had conducted a comprehensive review of campus safety and security, and a similar proportion indicated that changes had been made to policies, procedures or security systems as a result of the tragedy, according to the Midwestern Higher Education Compact (MHEC).

Cho’s ominous behavior and his writings worried professors, administrators and campus police. According to reports by Virginia Tech, during a commitment hearing Cho was found to be potentially dangerous. An off-campus psychiatrist sent him back to the school for outpatient treatment. It is alleged that Cho never completed his outpatient treatment.

“This was an individual who was troubled and threatening,” said Dr. Susan Silk, a coordinator for the American Psychological Association’s Disaster Response Network. “If there is a mandatory referral for outpatient monitoring, we have to make sure that it is implemented.”