MENTAL HEALTH RESPONSE TO MASS VIOLENCE AND TERRORISM: A FIELD GUIDE

INTRODUCTION

This Field Guide is intended for mental health and disaster workers; first responders; government agency employees; and crime victim assistance, faith-based, healthcare, and other service providers who assist survivors and families during the aftermath of mass violence and terrorism. All who come in contact with victims and families can contribute to restoring their dignity and sense of control by interacting with sensitivity, kindness, and respect. This Field Guide provides the basics of responding to those in crisis.

Human-caused events such as mass shootings, bombings, riots, exposure to biohazards, and acts of terrorism are deliberately planned and perpetrated for political, sociocultural, revengemotivated, or hate-based reasons. Acts of mass violence and terrorism target a building, neighborhood, particular site, or event. Those confronted with life threat, mass casualties, overwhelming terror, and human suffering may experience severe psychological stress and trauma. Survivors, families, and the affected communities cope not only with the resulting deaths, injuries, and destruction but also with the horrific knowledge that their losses were caused by intentional human malevolence. When rescue and recovery efforts extend over weeks and months, family members endure prolonged uncertainty and an ongoing threat of possible future attacks, which contribute to heightened anxiety and a sense of vulnerability. These traumatic realities also impact first responders, media personnel, government officials, and others whose job-related responsibilities bring them in contact with the disaster's tragic impact.

Because disasters caused by mass violence and acts of terrorism are also crimes, law enforcement and the criminal justice system fill primary roles. When the underlying motivation is terrorism, Federal criminal justice agencies are responsible for the investigation and prosecution. The disaster's impact zone becomes a secured crime scene. Crime victims and their families have the legal right to receive information about criminal justice activities, participate in the criminal justice process, and receive protection from intimidation and harassment. They may apply for benefits and compensation for crime-related expenses. This interplay of emergency response, criminal justice, and disaster relief and recovery systems is a defining feature of the response to mass violence and terrorism.

This Field Guide includes essential information about survivors' and family members' reactions and needs, with specific suggestions for assisting children, adolescents, adults, and older adults. It describes basic "helping" skills with indicators for when to refer someone to a licensed mental health professional. The last section presents strategies for worker* stress prevention and management.

This Field Guide draws from material contained in Mental Health Response to Mass Violence and Terrorism: A Training Manual and highlights practical approaches. The Training Manual provides indepth and comprehensive information, and references for additional reading.

*In this Field Guide, the term "worker" refers to service providers and others who assist survivors and families.

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