#JamesDonaldsononMentalHealth – #Suicide Deaths of #MassShooting Survivors Raise Questions Experts Can’t Yet Answer

There are no simple explanations when someone dies by #suicide; numerous risk factors, like easy access to lethal means, barriers to #mentalhealthtreatment, and a history of #mentalillness, can increase the likelihood that someone will take their own life. But these deaths forced the public to confront the potential ripple effects of surviving a mass shooting, which has led to calls for increased research on how survivors fare over the course of their lives.

While numerous studies have attempted to answer this question in recent decades, yielding important insights about the #mentalhealth of shooting survivors, researchers haven’t systematically looked at whether #massshootings make someone more likely to attempt #suicide.

“We just don’t have the kinds of studies that really inform us as to what the predictors are and who’s most at risk,” says Barbara J. Coffey, division chief of child and adolescent psychiatry at the University of Miami Miller School of Medicine.

Coffey’s division provided free counseling to #Parkland shooting survivors and community members last year, and has announced plans to offer formal assessments and treatment to youth following the #suicides. She has studied #suicide in adolescents and stresses the importance of effective treatment in reducing the risk of deadly self-harm.

Aiello graduated from the school last year, and her mother told CBS Miami that the 19-year-old experienced survivor’s guilt and had recently been diagnosed with post-traumatic stress disorder. Less is known about Desir’s exposure to the shooting and the recovery challenges he faced.

Just being exposed to shooting-related trauma could’ve increased the teens’ #suicide risk. In general, some form of #anxiety or #PTSD can be a risk factor for #suicidal thoughts or behavior, and combining that with other factors, like #depression, lack of family cohesion, recent relationship problems, or #traumaticchildhoodexperiences like sexual abuse would certainly “render children vulnerable to #suicide,” says Coffey. Her own research indicated that, among other factors, a teenager’s level of hopelessness about the future was closely associated with attempting #suicide.

While we don’t know much about the risk of #suicide for mass shooting survivors, some researchers are trying to learn more about the complex ways such trauma affects a survivor’s mental health. Research does show that the majority of people who survive trauma, disaster, or mass violence ultimately recover from the experience.

Heather Littleton, a professor in the department of psychology at East Carolina University, says that research can be hard to generalize too because mass shooting events aren’t identical. Some happen in close quarters or have fewer victims, while others, like the Pulse nightclub shooting or the Las Vegas music festival shooting, happen in larger spaces and claim many more lives. Shootings can also prompt different community responses.

Littleton’s study of Virginia Tech shooting survivors, for example, found that nearly a quarter of participants reported PTSD symptoms a year later. A study of people who survived a mass shooting almost a year later at Northern Illinois University found a much lower rate of PTSD after several months — 12 percent — among participants.

The notable differences between the two events could’ve played a part in different rates of PTSD for survivors, says Littleton. The Virginia Tech shooting took place in different locations across campus, leaving 32 people dead and numerous injured. It also became the subject of nonstop media coverage. The NIU shooting happened in a lecture hall and led to five victim’s deaths and more than a dozen injuries.

Littleton’s study of a subset of Virginia Tech survivors — those who experienced sexual trauma prior to the event — adds to the research, indicating that previous trauma can deepen one’s vulnerability to psychological distress following a shooting.

“[There’s the idea] that trauma shatters your ideas about the world,” says Littleton. “But for other folks, it’s confirming the negative beliefs you already had. You might think, ‘I’m a person that bad things happen to,’ or ‘I’m not capable of stopping bad things.’ A new trauma just serves to reinforce and confirm those beliefs.”

“The initial loss begets more loss and spirals.”

Littleton says there’s also a theory that the more a trauma results in “resource loss,” diminishing one’s ability to cope with traumatic grief, the more difficult it is to recover. And the more that survivors lose optimism in the future, the more likely they are to experience PTSD.

“The initial loss begets more loss and spirals,” says Littleton, who emphasizes that it’s common and normal for survivors to feel like they’ve overcome their struggles only to suddenly find themselves experiencing negative mood changes or resurgent PTSD symptoms.

“It’s never too late to need help, and it doesn’t mean something is wrong with you,” she says.

Littleton would like to see more funding to support evidence-based interventions for those affected by mass shootings. Currently, communities often improvise ways to help survivors, their loved ones, and the bereaved. She’d also like for grant-making organizations, including government agencies, to find ways to quickly fund researchers so they can start designing studies and collecting data within hours or days of a mass shooting, as opposed to months or years.

Sandro Galea, dean of Boston University School of Public Health, said in a tweet this week that the mental health of shooting survivors is “a clear area for action and research.”

Galea previously called for a national registry that would include fatal and nonfatal firearm injuries, similar to the The World Trade Center Health Registry, which has tracked the health effects of the Sept. 11 terrorist attack in New York City. Researchers could use such a database on firearm deaths and injuries to glean insights about what happens to survivors over a long period of time. In an email to Mashable, he reiterated his support for a registry in the wake of the suicides.

While the research that’s been done on the #mentalhealth of survivors has led to important insights, the suicide deaths of Aiello, Desir, and Richman are a tragic reminder that we simply don’t know enough about what survival looks like for the rest of someone’s life once they’ve lived through a mass shooting.

If you want to talk to someone or are experiencing suicidal thoughts, text the Crisis Text Line at 741-741 or call the National Suicide Prevention Lifeline at 1-800-273-8255. Here is alist of international resources.