In March, three people connected to mass school shootings died by suicide, raising questions about the lingering effects of such trauma on a persons mental health.
Two teenagers who survived the 2018 shooting at Marjory Stoneman Douglas High School in Parkland, Fla., took their own lives within days of each other. The father of a child killed in the 2012 Sandy Hook Elementary School shooting in Newtown, Conn., died by suicide a few days later.
Suicide can occur in clusters, especially among teens. But its too early to tell if these deaths are connected in any way, are related to having experienced similar mass traumas — or if they simply occurred close together by chance, says April Foreman. A psychologist in Baton Rouge, La., and board member of the American Association of Suicidology, Foreman is familiar with all three suicides. “These are really complicated events,” she says. (One thing they arent, some researchers say, is contagious; a person cant catch suicide like a common cold.)
But the deaths do shine light on a question that researchers are trying hard to answer: How does being connected to a mass trauma event like a school shooting affect a persons later risk for mental health problems and self-harm?
Heres what scientists know — and dont know.
Who is most at risk for developing mental health problems following a mass shooting?
What little is known about mental health problems following mass shootings largely stems from research efforts launched on college campuses where such shootings have occurred.
In 2008, a gunman opened fire at Northern Illinois University in DeKalb, killing five students and wounding 21 before taking his own life. By chance, researchers had already established a study there with women enrolled in an introductory psychology course to look at mental health problems related to sexual abuse.
Of 691 surveyed, about 42 percent experienced some symptoms of post-traumatic stress shortly after the shooting, according to a 2014 study in Behavior Therapy. That included feeling numb and disconnected and having trouble regulating emotions. In a follow-up survey more than eight months after the shooting with 588 of those women, those still experiencing symptoms had dropped to about 12 percent.
Exposure to previous trauma predicted a persons likelihood of developing PTSD, the researchers found. Other studies have shown that preexisting depression and proximity — both physical closeness to the actual shooting and emotional closeness to victims — raise the risk of experiencing ongoing psychological problems.
Who is most at risk for self-harm, including suicide?
Most people who survive extreme trauma, whether thats a mass shooting or some other abuse, dont kill themselves, experts say. But exposure to violence does seem to increase suicidal thinking and, for some, the ability to act on those plans.
“When youre exposed to that kind of violent loss, it breaks past that little barrier that most of us have that says This isnt how the world works or that life is sacred, ” says Amy Mezulis, an adolescent clinical psychologist at Seattle Pacific University.
Since the mid-2000s, suicide researchers have been looking at the factors that shift a person from thinking about suicide to actually carrying out the act (SN: 7/7/18, p. 12). One idea, dubbed the three-step theory, suggests that those who are able to act on suicidal thoughts have come to see violence as normal (through combat, a suicide of a loved one, self-harm or other means), are predisposed to handle higher levels of pain and have access to guns or other means to carry out their plans (SN Online: 3/9/18).
Such suicide theories are often used to explain higher rates of suicide among war veterans compared with the general population (SN: 12/29/15, p. 22). But they could also apply to those exposed to violence through mass shootings, says Michael Anestis, a suicidologist at the University of Southern Mississippi in Hattiesburg.
Are teens at greater risk for self-harm following a mass shooting than adults?
Its possible. The brain is still developing until the mid-20s and that could make teenagers and young adults more vulnerable to suicide, Mezulis says. Teens are more impulsive, they have a hard time envisioning a better future or the future at all, and they struggle to see how their death would affect their loved ones.
What drives clusters of suicides?
To probe that question, one team of sociologists has focused on a high-achieving and affluent community with the fictitious name of Poplar Groves (the community requested anonymity). Since 2005, at least 16 current or recent graduates of the local high school have killed themselves, with the suicides occurring in three distinct clusters. With about 2,000 students attending the high school at any given time, a normal rate would be about one student every 4.5 years.
People go through great lengths to make sense of suicides. And that tendency becomes stronger when the people who killed themselves dont fit expectations, says Seth Abrutyn, a sociologist at the University of British Columbia in Vancouver. That was the case in Poplar Groves: Many of the students who took their own lives were outgoing and social, got good grades and excelled at sports.
Interviews with close family and friends revealed that many students who killed themselves struggled with mental health problems. But teens outside that inner circle developed a different script, Abrutyn and his colleagues report March 29 in Society and Mental Health. That script said that the pressure to achieve put their friends over the edge.
That feeling of pressure applied to a lot of other students at the school. Now, students in Poplar Grove “could imagine why one would do it. They could imagine how one would do it,” says coauthor Anna Mueller, a sociologist the University of Chicago. And that could put them at risk for suicidal thinking and, potentially, action.
How do we help those most at risk?
Frustratingly, researchers dont really know, Mezulis says. “We have good data that describe the percentage of people who recover, [and] the percentage of people who develop post-traumatic stress. We dont have a good idea of what we can do following a trauma to change those outcomes.”
Following a 2014 shooting at her university that killed one student and wounded two others, Mezulis sent a survey to the entire school community. Of the 359 who responded, those who rated Read More – Source