This article was originally published on Statelinean initiative of The Pew Charitable Trusts.
A grim and familiar pattern has followed the parade of mass shootings across America. In their aftermath, the nation’s attention is focused on the direct victims of the attacks, the dead and injured, their families and friends, and the witnesses.
But a growing body of research finds that the negative effects of mass shootings spread much farther than previously understood, harming the health of local residents who were not directly affected by the violence. Mental health experts say the recognition should prompt authorities to direct more attention and resources to preventing such events – and helping a wider range of people once they do occur.
“This changes the whole picture of how much public resources we should use to attack gun violence,” said Erdal Tekin, co-author of a September brief on expanding research in the diary Health issues. “It would be informative for the public and policymakers to know that the impact of gun violence extends to people who think they are safe.”
Research shows that mass shootings lead to higher rates of depression and anxiety and a higher risk of suicide among young people. They also lead to a general decline in a community’s sense of well-being. One study found a higher incidence of babies born prematurely or with low birth weight in counties where there had been a mass shooting.
Some studies suggest that mass shootings harm economic prospects in a community, reducing productivity and income.
There is no consensus on what constitutes a mass shooting. of Health issues briefly describes mass shootings as: those with multiple casualties, which are sudden and random, usually occur in a public place, and are unrelated to another crime, such as gang activity or armed robbery. The FBI’s definition is one in which at least four people are killed by a gun.
Often, researchers say, mass shootings occur in areas not prone to routine gun violence, destroying the sense of safety and well-being that residents once took for granted for themselves and their families.
“We’ve known for years, decades actually, thanks to the work of neuroscientists and others, about the traumatic effects on actual witnesses of mass shootings,” said Aparna Soni, a health economist at American University who co-authored the piece in Health issues. “Anxiety, depression, PTSD. What we didn’t address well are the effects on the community, on those who live nearby, who are emotionally affected by something that happens in their community.”
Daniel W. Webster, co-director of Johns Hopkins University’s Center for Gun Violence Solutions, also said the new health research should change the calculus on the societal costs of gun violence.
“When we’re thinking about policies to reduce gun violence, whether it’s in communities or schools or whatever, there’s always this cost-benefit analysis that goes on for policymakers,” he said.
The community-wide impact of gun violence is rarely considered in that analysis, Webster said, whether in Baltimore, Chicago and other cities where shootings are common or in areas with mass events that draw national media attention.
“People really grossly underestimate the social cost of gun violence in all its forms in the United States,” he said.
Informing Public Debate
Even as political parties differ on what to do about guns, the new research should spur greater spending on mental health services, said Heather Harris, a criminal justice researcher at the nonprofit Public Policy Institute of California.
“Building community mental health is not only a way to prevent mass shootings, but a way to help the people who are affected when they happen,” she said. “All of this needs to be much stronger, but it takes resources and skilled people to do that work.”
The Affordable Care Act increased access to mental health services for millions who previously did not have health insurance. And after years of relatively flat federal funding for community mental health, the federal government recently made major new investments in the area. As of 2020, federal spending on community mental health has increased by about 75%, to nearly $3 billion in 2022, according to the federal Substance Abuse and Mental Health Services Administration.
Most of that extra spending came through one-time infusions included in various COVID-19 aid packages, which mental health advocates have celebrated, even as they worry about what happens when those investments run out.
“We have these huge, huge cash investments in these COVID packages, but as they run out, it’s a question of what happens then,” said Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness. “Will states step up to fill that gap, or will they look to the federal government to continue funding these services?”
Some states have increased mental health spending, spurred in part by mass school shootings. After the 2019 mass shooting at Marjory Stoneman Douglas High School, for example, Florida increased spending on school mental health by $100 million a year. In addition, the state increased spending this year on community mental health by $126 million.
The increases came after years of essentially flat state spending on mental health, said Melanie Brown-Wooter, president of the Florida Association of Behavioral Health. “Our legislature has made great strides in recognizing the need for mental health and substance use treatment,” she said. “They have shown more willingness not only to discuss it, but also to finance it.”
Many jurisdictions have psychological crisis services that intervene after mass shootings, especially when schools are involved. But gun violence experts say these services generally don’t last long and don’t reach the wider community.
Cost also remains a barrier for many residents who need mental health services. Even those with health insurance still often face significant out-of-pocket costs. But an equally acute problem is a severe shortage of mental health providersespecially in rural America.
“Even if you have sufficient funding and evidence-based best practices, if we don’t have the workforce to deliver that care, we’re not going to be able to help people, and it takes time to build that resource.” Wesolowski said.
