There has been a rising trend with the escalation of mass shootings: survivor suicide. When someone is diagnosed with a serious illness, family, friends, and communities typically rally to provide support. Yet people who experience trauma—and the serious psychological effects that go along with it—often find themselves struggling alone. In some cases, the emotional impact can put them at increased risk of thinking about, or even attempting, suicide.

The Long-Term Mental Health Consequences of Traumatic Events

The deaths by suicide of two survivors of the 2018 Marjory Stoneman Douglas High School mass shooting in Parkland, Florida, followed by the death by suicide of a father whose child was murdered in the Sandy Hook Elementary School shooting in Newtown, Connecticut, back in 2012, have called attention to the very serious and long-term mental health distress impacting people who have survived a tragedy.

These recent deaths also spotlight the need to provide ongoing support to help survivors cope long after the tragic event has passed, according to Nadine J. Kaslow, PhD, professor of Psychiatry and Behavioral Sciences at Emory University School of Medicine. She says that having the right such supports in place could actually help prevent other survivors from dying in a similar way.

The Growing Problem of Mass Violence

Dr. Kaslow, who is also Director of the Atlanta Trauma Alliance, explains that with mass violence on the rise in the United States and abroad, a growing number of people are affected today, making this a serious public health concern and one that is important to address proactively.

She points out that as these deaths illustrate, survivors of mass violence are forced to deal with the extreme emotional toll of the experience for the rest of their lives, and some of them may not be equipped to handle the weight of this on their own.

“I think that these deaths highlight the long-term consequences of surviving a major trauma,” Dr. Kaslow says. “No matter who you are, what type of support you have, and how resilient you are, you can never shake it from your mind and your heart. The experience will always be in the picture of your life story,” she stresses.

Is Being “Resilient” Enough?

Dr. Kaslow also points out that while there’s been a lot of focus on the word “resilient,” and we assume that this means that someone can weather a tragedy, that premise was debunked with the death of the Sandy Hook father. His death by suicide came seven years after his daughter was murdered, he was a neuroscientist, and he had started a foundation to support research into the brain abnormalities linked to violence.

By all accounts, he was quite resilient on paper, yet it didn’t take away the pain of the loss of his child. “There is survivor’s guilt, depression, and heartbreak, and these illnesses can lead someone to die. I think the pain is just intolerable,” she says, adding, “The pain will come forward and recede at different times, but it won’t ever go away.” That’s where the support of communities can be essential to help him, and others, through the pain.

The Link to Mental Health Effects

Sandro Galea, MD, a physician, epidemiologist, and author who is dean at Boston University School of Public Health, also weighs in on the recent tragic deaths and what they mean for society as a whole.

“We know that after traumatic events [such as the school shootings], there is a high prevalence of many mental illnesses, including depression and post-traumatic stress disorder [experiencing a fearful response even after the danger has passed, and survivor’s guilt]. These disorders are, in turn, a risk factor for suicide,” Dr. Galea explains.

While anyone affected by a tragedy can be vulnerable to the ill effects, he points out that kids can need even more support than their adult counterparts, as the two Parkland high school students’ deaths illustrate. “Traumatic events have substantial mental health consequences for both kids and adults. Kids, however, have a longer life trajectory and the impact can have consequences that are more long term over the life course,” he says.

Identifying Other Vulnerable Populations

It’s also necessary to recognize that people who are involved in such highly publicized tragedies like mass shootings aren’t the only ones at risk for mental health effects like post-traumatic stress disorder and suicide. People who have experienced a car accident, robbery, fire, rape, physical abuse, or natural disaster can also be susceptible to mental health effects.

Further, with the details of mass violence and natural disasters playing constantly on social media and in the mainstream press, even people without a personal connection to a tragic event may be struggling to make sense of it. For young people and adults who have suffered other traumas in their pasts, the impact on their state of mind can be magnified.

Social Support Matters

“The biggest protective factor [for people who have experienced a trauma of some type] is probably social support,” Dr. Galea stresses. It’s also important to know this support shouldn’t have an expiration date. While more research is needed to better understand the implications of surviving a horrific event, he points out that we do now know that providing continued support is truly necessary over the long haul. It’s also necessary to continually assess people’s states of mind to identify if they are struggling to cope.

Warning Signs of Trauma

According to the American Foundation for Suicide Prevention (AFSP), there are a number of clues that can be indicative that someone could be at risk for thinking about, or acting on, thoughts of suicide. Familiarizing yourself on the signs, and how to respond to them, could someday save a life.

Some of the warning signs provided by AFSP that a person is depressed, anxious, or considering suicide include:

  • Talking about killing themselves or researching methods
  • Saying they feel hopeless or like they have no purpose
  • Expressing that they are a burden to others or feel trapped
  • Increasing alcohol or drug use
  • Skipping normal activities or showing lack of interest in them
  • Becoming isolated from others
  • Sleeping more than usual, or less
  • Saying goodbye to family and friends
  • Giving away possessions
  • Seeming more tired than usual
  • Acting aggressive, agitated, or angry
  • Demonstrating depression and/or anxiety
  • Expressing humiliation and shame
  • Suddenly showing improvement (this can occur once someone makes the difficult decision to act on their thoughts of suicide)

What to Do

If you suspect someone could be anxious and/or depressed and may be considering suicide, ASPF says it’s always crucial to take the person’s feelings seriously and seek help from a trained professional.

Be sure to:

  • Talk to him/her one-on-one
  • Ask directly if he/she is considering suicide
  • Remain with the person and get rid of anything that could cause harm
  • Take him/her to the nearest emergency room
  • Call the National Suicide Prevention Lifeline at 1-800-273-8255
  • Text TALK to 741741 to connect for free with a crisis counselor through Crisis Text Line


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Last Updated: Jan 7, 2020