Covenant School Shootings: Mental Health Resources to Support Community Recovery
Acts of mass violence, such as the shootings at the Covenant School in Nashville, Tennessee cause extreme disruption within communities. Acts of violence against children are particularly distressing, and their occurrence at locations that are often thought of as safe havens, such as schools, further undermine feelings of safety within a community. Victims, family, friends, first responders, emergency personnel, and community leaders are among those affected. Caring for the mental health needs of communities and promoting resilience and recovery requires prompt interventions by educating people on common responses to trauma and the ways this may look different in children, providing guidance on actions to foster individual and family well-being, and ensuring access to timely resources and care when needed.
Ideal interventions promote the evidence-based principles of Psychological First Aid (PFA), including: safety, calming, self- and community-efficacy, social connectedness, and a sense of hope/optimism. Information relevant to this event and links to brief, easy to read, action-oriented education fact sheets are provided below.
RESOURCES FOR FAMILIES:
Helping Communities After Disasters
How Families Can Help Children
RESOURCES FOR HEALTHCARE PERSONNEL:
First Responders, Emergency Workers & Volunteers and Exposure to Human Remains
Supporting Those with Pre-Existing Mental Health Conditions
Maintaining the Well-Being of Healthcare Providers
RESOURCES FOR LEADERS:
Grief Leadership in the Wake of Tragedies
Leadership in Disasters & Lessons Learned
Risk and Crisis Communication for Leaders
Workplace and Organization Management After Disaster
RESOURCES FOR DISASTER PLANNERS & EDUCATORS:
Curriculum Recommendations for Disaster Behavioral Health
Common Responses to Disaster
Grief: Understanding and Managing
Special Populations at Increased Risk
Workplace and Organization Support
Health Risk and Crisis Communication
Common responses immediately after mass shootings include distress reactions (insomnia, irritability, loss of perception of safety, social isolation, blaming and scapegoating) and health risk behaviors (increased use of alcohol and tobacco, over-dedication to tasks, and reduced self-care). Children and adolescents often show distress in ways that are different from adults. Younger children may revert to earlier childhood behaviors, such as loss of toilet training, tantrums, and an increased need for parental closeness. Adolescents may respond with anger, isolation, or diminished academic performance. For teachers, leaders, family members, and healthcare personnel, being alert to these reactions and behaviors, promptly identifying them, and providing interventions can reduce distress and improve functioning and may decrease the likelihood of developing mental disorders. Normalizing the reactions and offering guidance about what to expect with symptoms over time, as well as when and where to get assistance if needed, helps people feel calm and increases self-reliance. The following resource(s) address this topic in further detail:
FACT SHEET: Helping Communities After Disasters
FACT SHEET: How Families Can Help Children
FACT SHEET: How Schools Can Help Students
FACT SHEET: Coping with Stress After a Mass Shooting
Grief is a near universal experience for those impacted by disasters, such as the earthquakes in Turkey and Syria. In the immediate aftermath, traumatic death of family, friends, and neighbors causes profound grief, which may be difficult to experience as individuals focus on basic needs to survive. Feelings of loss result from damage to homes, loss of cherished possessions (such as pictures, keepsakes and other items which comprise our lives), displacement from homes and familiar surroundings, and disrupted life routines. Community leaders, those leading disaster management efforts, and healthcare providers can help by proactively and respectfully inquiring about, acknowledging, and then allowing individuals to process grief. Grief support also involves addressing feelings of loss, mourning those losses, and helping people deal with fears about the future. Anxiety about the future is best managed through “problem solving” (supporting people in connecting with practical help when available). Be sensitive to the need for rituals, such as memorial and funerals. To support expressions of grief, allow for healing, which ultimately strengthens communities. The following resource(s) address this topic in further detail:
FACT SHEET: Helping People After a Loss
FACT SHEET: Grief Leadership in the Wake of Tragedies
FACT SHEET: Leadership in Disasters & Lessons Learned
Certain populations within a community may be more vulnerable than others and warrant unique considerations. Such populations include: new or junior personnel; individuals with limited social support; first responders and public health emergency workers (including volunteers); individuals with active pre-existing mental health conditions; children; pregnant and post-partum women; people with limited financial resources; persons with cognitive or mobility impairment. Marginalized groups may be reluctant to use government resources for fear of negative reactions or legal consequences, which limits their access to helping services. Focused interventions can more quickly and effectively address the unique needs of these populations. The following resource(s) address this topic in further detail:
FACT SHEET: Supporting Those with Mental Illness After Disaster
FACT SHEET: First Responders, Emergency Workers & Volunteers and Exposure to Human Remains
FACT SHEET: Maintaining the Well-Being of Healthcare Providers
Workplace and organization management following mass violence is an important part of restoring operational functioning. Workplaces, such as schools, hospitals, and other organizations, often provide a sense of meaning and social connectedness to those who work there. Effective support for personnel can enhance functioning for both the individuals, and more broadly, the affected workplace or organization. Caution should be taken to avoid overworking remaining employees in the workplace. Allowing for grief and loss through rituals and memorials enhances healing and recovery. The following resource(s) address this topic in further detail:
FACT SHEET: Workplace and Organization Management After Disaster
FACT SHEET: Recovery After Workplace Mass Violence: Guidance for Supervisors
FACT SHEET: Recovery After Workplace Mass Violence: Guidance for Workers
Risk and crisis communication are a critical behavioral health intervention that aids community recovery. For Commanders overseeing response to mass violence and other disaster events, understanding what to say and what not to say, when and how to say it are important elements. Basic principles include being clear and succinct, stating what is known and unknown; indicating when you don’t know the answer, committing to following up at a specific time, and then doing so; avoid lying or efforts to be overly reassuring as these erode trust. Effective communication following a disaster can reduce distress and enhance well-being for affected communities. It also increases participation of community members in helpful post-disaster response and recovery behaviors. The following resource(s) address this topic in further detail:
FACT SHEET: Leadership Communication During Crisis
Additional detailed resources can further knowledge about effective preparedness, response, and recovery measures. Some are brief while others are more detailed. Reading more detailed resources, such as books about disasters, during an actual disaster response is not likely to happen. However, as the initial response slows a bit, these offer much more in depth treatments of key topics to consider, which may assist with immediate response and recovery and enhance preparedness for future events. Links to additional websites, fact sheets, articles, and books can be found below:
Additional free fact sheet resources at the Center for the Study of Traumatic Stress
Disaster Psychiatry; What Psychiatrists Need to Know (T Ng)
Textbook of Disaster Psychiatry, 2nd Edition
Disaster Psychiatry (F Stoddard)
Resiliency in the Face of Disaster and Terrorism (J Napoli)
Integrating Emergency Management and Disaster Behavioral Health
Psychiatric Dimensions of Disaster Online Training (Disaster Psychiatry Canada)