Acts of mass violence, such as the shootings at the bar and bowling alley in Lewiston, Maine, cause extreme disruption within communities. When these events occur in locations people typically go to relax and let down their guard, they can be particularly distressing and undermine a fundamental sense of safety. The subsequent law enforcement search for perpetrator and resulting community lockdown prolong distress and create ongoing disruption and uncertainty. Victims, family, friends, first responders and emergency personnel, as well as community leaders are among those affected. Ongoing and graphic media exposure broaden the impacted disaster “community” far beyond the geographic region of the event.
Lowering distress and improving functioning is achieved by enhancing the five “essential elements”, including a sense of safety, calming, efficacy, connectedness, and hope. The information and brief, easy to read, fact sheets below provide actions that enhance these five elements to promote resilience and recovery.
Common responses immediately after disasters 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). For leaders, family members, and healthcare personnel, being alert to these reactions and behaviors, promptly identifying them, helping people get to care, and providing interventions can reduce distress, improve functioning, and may decrease the likelihood of ultimately developing mental disorders. The following resource(s) address this topic in further detail:
Grief is a near universal experience for those directly impacted by mass violence. Many will grieve loss of feelings of safety, control, and life routines. Kindness, caring, and listening are important ways to support family, friends, neighbors, and coworkers. Anxiety about the future is best managed through problem-solving and helping people get connected with support resources and healthcare if needed. Being sensitive to the need for rituals, such as memorial and funerals that support expressions of grief, can facilitate healing, and strengthen communities. Grief leadership involves anticipating feelings of loss, supporting people in mourning losses, and helping address fears about the future. The following resource(s) address this topic in further detail:
Vulnerable populations may be at increased risk for adverse mental health effects after a disaster and warrant unique considerations. Children have developmental limitations in their understanding and ability to respond and are also impacted by the distractions that typically occur for parents who are responding to a crisis. Women who are pregnant or postpartum have increased risk for stress response during these physiologic states. Cognitive and mobility impairment, as well as dependence on the system of care can make it more difficult to understand and follow recommended protective actions, like shelter-in-place or fleeing a dangerous area. First responders and public health emergency workers (including volunteers) may be both responder and victim, and have increased risk for exposure to death, dying, human remains, and considerable suffering. Marginalized populations (low socioeconomic status, migrants and refugees, LGBTQ persons, racial and ethnic minorities) may have limited access to resources, previous negative experiences using government or other community services, and fear retaliation or reprisals, ultimately leading to disparities in access and utilization of critical post-disaster resources. Community-based interventions can help address the unique needs of these (and other) populations by addressing vulnerabilities and reducing barriers to care. The following resource(s) address this topic in further detail:
Risk and crisis communication is a critical behavioral health intervention following a community disaster. Public health messaging is critical to shape health behaviors. Basic principles include using clear and consistent messages that are culturally and developmentally tailored for a given community; avoid misleading statements or efforts to be overly reassuring as these erode trust; minimize the use of medical jargon; and ensure messages are delivered by trusted messengers. Effective communication following a disaster can reduce distress and enhance well-being for affected communities. The following resource(s) address this topic in further detail:
Workplace management following a disaster is an important part of restoring community functioning. In addition to financial support, the workplace often provides a sense of meaning and social connectedness. After a disaster involving loss of life, certain workplaces may be understaffed. However, overworking remaining personnel leads to diminished functioning and demoralization. Effective support for personnel in the workplace can enhance wellbeing and functioning for both the individuals and the organization. The following resource(s) address this topic in further detail:
Additional detailed resources can further knowledge about effective preparedness, response, and recovery measures as time permits. These more in-depth treatments of key topics may be helpful as the initial response slows and serve to inform later response and recovery efforts as well as enhance preparedness for future events. Links to additional websites, fact sheets, articles, training, and books can be found below: