Mass violence & crisis events

Research finds mass shootings are linked to harm for survivors and for members of affected communities. People less directly exposed often feel at least short-term increases in fear and a lower sense of safety.

SAMHSA describes three things that shape reactions: how direct and severe the exposure was, what life was like before, and what happens afterwards, like stress, losses and support.

SAMHSA notes that when community violence happens, people may lose their sense of safety, their trust in neighbors, or their trust in local leaders, as well as people they love.

Many people feel unsafe in places that used to feel ordinary, like a school, store or place of worship.

SAMHSA notes it is a common misconception that people with mental health conditions are responsible for most mass violence. Research contradicts this. Most people with serious mental illness are never violent toward others.

• Difficult life experiences: survivor’s guilt and community violence
• Grief: caring for yourself after losing someone
• Natural & climate disasters: when the crisis is a storm, fire or flood
• Trauma & PTSD: when reactions last or get in the way of life

SAMHSA lists reactions like

• Chest pain or a racing heart
• Dizziness, chills or sweating
• Headaches
• Shallow breathing
• Stomach changes
• Tiredness and trouble sleeping

Common feelings

• Anger, even rage
• Anxiety and fear
• Grief and sadness
• Guilt or shame
• Shock, disbelief or numbness

SAMHSA says some people feel empty, numb or detached, or become short-tempered with others, even without a clear reason.

Confusion, trouble concentrating, memory slips and the event replaying in your mind are common in the early days.

Many people keep asking “why?” There may never be an answer that feels good enough, and that can be one of the hardest parts.

Being jumpy, having nightmares and avoiding reminders are common. Some people drink or use more to cope, which can make things harder over time.

Avoiding crowds or certain places can feel protective at first. If it starts shrinking your life, it’s a good time to talk to someone.

SAMHSA notes spiritual reactions too: a loss of meaning, doubt, mistrust, cynicism or a crisis of faith.

For others, faith and community become a deep source of comfort. Both experiences are human.

SAMHSA describes three phases

• Early on: shock, disbelief and denial
• In the following weeks: fear, anger, anxiety, poor sleep, trouble focusing at work or school, low mood
• Long term: coming to terms with what happened, with good stretches and harder ones

Most survivors do not develop long-term conditions, thanks to resilience and support.

NCTSN notes that survivors may face physical injury and long rehabilitation, involvement in police investigations, and worry about the safety of family and friends, all on top of the shock itself.

Some survivors feel guilty for living or for not doing more. The Difficult life experiences guide has a full section on survivor’s guilt.

Losing someone close in an attack is linked to a higher risk of long-lasting struggles, including post-traumatic stress and depression.

SAMHSA says grief has no timeline. For some it lasts months, for others a year or longer, depending on health, coping, culture and support.

NCTSN lists strong reactions to reminders, like seeing others who were there, media images, police or memorials, and being more sensitive to loud sounds.

Witnesses sometimes feel they “don’t count” because they weren’t hurt. Their distress is real and deserves support too.

In a 2019 national survey, 79% of U.S. adults said they feel stress about the possibility of a mass shooting, and a third said fear stops them from going to certain places or events.

The places adults most often named were public events, malls, schools or universities, and movie theaters.

SAMHSA’s Disaster Distress Helpline is open to survivors, loved ones of victims, first responders, relief workers, clergy, and parents and caregivers. You can call for yourself or for someone else.

Helpers often put themselves last. Rest, peer support and talking with someone you trust are part of doing the job well, not a sign of weakness.

SAMHSA notes that repeated viewing of graphic images can worsen distress, and that heavy, repeated media exposure puts people at risk of secondary traumatization.

The National Center for PTSD adds that research with children shows even more clearly that watching too much trauma-related TV can be harmful.

The National Center for PTSD suggests cutting back if you

• Can’t turn your news devices off
• Feel anxious or stressed after watching
• Find it hard to enjoy things
• Have trouble sleeping

• Avoid news right before bed
• Avoid replaying graphic videos or images
• Balance news with something calming or connecting
• Check the news once or twice a day, not constantly
• Keep news off around young children
• Read rather than watch, or learn what happened by talking with others
• Turn off autoplay and notifications for a while

NCTSN notes that media and social media can trigger fears of another attack and also spread rumors.

Media can also help, by sharing where to find support and what events are planned for survivors.

NCTSN’s approach

1. Ask what they have already heard
2. Listen for misunderstandings and hidden fears
3. Gently correct wrong information in simple words
4. Answer questions directly and honestly
5. Share how victims and families are being helped

A simple start: “Something scary happened. Lots of people are working to keep us safe.”

• Early elementary: brief, simple information balanced with reassurance
• Upper elementary and middle school: more questions about whether they are truly safe
• High school: strong and varied opinions about causes; listen and talk it through

Children often ask “Could it happen here?” They are usually asking “Am I safe?” It can be a good time to go over your family’s safety plans.

NCTSN says children may have trouble paying attention, become irritable or defiant, not want to be apart from caregivers, and sleep or eat differently. These usually lessen within a few weeks.

Children sometimes blame themselves for what happened, which can bring shame and guilt. Reassure them clearly that it was not their fault.

• Keep daily routines and family rules steady
• Limit what they see and hear on screens; keep very young children away from coverage
• Talk at mealtimes, not right before bed
• Let them take a break from talking about it or from memorial events
• Be a calm role model: share some feelings, and ways you’re coping
• Give extra patience, hugs and time

NCTSN suggests helping teens see that risky behavior, like drinking or reckless driving, is a dangerous way to express strong feelings, and talking about better outlets such as exercise, journaling or time with others.

Checking in more closely for a while is okay. Let them know it’s temporary, just until things settle.

The National Association of School Psychologists says school staff work with families and public safety providers to keep students safe, and that keeping to a regular schedule is reassuring.

One study after an attack in Norway found students’ grades and school functioning suffered, with more days absent.

Students may be coping away from home, with exams and deadlines still looming. Ask about counseling services, extensions and student support offices.

Patience matters: NCTSN notes young people may be more distracted and need extra help with schoolwork for a while.

SAMHSA notes that the stress of a traumatic event can lead to poor work performance and short tempers at work. Workplace routines may change too.

At work, your human resources department or an Employee Assistance Program may be able to help.

SAMHSA and NCTSN both suggest putting off major life decisions, like career changes, when you can. Big changes are harder to manage after a traumatic event.

SAMHSA says communities often need to come together to honor those who died and find meaning in a way that helps everyone recover, for example through community events or memorials.

Leaders who share accurate, timely information and encourage peer support help communities cope with stress and grief.

Flowers, notes, art and lasting memorials can help people express what words can’t. They can also be reminders that bring feelings back, which is okay.

SAMHSA notes communities may volunteer for youth programs, take part in cultural healing practices, or connect with local violence prevention offices.

Some people notice positive changes in time, like feeling closer to loved ones, more grateful, or more connected spiritually. There is no pressure to find a silver lining.

SAMHSA’s ideas for coping with grief

• Allow yourself to cry, and to feel joy at times
• Do things you used to enjoy, even if you don’t feel like it
• Get some exercise and eat regular meals
• Talk with people who understand and respect how you feel

The Disaster Distress Helpline supports people around anniversaries and reminders, not just right after an event.

NCTSN notes that many young people become more sensitive to loud sounds after a shooting. Fireworks, sirens or a slammed door can set off the alarm.

It can help to plan ahead for holidays and big events: know the exits, bring a support person, or choose a quieter way to celebrate.

The National Center for PTSD notes that media reports of current events can act as reminders of past events.

• Accept kindness and help from others
• Be aware that special days may be difficult
• Be gentle with yourself
• Do activities you enjoy, alone or with others
• Draw on your faith or spirituality if that helps you
• Help others, if that feels right
• Talk about your losses with someone you trust

The National Center for PTSD suggests

• Find a quiet time and place to talk
• Just be with them, and let them know they’re not alone
• Let them talk without interrupting, as much as you can
• Offer to talk again any time
• Remind them of their strengths and values
• Show interest, attention and care, without judgment

• “It sounds really hard.”
• “No wonder you feel that way.”
• “I’m really sorry this is such a tough time.”
• “What has helped you before when things got hard?”
• “We can talk more tomorrow if you’d like.”

Try not to ask for graphic details, compare their experience with others, or tell them how they should feel.

• Bring a meal or groceries
• Help with calls, forms or appointments
• Offer childcare or school pickups
• Offer a ride, or go with them somewhere hard
• Remember the hard dates, and check in

Supporting someone through trauma can stir up your own feelings. Rest, talk with someone you trust, and take breaks from the news.

You can call the Disaster Distress Helpline for yourself or on behalf of someone else.

SAMHSA’s Disaster Distress Helpline supports anyone in the U.S. and its territories with distress after incidents of mass violence, as well as other disasters, anniversaries and reminders.

• Call or text 1-800-985-5990
• For Spanish, press 2
• Interpreters in over 100 languages
• Deaf and hard of hearing callers can use their preferred relay service

If you’re thinking about suicide or are in emotional crisis, call or text 988, or chat at 988lifeline.org. It’s free, confidential and open 24/7.

The U.S. Office for Victims of Crime says victims may be eligible for crime victim compensation, which can help with costs like medical care, mental health counseling and lost wages. All states receive federal funds for victim assistance and compensation programs.

OVC also runs a program that supports victims and communities after terrorism and mass violence, and a directory to search for local victim services.

SAMHSA suggests talking with a primary care professional you trust about your grief and whether counseling might help. A faith leader may also be able to refer you, and a child’s school may know local support options.

Support groups can offer a safe space to share experiences and feel less alone.

Find A Helpline (findahelpline.com) is a free directory of crisis lines around the world, which the International Association for Suicide Prevention points people to.