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This is an inadequate summation I am afraid. Most of the world right now is experiencing a mental health crisis. A lot of the countries with similar populations and cultures to the US with primarily English speaking approximations - Australia, UK, Canada and the nordic nations... All of them are experiencing massive mental health and economic issues on a systemic level. There is something unique to the United States... The guns. Not just the lack of public safety measures to control guns but the culture of entitlement to weaponry and maintaining the fantasy of utilizing them against other humans in some sort of nebulous future extralegal event when some sort of universal concensus is reached that war is declared on the US government by it's rag tag highly individualist citizenry.
Unfortunately you cannot divorce the mental health issue from the gun issue in the States but neither can you solve the issue without actually addressing that guns at that level of saturation are a nightmare that causes a unique presentation of crisis. Calling for it to be addressed strictly as a mental health issue will go no where... And it's designed to go no where because as long as we are having this debate of whether it's a gun or a mental health problem neither get addressed... And quite frankly there are simply not enough mental health professionals in the field to address that demand. The burnout rate is real amongst professionals.
There were also mass school shootings before Columbine. The Ecole' Polytechnique massacre for instance in Canada had 22 victims in 1989 and was committed with a semi automatic weapon and it spurred a massive surge in gun regulation and restrictions for automatic weapons and maximum clip size capacity. The US is unique in that it is the only country to experience these mass shootings and yet refuse any wide ranging gun control reforms at a federal level in response.
The problem also spills over borders. 85 percent of weapons found to be used to commit crimes in Canada have been traced to purchases made in the US.