Multiple Vantage Points on the Mental Health Effects of Mass Shootings


The phenomenon of mass shootings has emerged over the past 50 years. A high proportion of rampage shootings have occurred in the United States, and secondarily, in European nations with otherwise low firearm homicide rates; yet, paradoxically, shooting massacres are not prominent in the Latin American nations with the highest firearm homicide rates in the world. A review of the scientific literature from 2010 to early 2014 reveals that, at the individual level, mental health effects include psychological distress and clinically significant elevations in posttraumatic stress, depression, and anxiety symptoms in relation to the degree of physical exposure and social proximity to the shooting incident. Psychological repercussions extend to the surrounding affected community. In the aftermath of the deadliest mass shooting on record, Norway has been in the vanguard of intervention research focusing on rapid delivery of psychological support and services to survivors of the “Oslo Terror.”

Grounded on a detailed review of the clinical literature on the mental health effects of mass shootings, this paper also incorporates wide-ranging co-author expertise to delineate: 1) the patterning of mass shootings within the international context of firearm homicides, 2) the effects of shooting rampages on children and adolescents, 3) the psychological effects for wounded victims and the emergency healthcare personnel who care for them, 4) the disaster behavioral health considerations for preparedness and response, and 5) the media “framing” of mass shooting incidents in relation to the portrayal of mental health themes.

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Conflict of Interest

James M. Shultz, Siri Thoresen, Brian W. Flynn, Glenn W. Muschert, Jon A. Shaw, Zelde Espinel, Joshua B. Gaither, Yanira Garcia-Barcena, Kaitlin O’Keefe, and Alyssa M. Cohen declare that they have no conflict of interest.

Frank G. Walter has financial relationship with and has received paid travel expenses from Heyltex Corp.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to James M. Shultz.

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This article is part of the Topical Collection on Disaster Psychiatry

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Shultz, J.M., Thoresen, S., Flynn, B.W. et al. Multiple Vantage Points on the Mental Health Effects of Mass Shootings. Curr Psychiatry Rep 16, 469 (2014).

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  • Mental health
  • Mental disorders
  • PTSD
  • Stress disorders/post-traumatic
  • Shooting
  • Mass shooting
  • Shooting massacre
  • Rampage shooting
  • Weapons
  • Firearms
  • Guns
  • Gunshot wounds
  • Violence
  • Firearm violence
  • Workplace violence
  • Homicide
  • Gun control
  • Media framing