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U.S. Department of Health and Human Services

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Promoting Calm and Coping in Your Community following Acts of Mass Violence

Author: CDR Aimee Williams, DHSc, LCSW-C, USPHS and Rachel Kaul, LCSW, CTS
Published Date: 4/30/2019 11:13:00 AM
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Over half of all recorded mass shootings have happened in the last decade.  From major cities like Las Vegas, NV and Tampa, FL to smaller places like Newtown, CT and Aurora, CO, communities have been struck by violence that inspires fear, stresses local healthcare systems, and leaves lasting scars.  Unfortunately, today mass shooting can happen anywhere, from schools and college campuses to movie theaters, concerts and night clubs.

But just as emergency managers, healthcare facilities, and communities can prepare for deadly hurricanes, wildfires or tornadoes, they can also prepare to help the people who rely on them after an act of mass violence.

Responding in the First Hours:  How You Can Get Ready

Acts of mass violence are typically perpetrated to inspire fear and panic in survivors – and they often do.  One of the best ways for public health professionals to help their communities prepare is to develop a basic understanding of the psychological impact of mass violence.

Before a disaster strikes, build partnerships with community organizations in the areas you serve. Developing a Disaster Behavioral Health Coalition to bring partners together before a disaster strikes could help you coordinate health services more effectively. You can also learn more about your community’s strengths and areas for improvement by using the Disaster Behavioral Health Capacity Assessment Tool.  Before a disaster strikes, learn about programs and resources that already exist to help you respond to a disaster. You can also tap into volunteer resources by working with the Voluntary Organizations Active in Disaster (VOADs) to respond more effectively.

In the moments and days after a disaster, people typically feel a wide range of emotions, from shock and numbness to anger and despair.  Make sure that members of your community – from emergency responders to members of community groups and other partners – understand and are ready to administer psychological first aid.

Although most disaster behavioral health activities are carried out by state, local, tribal and territorial entities (SLTT), federal partners, particularly those from the U.S. Department of Health and Human Services, can help its SLTT public health professionals prepare for, respond to, and recover from the behavioral health impacts of disasters. To learn more about the tools, guidance and partnership opportunities, see Disaster Behavioral Health:  What the Feds Do.

Preparing Your Community to Respond

Arming your community members with basic information on disaster response can enable them to help protect health and save lives during disasters. Teaching people about the basics of emergency response can also help them feel less helpless in a disaster by empowering them to help.

Did you know that a person can die from blood loss in just five minutes?  Typically, bystanders are first on the scene after a mass-casualty incident and they are the people who are best positioned to provide lifesaving care in an emergency.  Learning to apply a tourniquet takes only a few minutes and it can save someone’s life.  Use the Stop the Bleed materials to help teach people in your community the three easy steps they need to know to help save lives in an emergency.

To give your community a more in-depth understanding of simple things that they can do to help in a disaster, use the Until Help Arrives program.  The course is available as an online training and many Medical Reserve Corps (MRC) units teach a more in-depth version of the course.  If you are interested in getting MRC units to help, reach out to a unit in your area.  You may also want to consider hosting courses for the community in psychological first aid.

Facing Mid- and Long-Term Issues

Over time, as individuals and communities recover, many of the people who were directly affected by the incident will return to their normal daily routine and activities, feeling better in a matter of weeks. Others, however, may continue to have difficulty readjusting to their day-to-day lives. 

Some members of the community may isolate themselves, report feeling on edge, have difficulty sleeping, or have other long-term mental health issues related to the disaster.  These members of the community may have post-traumatic stress disorder (PTSD), which can be treated.  Learn about treatment options and work with your partners, especially those in your Disaster Behavioral Health Coalition, to help people with PTSD get the treatment they need.

Acts of mass violence stress communities and can cause serious psychological stress. By planning for a no-notice mass casualty event, public health professionals and their partners will be better equipped to support their communities through the recovery and healing process. 


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