The Washington PostDemocracy Dies in Darkness

Mass violence takes toll on Americans’ psyches

Repeated shootings in schools, churches and stores erode sense of safety

People attend a vigil for the Robb Elementary School students and teachers May 25 in Uvalde, Tex. (Joshua Lott/The Washington Post)
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When the American Psychological Association surveyed more than 2,000 people about their stress levels just days after back-to-back mass shootings in El Paso and Dayton, Ohio, in 2019, the findings laid out the toll of seemingly ceaseless, random violence.

A third of the respondents said they would no longer go to certain public places for fear of becoming a casualty of a mass shooting. Almost as many said they could not go anywhere without worrying about being shot. Twenty-four percent said they had made changes in their lives due to their fear of a mass shooting.

Sixty-two percent of parents said they lived in fear of their children becoming victims of a mass shooting, and 71 percent said the possibility of mass violence was adding stress to their lives. The poll used on an online survey with non-random methods so the results may not be nationally representative.

The assaults on Americans’ psyches have only intensified since then, with a two-year-plus pandemic that has taken 1 million U.S. lives; street battles in the struggle for racial justice; a war in Ukraine that has renewed fears of a nuclear conflict; a roller-coaster economy; an insurrectionist riot at the U.S. Capitol; visibly worsening effects of climate change and many more mass shootings. Those culminated in the massacre Tuesday of 19 children and two adults in a Uvalde, Tex. elementary school, just 10 days after the slaughter of 10 Black shoppers and workers at a Buffalo supermarket.

Experts say the unrelenting developments are taking a toll on our mental and physical health and how we interact as a society. The targeting of churches and schools has been particularly distressing to many people who have long regarded them as spaces safe from the tumult of the world.

“People are emotionally exhausted,” said Roxane Cohen Silver, a University of California at Irvine psychologist who has studied trauma for decades. “We cannot see any one of these events in isolation. We are seeing a cascade of collective traumas. … I don’t think that many people could have conceived of this degree of loss.”

The impact is felt most deeply by communities already under stress. “It takes a toll on the country as a whole and an even higher toll on people of color, who are largely the victims of these last two incidents,” said the Rev. Ray Hammond, pastor at Bethel AME Church in Boston, who has worked on anti-violence initiatives for decades.

“Even though intellectually you know this is a rare thing, the sense of insecurity is cumulative, and I think for a lot of people extremely unsettling,” he said.

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The notion that people of color feel more vulnerable is supported by the APA survey, which was incorporated into the organization’s annual Stress in America report. Hispanics, Blacks, Asians and Native Americans all reported more stress from mass shootings than Whites.

A Quinnipiac University poll and a Pew Research Center survey, both conducted in 2018 after the mass shooting at Marjory Stoneman Douglas High School in Parkland, Fla., showed the same results, with Blacks and Hispanics more fearful of mass violence than Whites, and younger people more worried than older respondents.

At a vigil for the victims of the shooting at Robb Elementary School in Uvalde, Tex., residents and families gathered to seek comfort in their community. (Video: Alice Li, Jorge Ribas/The Washington Post)

Tuesday’s rampage brought an extra measure of anguish to a nation that saw the faces of children such as 10-year-old Amerie Jo Garza, smiling proudly with her Honor Roll certificate just hours before she was murdered by a gunman with an assault rifle.

The surveys, experts said, affirm their belief that repeated exposure to shocking acts of violence that happen with horrific regularity in this country, alone among its peers, is affecting people’s health.

“It’s clearly having a significant negative impact, and particularly on our mental and our physical health,” said Vaile Wright, senior director for health-care innovation at the APA, who works on the Stress in America surveys that have been conducted each year since 2007.

When acts of mass violence “are repeated in this way, they start to feel more and more overwhelming, and a sense of hopelessness starts to set in,” she said.

Human bodies are not meant to be so frequently in a state of agitation, she said. The result is hyper-vigilance, anxiety and an inability “to be in the moment.” Some people may become desensitized to violence as a defense, she said.

“People feel so overwhelmed by the stress and worry that they have to compartmentalize it to a certain extent,” Wright said.

Joshua Morganstein, a psychiatrist and chair of the American Psychiatric Association’s Committee on Psychiatric Dimensions of Disaster, noted that schools are considered safe places, as are houses of worship — both of which have been attacked in mass shootings in recent years.

It is particularly distressing when these places are struck by violence, he said. And the deaths of children in violent acts adds another layer of horror: “It also challenges our perception and belief about the natural order of life in the world, which is that parents are supposed to precede their children in death, not the other way around,” he said.

Morganstein suggested that people monitor their consumption of news about horrific events such as the Uvalde shooting. It is not being callous to turn off the news, he said — it can be necessary for mental health.

“The media is such an important source of information for us, but we know that exposure to disaster-related media is consistently associated with feelings of anxiety, depression, post-traumatic stress symptoms, trouble sleeping, increased use of alcohol and tobacco,” he said.

Silver, the California psychologist, studied the health consequences of exposure to news about the 9/ 11 attacks and the Iraq War, and found evidence that suggests some people developed new cardiovascular illnesses as a result. She is now studying the psychological and physical health consequences of this “ongoing onslaught” of bad news on our sense of safety.

Previous research on collective trauma shows that some people can develop conditions that include short-term anxiety, depression, post-traumatic stress disorder and other mental health issues.

And those exposed to multiple tragedies tend to have “greater distress, functional impairment and lower life satisfaction,” according to a 2020 commentary Silver published in Nature Human Behavior, based on numerous studies. The bad news is amplified by rapid dissemination on social media and repetition through the 24-hour news cycle.

“We are not only seeing or hearing the news of these tragedies, but we are seeing that in graphic color,” she said.

In addition to reducing news consumption, experts advised focusing on what can be controlled rather than worrying about what might happen, and to put upsetting information into a broader context.

Mass shootings in which four or more people are killed account for fewer than 1 percent of the roughly 20,000 firearm homicides in the United States each year, according to Jillian Peterson, an associate professor of criminology and criminal justice at Hamline University in St. Paul, Minn. Suicides by firearms make up about 60 percent of all gun deaths each year.

“The most dangerous thing you will do today is ride in a car,” said Joel Dvoskin, a clinical assistant professor of psychiatry at the University of Arizona College of Medicine. “And in fact we’ve made that safer.”

But Beverly Kingston, director of the Center for the Study and Prevention of Violence at the University of Colorado, said society is only now beginning to ask “how do we heal collective trauma? How do we acknowledge our society is built on top of layers of trauma?”

“I worry about our collective trauma getting in the way of what we could be doing to create a better society,” she said.