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Incidents of Mass Violence

By Substance Abuse and Mental Health Services Administration


Learn about who is most at risk for emotional distress from incidents of mass violence and where to find disaster-related resources.


Incidents of mass violence are human-caused tragedies that can impact whole communities and the country at large. These types of disasters, which include shootings and acts of terrorism, often occur without warning and can happen anywhere, as shown by the Sandy Hook Elementary School tragedy of 2012 and the events of September 11, 2001.


These violent acts typically target defenseless citizens with the intent to harm or kill. They can instill feelings of confusion, fear, and helplessness in survivors. Incidents of mass violence disturb our collective sense of order and safety, and may even impact those with no personal connections to the event.


Because of the unpredictable nature of these types of disasters, it’s normal for people to experience emotional distress. Feelings such as overwhelming anxiety, trouble sleeping, and other depression-like symptoms are common responses to incidents of mass violence. Other signs of emotional distress related to incidents of mass violence may include:


Feeling numb or like nothing matters

Feeling helpless or hopeless

Worrying a lot of the time; feeling guilty but not sure why

Feeling like you have to keep busy

Excessive smoking, drinking, or using drugs (including prescription medication)

Symptoms of distress may appear before, during, and after such an event and may manifest in the hours, days, weeks, months, or even years after they occur. These are just a few warning signs of disaster-related distress. Learn more about warning signs and risk factors for emotional distress related to incidents of mass violence and other disasters.


Where Can I Get Help?

If you or someone you know shows any of these symptoms for two weeks or more, whether you know they are in relation to an incident of mass violence or if it is unclear how they started ... Talk with us. You are not alone! Call or text the Disaster Distress Helpline at 1-800-985-5990 for support and counseling. The Disaster Distress Helpline is a national hotline that provides 24/7, year-round crisis counseling for people who are experiencing emotional distress related to any natural or human-caused disaster.


This toll-free, multilingual, and confidential crisis support service is available to all residents in the United States and its territories. Calls and texts are answered by trained, caring counselors from crisis call centers located throughout the United States.


Standard text and data message rates will apply when texting from mobile phones. International text and data rates may apply from within U.S. territories and free association nations.


Who is at Risk for Emotional Distress?

People at risk for emotional distress due to the effects of incidents of mass violence include:


Survivors. Injured victims as well as bystanders in close proximity to the event are especially at risk for emotional distress.


Friends and loved ones. It’s normal for friends and family members located outside the impacted area to feel anxious about people who are in direct proximity to an incident of mass violence.


First responders and recovery workers. These individuals may experience prolonged separation from loved ones during the incident and show signs of mental fatigue.

Community members. People who live the area surrounding the event may experience emotional distress.


If a terror alert, lockdown notice, or other warning is issued via television, radio, social media, or text alert systems, the risk for emotional distress becomes greater. It’s normal to feel unprepared, overwhelmed, or confused, particularly if you are not at home. You may also feel isolated if you are separated from friends or family members.


Remember, too, that the anniversary of a disaster or tragic event can renew feelings of fear, anxiety, and sadness in disaster survivors. Certain sounds such as sirens, or large crowds, can also trigger emotional distress. These and other environmental sensations can take people right back to the event, or cause them to fear that it’s about to happen again. These “trigger events” can happen at any time.


Most people who experience disasters are able to recover quickly, but others may need additional support to move forward on the path of recovery. Finding ways to manage stress is the best way to prevent negative emotions from becoming behavioral health issues. Get coping tips for dealing with emotional distress related to incidents of mass violence and other types of disasters.


Additional Resources for Incidents of Mass Violence

Coping With Grief After A Disaster Or Traumatic Event

Tips for Talking With and Helping Children and Youth Cope After a Disaster or Traumatic Event: A Guide for Parents, Caregivers, and Teachers

Terrorism at the National Child Traumatic Stress Network

Tips for Disaster Responders: Preventing and Managing Stress – 2014 (Spanish)

Tips for Disaster Responders: Identifying Substance Misuse in the Responder Community

School Shooting Resources

Mass Violence Resources

NCTSN Resources


The SAMHSA Disaster Technical Assistance Center (DTAC) also helps states, territories, tribes, and local entities deliver an effective mental health and substance abuse (behavioral health) response to incidents of mass violence and natural disasters. Learn more about these issues and find more disaster-related resources at Disaster Preparedness, Response, and Recovery.


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