Over the years, the world has seen mass shooting episodes on the rise with majority being covered by the media. However, the mass shootings have resulted into high fatalities and injury rates which have raised a substantial number of concerns among people. Such events always leave people shocked while those who were at the scene of the crime end up having different psychological effects. This may extend to the communities and the nation at large especially if the number of fatalities was high. Nevertheless, the psychological effects in people differ due to several factors. For instance, the events occur differently and take place in different locations at different time while at the same time claim numerous victims who differ by occupation, gender and age. One thing is evident regardless of the available factors and variation in the mass shootings. Research has it that anyone who was exposed to these events ends up having PTSD. A scientific literature review that was conducted from the year 2010 to 2014 revealed that some of the mental health effects include posttraumatic stress, anxiety symptoms and depression (Orcutt, , Miron, & Seligowski, 2014). At the same time, the psychological effects of the mass shootings may have an indirect psychological impact on the society. There are broader mental health effects that mass shootings have on people in the field of emergency because of their direct exposure to these events leading to them experiencing PTSD such as stress, anxiety and depression and these conditions are evaluated below.
Understanding Mass Shooting
Mass shootings is an act that can be conducted by an individual either male or female who may be acting alone or as a group with various motivational factors such as anger, stress and depression. The process involves the individual entering a place which is densely populated and starting to shot at individuals at the ground; it is possible that they may end up killing or injuring many people. In most cases, some of the perpetrators of the crime may end up taking their life while others are shot and killed by the police. When mass shootings take place, people are affected differently based on their traumatic experience. Also, the individual’s character plays a crucial role.
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Mental Health Illness Among Emergency Workers
It is the role of emergency workers to respond quickly to such events as mass shootings. The emergency healthcare workers mainly comprise of the medical workers who get involved in handling the injured patients in the scenes of mass shootings. Just like the victims, they have a direct connection to the events but their situation is much worse because they deal with several issues simultaneously. Research has it that they are at the greatest risk of experiencing mental health illnesses such as stress and emotional disorders because of the traumatic incident. For instance, in a traumatic incident such as mass shooting, the emergency workers are exposed to injured adults/children, loss of their colleagues and dead bodies all over the area (Orcutt et al., 2014). At the same time, they have to deal with violence that takes place during the mass shootings especially when it comes to rescuing the captives from the perpetrators of the crimes.
When conducting the humanitarian emergency work during a shooting incidence, the majority of the emergency workers are likely to develop fear, hopelessness, guilt, and even grief which might affect the ways in which they operate. This is the major cause of frequent mental health problems among the emergency health care workers. Very often, if not handled properly, such conditions may have extremely negative consequences, which, sometimes, may lead to losing their lives. The research conducted by National EMS Management Association reveals that about nine of the ten emergency service workers undergo stress suffering from poor mental health and low mood (National EMS Management Association, 2016). It means that more than half of the individuals working in the emergency field in health care institutions are found to have problems with their mental health compared to the general workforce. The survey also revealed that less than half of people working in the emergency department take time off during their work. This increases their level of stress while at the same time aggravating their mental health problem. It has also been revealed that these individuals are not allowed to disclose any information regarding their mental health problem which shows that it is more of a taboo to talk about such important issues.
The results of an online survey that was conducted on emergency health care workers showed that about 27 per cent of them had once in a while thought of committing suicide as a result of having poor mental health or experiencing stress at their work (National EMS Management Association, 2016). At the same time, about two thirds of them had thought of leaving their jobs and starting another career due to their mental health that was deteriorating with time. On the other hand, those who are not able to deal with the work related stress in the emergency departments have ended up abusing substances and alcohol which have weaken their ability to perform their duties effectively as required or take care of the emergency issues as expected.
NIOSH has given recommendations regarding the need to care about those individuals who work in the field of emergency to help minimize the risk factors that are associated with stress caused by traumatic incidences (CDC, 2013) They utilize simple methods to maintain, monitor and also recognize the health on site of these emergency workers. In order to evaluate whether one of their colleagues is experiencing stress, the health care workers in the emergency department need to look for emotional, behavioral, cognitive, and physical stress symptoms (Hills-Taquechel, Littleton, & Axsom, 2012). The majority of these symptoms often occur at the scene of the traumatic event while others may take place months or weeks later.
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Examples of Mental Health Illness among People Working in the Field of Emergency
Posttraumatic Stress Disorder (PTSD)
This is the most common mental health effect that occurs when an individual is exposed to the stressful conditions. PTSD is most likely to affect people working in the field of emergency because of their direct connection with the mass shootings especially in the process of rescuing people in the middle of the shootings or seeing/handling of the dead bodies. The severity and chronicity levels of PTSD depend on different variables with the most common one being exposure to the traumatizing events such as mass shootings. Research has it that even among the individuals who are most vulnerable to mental health problems PTSD has no way of being experienced by an individual who was not exposed to a traumatic event. For instance, when you take into consideration the health care system emergency department, you find that nurses and doctors who were not at the scene of the shootings when the event took place are not vulnerable to PTSD. The most common symptoms of PTSD include: numbing and avoidance symptoms, increased level of arousal, impairment of individual functioning ability, re-experiencing symptoms and traumatic stressors which may last for more than one month.
Acute Stress Disorder (ASD)
Research has revealed that people in the emergency field in the health care institutions who find themselves at the scene of the mass shootings for the purpose of handling various emergencies especially in the case when there are several casualties may end up having acute stress disorder (ASD). The stress symptoms sometimes occur immediately after an individual has undergone the traumatic event and in this case, the mental health problem is likely to be PTSD. It is important to note that PTSD shares several symptoms with ASD with the most common criteria comprising of arousal symptoms, intrusive thoughts, emotional numbness, disconnection from the environment and feeling unreal. Nevertheless, for a person who has been victim of a mass shooting to be diagnosed with ASD, the above symptoms should have lasted for a period of four weeks or sometimes two days after the traumatic experience.
Research has it that the vulnerability rate among women is high when it comes to developing PTSD as compared to their male counterparts in the same field of work as a result of the increased level of stressors that they are exposed to such as mass shootings (Fergus et al., 2012). At the same time, if a woman has a history of depression, she is more likely to develop PTSD after the shooting ordeal. On the other hand, the studies also revealed that in the same manner by which traumatic events can increase vulnerability among victims, it can also strengthen their protective factors. The main explanation for this factor is that by being exposed to the traumatic event, they gain various experiences that help them master the events of trauma. They will, therefore, be less affected by ASD and PSTD as compared to those who had never been exposed to such traumatic events.
Mental Health Effects on Homeland Security Officers
When mass shootings take place, it is the role of homeland security officers along with other government officials to unite efforts in an attempt to gain control over the situation. The aim of the officers is to ensure that there are a minimal number of deaths whenever possible. It means that they have to do everything possible to control the situation. Most often, based on the reports in the media, it is easy to see how much the officers struggle to kill or deter the main perpetrators from killing. There are instances whereby several officers have ended up losing their lives too. The government always takes the responsibility to ensure that the officers who get involved in the shootings have a good health both mental and physical. Dealing with crime may be part of their jobs but it is important to understand that they are humans too and thus can be affected when they see several people injured. There have been a few stories in books and films that narrate the mental health impacts that war has on the officers with several experiencing PSTD while others suffering from ASD.
Research has it that the police officers who are directly involved in the shoot-outs end up suffering from negative emotional consequences especially after the traumatic experience. They may eventually develop symptoms such as acute anxiety, depression and anger. At the same time, the possibility of developing psychological torture while conducting the shootings is very high. In the end, the traumatic experiences may cause them to have major flashbacks on the events which may inhibit their patterns of sleep which would affect the ways in which they perform their duties.
On the other hand, the majority of officers end up facing physical consequences from the shootings which may result in emotional distress which they always experience after the traumatic event. There are some officers who might have severe injuries while others may suffer from distorted memory and at the same time there are those who may experience blurred vision. This may not only be stressful for them especially during the healing process but also affect the ways in which they perform their everyday duties.
Case studies
1. Winnetka School Shooting
In the year 1988 on May 21st, a shooter managed to enter Winnetka elementary school in Illinois. Luckily, he ended up killing only one child though several were left injured. The shooter ended up committing suicide after the whole ordeal. The main focus of the study was on PTSD and the prevalence rate was found to be 27% among the children and 19% among the adults who in this case involved the health care workers belonging to the emergency field department (Haravuori et al., 2012). The emergency workers were emotionally affected by the event. Nevertheless, based on the study that was conducted, it was revealed that such kind of information did not provide any clear ideas regarding the ways in which the shootings had affected the emergency workers psychologically. This is because there was no information showing that perceptual distortion took place during the shooting process. This made it hard for people to establish the emotional distortion that had occurred in the officers because the shooter was one individual and there was only one child who died in the process. However, one thing that is always clear for the emergency workers in various fields especially in the event of mass shootings is the fact that they experience perceptual destructions (Hughes et al., 2011). However, the level of emotional consequences and stress is relatively high because of the increased shoot-outs that they have to face at that particular moment.
The main conclusion that had been made was that mental health impact is high among people who become direct witnesses of mass shootings that are as serious as the one that took place at Winnetka School (Follman, Aronsen, & Pan, 2014). The level of distress was also found to be high among the health care emergency workers because of the event exposure. This left 19% of the adults experiencing pre-trauma, maladaptive coping and memory loss as a result of fear that they experienced during the entire ordeal. The findings also revealed that the media accelerated the development of PTSD among the emergency workers because of their direct experience during the event. Each time they were interviewed by various media, it triggered horrific thoughts of fear and anxiety among them. At the same time, the interviews triggered various experiences including those of past crimes that they had undergone before (Crepeau-Hobson et al, 2012).
2. The Orlando Mass Shooting
The Orlando Pulse nightclub shooting which targeted the homosexual community is considered to be among the worst mass shooting incidences after the Virginia attacks. More than 49 people lost their lives while hundreds were injured (Winsor, Barzilay, & Glick, 2016). However, the emergency personnel or the medics were not allowed to get inside the nightclub because the shooter was still not captured. They were instead left outside to take care of the injured victims who had been placed on the stretcher and backboard outside the pub (Winsor et al., 2016). Studies on the event have revealed that despite their high level of training, the medics working in the emergency department had to struggle to contain themselves because of the massive injuries in the victims and at the same time the high number of people whom they had to attend to on that particular day. It was very easy for them to develop psychological trauma after the mass shooting. Therefore, there was a great need to address PTSD symptoms and mental health problems among the victims, especially the survivors, the health care professionals and the police officers (Winsor et al., 2016).
In conclusion, the experiences associated with mass shootings are always severe thus being the reason for an increase in the mental health effects among people working in the emergency field in the health care department. In addition, their direct exposure to the events leaves them vulnerable to PTSD and ASD such as increased levels of depression, anxiety and stress. However, regardless of the increased rates of mental health problems that are related to their work, it is recommended that the health care workers maintain a high level of safety in order to stay focused while performing their job duties. At the same time, they need to monitor their physical and mental health to enable them to get timely help and ensure that they perform well in their work.
